make you healthy?

健康にできるのでしょうか

In 2001 I got hit by a train.

2001年 私は心臓発作という

My train was a heart attack.

列車にはねられました

I found myself in a hospital

気がつくと

in an intensive-care ward,

集中治療病棟にいて

recuperating from emergency surgery.

緊急手術からの回復中でした

And I suddenly realized something:

私には

that I was completely in the dark.

何がなんだかわかりませんでした

I started asking my questions, "Well, why me?"

自分に問いました　"なんで私が?"

"Why now?" "Why here?"

"なぜ今?"　"なぜここなのか?"

"Could my doctor have warned me?"

"医者は警告できなかったのか?"

So, what I want to do here in the few minutes I have with you

今日は｢健康な人生の秘訣｣について

is really talk about what is the formula for life and good health.

お話ししたいと思います

Genetics, lifestyle and environment.

遺伝 生活習慣 環境

That's going to sort of contain our risks,

これらが持つリスクに

and if we manage those risks

うまく対処できれば

we're going to live a good life and a good healthy life.

健康的で素敵な人生を過ごせるでしょう

Well, I understand the genetics and lifestyle part.

遺伝や生活習慣というのは良く分かります

And you know why I understand that?

なぜかというと

Because my physicians constantly

医者はいつもこればかり

ask me questions about this.

聞いてくるからです

Have you ever had to fill out those long,

病院であの長い記入用紙に

legal-size forms in your doctor's office?

記入しなければいけなかったことはありませんか?

I mean, if you're lucky enough you get to do it more than once, right?

運が良ければ そんな機会に度々恵まれますね

(Laughter)

(笑い声)

Do it over and over again. And they ask you questions

その度に同じことを何度も...

about your lifestyle and your family history,

そして あなたの生活習慣 家族の病気歴

your medication history, your surgical history,

処方歴 手術歴 アレルギー歴などについて

your allergy history ... did I forget any history?

質問してきます

But this part of the equation I didn't really get,

しかし 環境ということに関しては

and I don't think my physicians

私も医者も

really get this part of the equation.

よく理解できていないと思います

What does that mean, my environment?

環境とはどういう意味でしょう?

Well, it can mean a lot of things.

いろんな捉え方がありそうです

This is my life. These are my life places.

これは私の人生で これらは生活空間です

We all have these.

みなさんも同じですね

While I'm talking I'd like you to also be thinking about:

今まで何か所くらい異なる場所で

How many places have you lived?

生活をしたことがありますか?

Just think about that, you know, wander through

考えてみてください

your life thinking about this.

振り返ると意外に多くの場所で

And you realize that you spend it in a variety of different places.

時間を過ごしているのがわかります

You spend it at rest and you spend it at work.

仕事でも それ以外でもね

And if you're like me, you're in an airplane a good portion of your time

私のような人なら かなりの時間を

traveling some place.

移動の飛行機の中で過ごしているでしょう

So, it's not really simple

そう　生活や仕事の場を

when somebody asks you, "Where do you live, where do you work,

尋ねる質問は

and where do you spend all your time?

意外と複雑なんです

And where do you expose yourselves to risks

そして何処で目に見えないリスクに

that maybe perhaps you don't even see?"

身をさらしているのでしょうか

Well, when I have done this on myself,

私の場合

I always come to the conclusion

人生の約75パーセントを

that I spend about 75 percent of my time

ある一定の場所で過ごし

relatively in a small number of places.

ほどんどの時間を

And I don't wander far from that place

そこから離れずに生活している―

for a majority of my time,

という結果になります

even though I'm an extensive global trekker.

これでも私は世界中を回る旅人なんですけどね

Now, I'm going to take you on a little journey here.

こちらをご覧ください

I started off in Scranton, Pennsylvania.

ペンシルバニア州 スクラントンから始まりました

I don't know if anybody might hail from northeastern Pennsylvania,

ここに同郷の人がいるかわかりませんが

but this is where I spent my first 19 years

ここで私の若い肺は

with my little young lungs.

19年間を過ごしました

You know, breathing high concentrations here

高濃度の二酸化硫黄

of sulfur dioxide, carbon dioxide

二酸化炭素やメタンガスを

and methane gas,

不特定量 吸い続けました

in unequal quantities -- 19 years of this.

