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Bodies and buildings nyu itp 2 4 13

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Bodies and buildings nyu itp 2 4 13

  1. 1. BODIES &BUILDINGSNYU ITP LECTURE COURSE SPRING 2013CLASS 2: FEBRUARY 4, 2013JEN VAN DER MEER @JENVANDERMEER WWW.JENVANDERMEER.COM
  2. 2. LEVERAGE POINTS Class assignment for 2/4/2013Mandatory! Read ALL OF Donella Meadows: Leverage Points: Places to Intervene in a System Take leverage points 9, 8, 7. Write a 1 page or 500-6000 word essay on the following topic: How do mobile apps try to affect leverage points 9, 8, and 7. 9) The length of delays, relative to the rate of system change8) The strength of negative feedback loops, relative to impacts they are tryingto correct against7) The gain around driving positive feedback loopsGive one example and explain how the app is or is not designed to affect eachof these leverage points. How effective do you think this app will be atchanging behavior? You will be asked to present your work, so practice rehearsing your in classpresentation at least two times. February 4, 2013 2  
  3. 3. PLACES TO INTERVENE IN A SYSTEM: 12. Constants, parameters, numbers (subsidies, taxes, standards)11. The sizes of buffers and other stabilizing stocks, relative to their flows10. The structure of material stocks and flows (transport networks, population age structures)9. Length of delays, relative to the rate of system change8. The strength of negative feedback loops, relative to the impacts they are trying to correct against7. The gain around driving positive feedback loops6. The structure of information flows (who does and does not have access to what kinds of information)5. The rules of the system (such as incentives, punishments, constraints)4. The power to add, change, evolve, or self-organize system structure3. The goals of the system2. The mindset or paradigm out of which the system – its goals, power structure, rules, its culture-arises1. The power to transcend paradigmsFebruary 4, 2013 3  
  4. 4. BODIES IN THE NEWSLabDoor Launches: lets users search for their dietarysupplements and view grades reflecting their clinical efficacyand ingredient safety.New HIPAA rules finalized: When a patient is required by aprovider to request records or documents in writing, the requestmay be made electronically.In a video produced for the release of Bill Gatess 2013 AnnualLetter, Swedish academic Hans Rosling explains why commonnotions of developing vs. developed countries are no longerclear-cut. February 4, 2013 4  
  5. 5. BODIES: THEOBESEITY EPIDEMICBODIES & BUILDINGS 5  
  6. 6. BODIES +We have made huge strides in life expectancy, but we havereached limits of growth. February 4, 2013 6  
  7. 7. NATIONAL OBESITYCRISISFebruary 4, 2013 7  
  8. 8. US OBESITY GROWTH RATEFebruary 4, 2013 8  
  9. 9. OBESITY TRENDSToday’s children may well bethe first generation ofAmericans whose lifeexpectancy will be shorterthan that of their parents. February 4, 2013 9  
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  13. 13. Data from 3,139 counties in the U.S. Quintiles are cohorts of counties ranked by the percentage of people living with poverty. Levine J A Diabetes 2011;60:2667-2668Copyright © 2011 American Diabetes Association, Inc.
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  15. 15. DIGITAL DIVIDE + DIABETESSocial disparities in internetpatient portal use in diabetes:evidence that the digital divideextends beyond access. Urmimala Sarkar, Andrew JKarter, Jennifer Y Liu, et al.J Am Med Inform Assoc 201118: 318-321 originallypublished online January 24,2011. 15  
  16. 16. GLOBAL OBESITYPANDEMIC“GLOBESITY” GLOBAL OBESITY: TRENDS, RISK FACTORS AND POLICYIMPLICATIONS. VASANTI S. MALIK, WALTER C. WILLETT & FRANK B.HU. NATURE REVIEWS ENDOCRINOLOGY 9, 13-27 (JANUARY 2013) 16  February 4, 2013
  17. 17. Figure 1 Global trends in the prevalence of obesity among women and men in 1980 and 2008 from select regions of the world Malik, V. S. et al. (2012) Global obesity: trends, risk factors and policy implications Nat. Rev. Endocrinol. doi:10.1038/nrendo.2012.199
  18. 18. Women18  
  19. 19. Men 19  February 4, 2013
  20. 20. OBESITY + GLOBALIZATION 20  February 4, 2013
  21. 21. THINKING INCIRCLES ABOUTOBESITYAPPLYING SYSTEMS THINKING TO WEIGHT MANAGEMENT. TAREK K. A. HABI 21  February 4, 2013
  22. 22. HOW THE PROBLEM SNEAKED UP ON US As the upward and outward trendin the population’s weight andwaistline accelerated in the late1980s and 1990s, most publichealth experts failed to perceivethe escalating threat. •  Unlike communicable diseases, no immediate symptoms.•  Initially only affected a few people. •  The science establishing links between diet, weight and health were just beginning. 22  February 4, 2013
  23. 23. HOW MANY CAUSESCAN WE COUNT? 23  February 4, 2013
  24. 24. BUCKET THEORY OF MIND•  Minds seen as containers – Karl Popper. •  Public understanding is viewed as a function of how much scientific facts are known. •  How many scientific facts public minds contain. •  Irony: Americans know more about food and nutrition than in any time in their history, but they are gaining more weight. •  “Knowledge (in the bucket) without the requisite decision- making skills will produce little change. 24  February 4, 2013
  25. 25. THE LEVERAGE (OR THE IMPEDIMENT) ISWITH THE PEOPLE •  In the US, most obese individuals attempting to lose weight do so themselves, without seeking professional help. •  Weight has been seen as an individual, personal problem. •  The wellness movement is rooted in the concept of personal control. 25  
