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Cambridge Festival of Ideas spotlights health

Should we have freedom or more state control over our diets? Cancer screening saves lives, but does it cause more harm than good? Is marriage the answer to our health issues?  

These are some of the questions being asked during the 2018 Cambridge Festival of Ideas, which runs from 15th to 28th October and features over 200 events focussed on the most topical issues facing us as a society. This year, the Festival’s theme is ‘extremes’.

Following the report from Pubic Health England this week, which revealed growing rates of obesity as one of the leading risk factors for ill health, an event on 23rd October investigates whether we or the state should have more control over our diets.

Across the world our diets are often poor – damaging our health and putting pressure on collective resources such as healthcare, with the poorest in society often hit hardest.

Do public health policies that aim to address this restrict our individual liberty to make our own choices? Or does the state have a duty to protect us from profiteering corporations and our own worst instincts? Are there universal answers to these questions, or are they different for different groups and individuals in a society?

Public health and policy experts form part of the lively panel discussion, Improving our diets: more freedom or more control? which explores these questions and the practical and philosophical challenges they raise.

Panellists include Dr Jean Adams, Centre for Diet and Activity Research; Dr Thomas Burgoine, Centre for Diet and Activity Research; Professor Mike Kelly, Department of Public Health and Primary Care and former Director of the Centre for Public Health at the National Institute of Health and Care Excellence (NICE); and Professor Jaideep Prabhu, Judge Business School.

Speaking ahead of the event, Dr Jean Adams said: “The debate about what people put on their plates can become very polarised – the free individual versus the controlling nanny state. But the reality is much more complex. Where we live, our background, and our financial or social resources will all influence how free we are to make certain choices. And for those setting policy, it can be a fine balancing act between respecting this freedom of choice and needing to act on pressing challenges facing society and the economy. We also need to know what is and isn’t likely to work to improve diets, which often isn’t a straightforward question.”

Cancer screening comes under scrutiny during the CRUK Cambridge Centre Early Detection Programme event Cancer overdiagnosis: what is it? on 26th October. Speakers include Dr Stephen John, Hatton Lecturer in the Philosophy of Public Health and Dr Maryon McDonald, Fellow in Social Anthropology at Robinson College, Cambridge, who discuss some of the issues around cancer screening and diagnosis.

Commenting on the intensely personal and politically complicated and controversial issues around overdiagnosis, Dr John said: “Because early-stage cancers are far easier to treat than late-stage cancers, there are excellent reasons to try to detect cancerous growths as soon as possible. Unfortunately, there is also a problem: the earlier we diagnose a growth, the less certain we can be that the growth will go on to cause illness or death. We risk ‘overdiagnosing’ and therefore ‘overtreating’ patients.

“This gives rise to a series of problems: how should we balance the harms of overtreating some against the benefits of helping others? Answering this is difficult because we may never know who was helped and who was harmed by our intervention: once we have removed a cancerous growth, there is no way of knowing whether, if left untreated, it would have caused symptoms. ‘Cancer survivors’ who celebrate the fact that their lives were saved by screening might, in fact, never have needed treatment in the first place. This fact raises tricky questions about how to apply everyday moral frameworks to early detection; does the core principle of medical ethics, ‘first, do no harm’, make sense when no-one will ever know that they were harmed?

“At the same, screening and early detection decisions are not only about statistics, but they affect individuals. Some writers claim that constant screening and testing can cause new illnesses; more generally, screening changes our self-identity by telling apparently healthy people that they are, in fact, ill. In screening, then, we not only cure, but create ill people.”

On 17th October, two historians, a psychologist, a scientist and a relationship counsellor come together to debate and ask: Does marriage make us healthier? 17 October.

Spouses promise to care for one another in sickness and in health, but research suggests that these vows might determine the quality and length of your life. Recent scientific studies show that couples mutually influence each other’s mental and physical health trajectories. Being married has been linked to a lower incidence of disease and higher rate of recovery. Pooled data from University College London reveals that lifelong singletons are 42% more likely to develop dementia than their married counterparts. Having a spouse can improve social connectedness, lower inflammation, promote early detection of certain diseases and facilitate the adoption of healthy behaviours. But it is not all good news. If your spouse suffers from poor health – mental or physical – this can directly impact on your own. Marital discord can similarly cause or worsen certain health conditions. A 2014 study showed that those in troubled marriages were 25 times more likely to be depressed than those in ‘happy’ marriages. The quality of marriage, one study suggested, could have the same impact on wellbeing and life-expectancy as diet or exercise.

The speakers for this event are historians Dr Mary Harlow, University of Leicester and Dr Boyd Brogan, University of York; social psychologist Dr Lisa Marie Warner, Medical School Berlin; clinical training fellow in psychiatry Dr Andrew Sommerlad, University College London; senior Relate practice consultant Dr Rachel Davies.

Further events related to health include:

  • Dance in hospital, 15 October. A discussion about the health impacts of dance. For the past two years, Cambridge University Hospitals has run the UK’s first hospital dance programme, bringing professional dancers to regular sessions on wards. Researchers, dancers and nurses discuss the impact of these sessions and the evidence for dance improving patient care.

  • Under the skin: exhibition, 15 – 28 October. Photographer Richard Fraser looks under the skin of the NHS at Addenbrooke’s, seeking out hidden corners, unseen aspects of care and what makes the hospital work even under unprecedented pressure.

  • Care: from periphery to centre, 15 – 28 October. Site-specific installation by renowned artist Elena Cologni. The project highlights Maud Cloudesley Brereton and Leah Manning as figures of international importance, representing Homerton College’s historic concern with health and wellbeing.

  • Under the skin: artist’s talk, 15 October. Seeing a hospital as an abstract space, can we understand better the challenges facing the NHS? Architectural photographer Richard Fraser and Addenbrooke’s Head of Arts, Damian Hebron, discuss healthcare through the photographer’s lens.

  • Do we have the right to exterminate (all) parasites? 20 October. Interactive debate that explores our relationship with parasites and discusses their right to live.

  • Care: historical and contemporary perspectives, 21 October. Historians, art curators and medical researchers compare concerns over care, health and wellbeing, and reflect on how ideas, practices and spaces of care have moved from peripheral to central roles in society.