19年の間ずっとです

And if you've been in that part of the country,

ここに行ったことがあれば ご存知でしょうが

this is what those piles of burning, smoldering coal waste look like.

これは燃えくすぶる石炭廃棄物の山の様子なのです

So then I decided to leave that part of the world,

私はこの地域を去り

and I was going to go to the mid-west.

中西部に移動し

OK, so I ended up in Louisville, Kentucky.

ケンタッキー州 ルイビルに住むことになり

Well, I decided to be neighbors to a place called Rubbertown.

ラバータウンという地域の近くに落ち着きました

They manufacture plastics. They use large quantities chloroprene

そこはプラスチックを生産していて

and benzene.

大量のクロロプレンやベンゼンを使用します

Okay, I spent 25 years, in my middle-age lungs now,

ここでは25年間 中年期の肺で過ごし

breathing various concentrations of that.

それらの化学物質が濃縮された空気を吸っていました

And on a clear day it always looked like this, so you never saw it.

晴れた日はいつもこんな感じで 目には見えませんが

It was insidious and it was really happening.

少しずつ しかし確実に蝕まれていたのです

Then I decided I had to get really smart,

そして極めつけに

I would take this job in the West Coast.

西海岸での仕事を選び

And I moved to Redlands California.

カルフォルニア州 レッドランズに越しました

Very nice, and there

いい感じです

my older, senior lungs, as I like to call them,

そこでは私の年老いた肺を

I filled with particulate matter, carbon dioxide and very high doses of ozone.

粒子状物質 二酸化炭素 高濃度のオゾンで満たしたのです

Okay? Almost like the highest in the nation.

国で最も高濃度のオゾンです

Alright, this is what it looks like on a good day.

天気が良くても この眺めです

If you've been there, you know what I'm talking about.

ここにいた人ならわかりますよね?

So, what's wrong with this picture?

コレのどこが問題なんでしょう?

Well, the picture is, there is a huge gap here.

実は大きく欠落しているモノがあります

The one thing that never happens in my doctor's office:

ソレは病院では起こることのないことです

They never ask me about my place history.

"どこで暮らしたことがあるか?"

No doctor, can I remember, ever asking me,

と尋ねてきた医者は

"Where have you lived?"

誰ひとりいません

They haven't asked me what kind of the quality

どのような質の水

of the drinking water that I put in my mouth

食べ物などを摂取していたか

or the food that I ingest into my stomach.

そういうことは全くと言っていいほど

They really don't do that. It's missing.

聞いてきません

Look at the kind of data that's available.

このデータを見てください

This data's from all over the world --

これは世界中から集められたもので

countries spend billions of dollars investing in this kind of research.

多くの国が このような研究に何十億ドルも投資しています

Now, I've circled the places where I've been.

私が住んだ所にマルをつけてみました

Well, by design, if I wanted to have a heart attack

どうやら私がいた所は

I'd been in the right places. Right?

心臓発作の要因には もってこいの場所だったようです

So, how many people are in the white?

白のスペースで

How many people in the room have spent the majority of their life

人生の大部分を

in the white space?

過ごした人はどれくらいいます?

Anybody? Boy you're lucky.

ラッキーですね

How many have spent it in the red places?

赤のスペースにいた人は?

Oh, not so lucky.

うーん よくないですね

There are thousands of these kinds of maps

世界中にある地図帳には

that are displayed in atlases

このようなマップが

all over the world.

いくつも記載されています

They give us some sense of what's going

これらは病気の要因への

to be our train wreck.

ヒントを与えてくれます

But none of that's in my medical record.

しかし私たちのカルテには

And it's not in yours either.

一切こういったものがないのです

So, here's my friend Paul.

同僚のポールは

He's a colleague. He allowed his cell phone to be tracked

この2年間 彼の携帯電話を年中

every two hours, 24/7,

２時間ごとに追跡させ

365 days out of the year

彼が訪れた場所を

for the last two years, everywhere he went.

全て記録させたのです

And you can see he's been to a few places around the United States.

彼が国内の数か所に行ったことがわかりますね

And this is where he has spent most of his time.

これは彼が最も時間を過ごしたところです

If you really studied that you might have some clues

よく見ると ポールの趣味はなにか?

as to what Paul likes to do.

というヒントが隠れています

Anybody got any clues? Ski. Right.