  26. 26. WE ASSUME MORE CONTROL THANACTUALLY EXISTS •  Obesity is a complex multi-factorial disease involving genetics, physiology, and biochemistry, as well as environmental, psychosocial, and cultural factors. •  In managing our health – and our bodies – we are decision makers who are managing a truly complex and dynamic system: the human body. •  Living systems do not come with an operator’s manual. It requires skills to see through complexity to the underlying structures generating a complex situation or problematic behavior. 26  
  27. 27. IT’S SO EASYCALORIES IN. CALORIES OUT. 27  February 4, 2013
  28. 28. MORE COMPLEX THAN THAT •  Body’s homeostatic process- adaptive (and defensive) mechanisms that continuously aim to maintain the body’s internal stability. •  Weightloss is not linear, but curvilinear. •  Unrealistic optimism causes us to ignore legitimate risks. •  Failure to learn from failure. Learning has not occurred. 28  February 4, 2013
  29. 29. PHYSIOLOGICAL ASYMMETRY•  Humans are wired to compensate for caloric dilution but not the reverse. •  Asymmetry in energy expenditure- basal metabolism. •  Asymmetry in energy storage- when body fat is shed during weight loss, the size, but not the number, of fat cells dwindles. 29  February 4, 2013
  30. 30. SINGLE LOOP LEARNING Consequences Decisions, Feedback Actions Single loop 30  February 4, 2013
  31. 31. SINGLE LOOP DIETING 31  February 4, 2013
  32. 32. SINGLE LOOP LEARNING •  Often we find ways to move closer to our desired state without changing our mental model. •  Learning to use life’s raw experiences to adjust our entrenched worldviews is hard and, therefore, uncommon. •  Experience, after all, provides only data, the raw ingredients for learning, not knowledge. •  Single loop: we learn to tweak our decisions without altering our mental models or their associated decision rules. •  (A thermostat that sense when it is too hot or cold). 32  February 4, 2013
  33. 33. SINGLE LOOP DIETING 33  February 4, 2013
  34. 34. WHAT IS TO BEDONECHALLENGE INGRAINED ASSUMPTIONS 34  February 4, 2013
  35. 35. DOUBLE LOOP LEARNING Consequences Decisions, Feedback Actions Single loop Decision Rules, Mental Models Strategies Of Real World 35  February 4, 2013
  36. 36. DOUBLE LOOP LEARNING •  Learning that occurs when we use the feedback information to enhance our fundamental understanding of the decision task. •  Learning is discovery of mental maps and decision rules that are better aligned with the decision task at hand. 36  February 4, 2013
  37. 37. SHIFT IN PUBLIC POLICY•  From: stuff buckets with nutritional guidelines/scare into good health •  To: challenge people’s deeply ingrained assumptions. Provide them with the conceptual skills to JUMP. •  From: attention on the separate mechanisms of human weight and energy regulation. •  To: the hole bioenergetics systems as an integrated operating system. 37  February 4, 2013
  38. 38. FRAGMENTIC ANALYSIS LENS•  Nutrition out of the context of lifestyle•  Biology out of the context of behavior•  Behavior out of the context of environment “The performance of any system (whether it is an oil refinery,an economy, or the human body) obviously depends on theperformance of its parts, but a system’s performance is neverequal to the sum of the actions of its parts taken separately. Rather it is a function of their interactions.” 38  February 4, 2013
  39. 39. SHIFT IN CULTURAL UNDESTANDING •  From: solely individual interventions. A sole focus on the obese person and how to help them gain control. •  To: Why is society obese. How can we help society. 39  February 4, 2013
  40. 40. SHIFT HEALTHCARE PRACTICE 40  
  41. 41. NETWORKED MEDICINE 41  
  42. 42. ASSIGNMENT:FEBRUARY 11 42  February 4, 2013
  43. 43. READING Read: Networked Medicine: From m Obesity to the “Diseasome”. Editorialby Albert-László Barabási, Ph.D. NEJM. July 26, 2007. Optional: Deeper Reading: Original Study by Christakis and Fowler:The Spread of Obesity in a Large Social Network over 32 Years. NEJM. July26, 2007. Critique of this study: Lyons. The Spread of Evidence-Poor Medicine via Flawed Social-Network Analysis.Statistics, Politics, and Policy: (2011) Vol. 2 : Iss. 1, Article 2. Last revised 5May 2011Watch:Catherine Kerr on Cortical Measures in Mindfulness Meditation atQuantified Self. Personal account of Weight Watchers by Laura Beck at Jezebel. 43  February 4, 2013
  44. 44. ASSIGMENTWhen developing ideas and concepts for our student projects,and future projects, business ideas, and save-the-world ideas, weoften start by designing for ourselves.For this assignment, research a part of the world at a local level(city, state, province, county) that has a problem with obesity.The only requirement: pick somewhere that you have never been.In a one page essay, describe the social, cultural, technological,economic, and other conditions of this region that may becontributing to a growth in the prevalence of obesity. You maychoose to write a non-fiction account or take this as a creativewriting assignment – imagining a first person day-in-the-lifeaccount of what it feels like to live here. 44  February 4, 2013
  45. 45. LINKS AND PRESENTATION Today’s class presentation is available http://jenvandermeer.com/2013/02/bodies-buildings-class-2-february-4/And Links from this presentation are available here atAnnotary. https://annotary.com/collections/9149/bodies-and-buildings-class-2-nyu-itp 45  February 4, 2013

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