At the end of the 19th century, there was a revolution in human health. Diarrhea in infants, the smallest wound, pneumonia, all sorts of diseases, surgery and child birth were all potential killers. In 1900, the life expectancy for white women was 50. If you were a working class woman and had a baby in a hospital you would be lucky to go home alive. No one drunk water.

The issue? Infection. The revolution? The discovery by Louis Pasteur that the origin of infection were germs. The war against germs has been at one level a huge success. Western life expectancy has almost doubled. But it has come with a price. We now see disease as a largely mechanical issue. Cause and effect. Smart doctor prescribes pill and we are cured. But the “diseases” that we mainly suffer from today do not respond well to this simple cause and effect idea. Obesity. Diabetes. Anti Social Behavior or ADD or ADHD. Depression. Heart Disease. Cancer. We tend to think of them as lifestyle diseases.

There are pills and treatments that work to suppress their symptoms but they are not cures and nor do they prevent the problem. Worse they often have powerful and bad side effects and are very expensive. People also stop using them. 90% of people diagnosed with dangerous heart disease stop taking their pills within a year.

I think that we can establish that they are in fact “Social”. They have a root cause that is Social and they can only be “Cured” socially.

I think that Social Software may play the kind of role here in both prevention and cure that germ theory played in disease.

Let’s look at the work of a new Pasteur, Dr Michael Marmot, to get a look at how powerfully social status affects our health

This slide is taken from the Whitehall Study where Dr Marmot looked at health outcomes in the British Civil Service over 25 years. On the left are the most senior folks. On the right the least. All have been well educated and none are poor. But look – the folks at the bottom of the pile with the least amount of control in their lives, are 4 times more likely to die of heart disease than the top people. We used to think it was the A types who would drop dead of a heart attack but it is the opposite.

Also look at the weighting of risk. We hear all the time from our doctors about our cholesterol levels – our blood pressure – smoking etc. But in the folks with the most risk, these are modest factors. The big factor in “Unexplained”.

What is the “Unexplained”? It is the risk from stress. What stress? From Cortisol’s corrosive effect on every aspect of the immune system and our health. At the bottom of the social pile you tend to have demands put upon you and no way of speaking out or of controlling your world. You are the Baboon at the bottom of the social hierarchy. You are the hen who gets pecked. With no outlet for your social stress, you are damaged by the hormone Cortisol that we produce in the flight or fear response to danger. What does this do to you?

• It acts as a physiological antagonist to insulin by promoting glycogenolysis (breakdown of glycogen), breakdown of lipids (lipolysis), and proteins, and mobilization of extrahepatic amino acids and ketone bodies. This leads to increased circulating glucose concentrations (in the blood). There is a decreased glycogen formation in the liver . ^[2] Prolonged cortisol secretion causes hyperglycemia.

• It can weaken the activity of the immune system . Cortisol prevents proliferation of T-cells by rendering the interleukin-2 producer T-cells unresponsive to interleukin-1 (IL-1), and unable to produce the T-cell growth factor.^[3] It reflects leukocyte redistribution to lymph nodes, bone marrow, and skin. Acute administration of corticosterone (the endogenous Type I and Type II receptor agonist), or RU28362 (a specific Type II receptor agonist), to adrenalectomized animals induced changes in leukocyte distribution.

• It lowers bone formation thus favoring development of osteoporosis in the long term. Cortisol moves potassium into cells in exchange for an equal number of sodium ions.^[4] This can cause a major problem with the hyperkalemia of metabolic shock from surgery.

• It helps to create memories when exposure is short-term; this is the proposed mechanism for storage of flash bulb memories. However, long-term exposure to cortisol results in damage to cells in the hippocampus. This damage results in impaired learning.

• It increases blood pressure by increasing the sensitivity of the vasculature to epinephrine and norepinephrine. In the absence of cortisol, widespread vasodilation occurs.

• It inhibits the secretion of corticotropin-releasing hormone (CRH), resulting in feedback inhibition of ACTH secretion. Some researchers believe that this normal feedback system may break down when animals are exposed to chronic stress.

• It increases the effectiveness of catecholamines.

If your social situation causes you to feel out of control then you are swimming in cortisol. Look at how the damage links to most of the problems of our modern life.

It is the same in families. If your family social unit creates a lot of social stress – if parents are abusive, unsafely permissive, themselves out of control, then the baby is also swimming in cortisol and has a very poor prognosis.

So what is the cure? A reduction of stress and a rewiring of how we react to events. For we get patterned to see danger and stress. If our dad used to shout at us at home, so when our boss presses, we flash back and become frightened little boys again.

How do we reduce stress and rewire our habits?

We have to have a safe place to find a voice and to find social acceptance.

I am fat now. A lifetime of sloth has created a habit and a fear. How can I change the habits of a lifetime? Well I am using a client. UFIT – this is a social way to find health. The results have been incredible – not just in weight lost but in how people have found their spirit and confidence. They discover how take control of their lives and their ingrained habits.

Imagine if your daughter has just been diagnosed with Type 1 diabetes. Sure you have been listening to the doctor and the nurse about what to do – but really you are scared and you need help and you need support. This type of site is popping up all over. Parents are taking back control.

You are depressed. It is a terrible secret that you dare not share. You and your family suffer in silence. Butwe are finding that even depression can be alleviated if the depressed get together. Here is my niece’s Facebook Group.

You work for a maniac. But Social Software will enter the work place. As it does, it will give the lowly a voice. The social gradient will level and health will improve for many.

You are bored silly at school. Social Software will enter our education system. The social gradient will also level here too.

Our diseases are a product of our society. As man urbanized, infection became the issue. As we industrialized, social atomization became the issue. Natural growing immunity, public health and alopathic medicine made urban living feasible. Social Software and the understanding of the immune system will help us go the next step.