わかりますか?　そう! スキーです!

We can zoom in here, and we suddenly see

さらに拡大すると

that now we see where Paul has really spent a majority of his time.

彼が過ごした場所の詳細がわかります

And all of those black dots are all of the

この黒の点は　米国環境保護庁によって

toxic release inventories

確認された

that are monitored by the EPA.

有害物質の排出場所を意味します

Did you know that data existed?

こういうデータがあること ご存じでしたか?

For every community in the United States,

合衆国では どのコミュニティーでも

you could have your own personalized map of that.

この個人用マップを作ることができるのです

So, our cell phones can now build a place history.

これで所在地歴は携帯電話で作れます

This is how Paul did it. He did it with his iPhone.

ポールが彼のアイフォーンでやったようにね

This might be what we end up with.

診察室に入ると

This is what the physician would have

このマップを持った医者が

in front of him and her when we enter that exam room

イスに座って待っている

instead of just the pink slip that said I paid at the counter. Right?

こういった風になるのではないでしょうか？

This could be my little assessment.

そして医者は

And he looks at that and he says,

それを見て こう言うでしょう

"Whoa Bill,

"ビルさん！

I suggest that maybe you not decide,

いつも暖かくこの美しい

just because you're out here in beautiful California,

カルフォルニアにいるからって

and it's warm every day,

午後6時に

that you get out and run at six o'clock at night.

ジョギングをするのは

I'd suggest that that's a bad idea Bill,

このレポートの結果上

because of this report."

お勧めできませんね "

What I'd like to leave you for are two prescriptions.

みなさんには２つの課題を託したいと思います

Okay, number one is, we must teach physicians

ひとつ目は 私たちの医者に

about the value of geographical information.

地理情報の大切さを教えることです

It's called geomedicine. There are about a half a dozen programs in the world right now

それは地理医学と呼ばれ 世界中で複数の計画が

that are focused on this.

現在取り組まれています

And they're in the early stages of development.

まだ発展初期段階にあり

These programs need to be supported,

サポートを必要としています

and we need to teach our future

そして今日みなさんに

doctors of the world

お話しした内容の大切さを

the importance of some of the information

未来の医者たちに

I've shared here with you today.

教えなければいけません

The second thing we need to do

ふたつ目には

is while we're spending billions and billions

何十億ドルもの資金を

of dollars all over the world

電子カルテの作成に費やすと同時に

building an electronic health record,

この所在地歴を

we make sure we put a place history

カルテの中に

inside that medical record.

確実に入れることです

It not only will be important for the physician;

これは医者だけでなく

it will be important for the researchers

研究者にも

that now will have huge samples to draw upon.

重要なことで 私たちにとっても

But it will also be useful for us.

役に立つことなのです

I could have made the decision, if I had this information,

もしこのことを知っていたら

not to move to the ozone capital

アメリカのオゾン首都には

of the United States, couldn't I? I could make that decision.

引っ越さなかったかもしれませんし

Or I could negotiate with my employer

上司と移動についての―

to make that decision

交渉も

in the best interest of myself and my company.

可能になるかもしれません　会社と私自身のためにもね

With that, I would like to just say that Jack Lord said

ジャック ロードは

this almost 10 years ago.

"地理は医療の鍵である"

Just look at that for a minute.

そう言いました

That was what the conclusion

これは

of the Dartmouth Atlas of Healthcare was about,

ダートマス アトラスの結論で

was saying that we can explain the geographic variations

地理の変動は

that occur in disease, in illness, in wellness,

病気や健康状態 健康管理システムに

and how our healthcare system actually operates.

大きく影響するということを

That was what he was talking about

あの言葉の中で

on that quote.

言っていたのです

And I would say he got it right almost a decade ago.

彼は10年も前から分かっていたのです

So, I'd very much like to see us begin to

私は この地理情報が

really seize this as an opportunity to get this into our medical records.

私たちのカルテに入るチャンスをつかんで欲しいのです

So with that, I'll leave you that

この私なりの見解を

in my particular view of view of health:

みなさんに託したいと思います

Geography always matters.

地理情報はとても重要で

And I believe that geographic information

私たちをより健康にできる

can make both you and me very healthy. Thank you.

そう信じています　ありがとう

(Applause)

(拍手)