Bridging the Health Gap: Inclusivity and Lifestyle Medicine with Dr. Dexter Shurney

This paradox , as I view it , is the trust , interaction and communication gap that exists between fitness professionals and our medical community . This podcast is all about closing off that gap by disseminating the latest , most evidence-based and most engaging information in the health sciences .

And to do that , in episode 129 , we're joined by Dr Dexter Schurney and , as you'll hear in this conversation , dr Schurney has had a very , very wide variety of responsibilities during his career general surgery to lifestyle medicine , to being chief medical officer for a health insurance organization , to being the president of the American College of Lifestyle Medicine ,

and then currently he's in the role at the Blue Zones Wellbeing Institute that we'll get into in our conversation .

This discussion starts with , I think , the very important conversation around diversity , equity and inclusion in the fitness and wellness space , and then we drill down a little bit more tactically on what that means for the frontline exercise professional , and then I also took the opportunity in this episode to find out a little bit more about what Blue Zones can do

in terms of providing us insight as exercise professionals , so I think you'll find that part of the conversation fascinating . Dr Sherney is a wealth of knowledge with tremendous experience , and I think you'll really enjoy this insightful discussion , primarily focused around DEI , but also more broadly on how we just get more people moving .

Any information we'd like to share with you from today's episode can be found on the show notes page , that's by going to wellnessparadoxpodcom . Forward slash episode 129 . Please enjoy this conversation with Dr Dexter Schurney Today . We're delighted to be joined by Dr Dexter .

As I said , before we got in the air , so many people have told me that we should connect over time and have to give a shout out to our mutual friend , vicki Shepard , who is the master connector , and at this point I feel like she'd be on the payroll of my podcast , but she's sent me so many amazing guests .

But so you know , thank you again , vicki , and I'm really excited about this discussion because we're going to get into diversity , equity and inclusion , which I think is such an important topic for exercise professionals to consider . And , dr Schoenig , I know you have a wealth of knowledge in that area , as well as many other areas .

So , before we jump into that conversation , why don't you give our audience a little bit more of an idea of your background to provide some context ?

I was originally trained in general surgery and then I quickly made the pivot after a few years into preventive medicine and also lifestyle medicine because I started to work for corporations .

My first corporate job was at Blue Cross , blue Shield of Michigan so not far from where you are , and I was there for many years and before I left I was actually the chief medical officer for Blue Cross , blue Shield of Michigan .

So I have a lot of from that experience and others , insight into employee benefits and working with population health and can't make my change from general surgery to lifestyle and preventive medicine . I'm also the past president of the American College of Lifestyle Medicine and that really occurred after some of the research I did .

After I left the Blues I went to Vanderbilt University and I ran employee benefits , health care benefits and I also was faculty in the medical school and did research along the lines of lifestyle medicine , food as medicine , and so that really kind of catapulted my career into visibility for things such as ACLM , the American College of Lifestyle Medicine .

More recently I've been the chief health equity officer for Adventist Health . You mentioned DEI , so I was the Chief Health Equity , diversity and Inclusion Officer for that 24 hospital system West Coast , california , oregon , washington and Hawaii .

And also I'm the current president of the Blue Zones Wellbeing Institute and Blue Zones we can talk a little bit about that but just places where people live to be quite old routinely without a lot of health issues , both mental health and physical health . So glad to be a part of this conversation and happy for you to take it wherever you want to take it .

But I really do want to focus on the DEI conversation because I think broadly in the exercise profession , and maybe even more broadly the fitness industry , we've not very much been very DEI focused . We tend to not be the most broadly inclusive industry in the world .

I often say that if you Google exercise stock photos , you'll find photos that are disproportionately young , disproportionately fit and disproportionately white , and so I think you kind of don't have to look much further than the natural imagery that's out there to get a sense of the diversity and inclusion in a field .

So I think , starting from a really , really high level here from your perspective , why is DEI such an important topic to consider in the wellness realm ?

And so I mean it's a greater population in terms of purchasing power and just where people are showing up and how we make decisions regarding segments of markets , and so I think we do need to understand it for that . The other thing is that we're all connected .

I mean , if some of us are doing really well and others are not doing so well , that's not good for the country , it's not good for society . So I think we need to understand that we are connected and so we can find ways to benefit one group that may be disadvantaged . It helps us all .

So I'm curious , leaning on your experience in health care , I mean it's not lost on me the challenge of probably what you face in your role as a health care executive , focusing on DEI and such a broad type of a business . I mean you mentioned different states , different regions . I mean there's just so much diversity that exists between those places you were .

If you were to maybe distill some of the important pillars of DEI , or maybe some of the important principles to start to educate our audience on this , I think that would be a really helpful starting point , because I don't know if exercise professionals are really even well acclimated yet with some of the fundamental principles of DEI .

So how would you get people to think about that ?

But , you know , oftentimes we say that , but we don't really listen to find out truly where they are . But you know , oftentimes we say that but we don't really listen to find out truly where they are . We just kind of go in there and say , oh , you know , you look a certain way or you live in a certain place and so therefore , that's where you're at .

Well , not necessarily . Yeah , and so we're all different , we're all individuals . You know , sometimes I talk about , you know , I try to be a little provocative sometimes in conversations and I'll say what do Barack Obama , kamala Harris and Tiger Woods have in common ? And a lot of times people say , well , they're all black .

They're all black , you know celebrities and that's true , but if you think about it , they're all Black , but they're not all Black from the same roots .

Yeah , you know , barack's parents were white and African , kamala was Indian , from India and Black , and Tiger , asian and Black , and so even though we kind of look at them and we want to put them in a box , they are very different .

You know , imagine somebody that has Asian roots versus somebody that has African roots in their background and how they might perceive the world . So it just gets to my point that we really have to be intentional about listening to people and really truly finding out who they are and where they're coming from , and not just making assumptions .

And it is a challenge , you know , certainly , but it's something that I think we all can be better aware of and work on it .

But I think sometimes when we look at people that come into our space and and we look at them and we say you know how come you're overweight , you know how come you don't eat better , how come you don't do this , and there's this tendency to blame the victim , you know , or blame the person , and not really understanding what's really going on with that person .

I mean , I think most people want to be healthy if they're given a choice . And I was talking to one of my physician colleagues , david Bowman , who's out of Washington DC and also on the board for ACLM , and he was saying we shouldn't be asking the question what's wrong with you ? We should be asking the question what happened to you ?

You know , and that just kind of flips it a little bit , because you know some of these individuals , they live in situations where it's impossible or very difficult for them to exercise in the way it is for others , right , and we try to say well , you know , just do this or just do that .

And it's not so simple for some of these individuals , not just because of where they live , but because of family obligations , work obligations , you know , things can be very different and make it difficult .

And when individuals have to face those kinds of challenges day in and day out , there's also a tendency , depending on the individual , to kind of lose hope , you know . And then if you lose hope , it then becomes more difficult to change your behaviors , because it's like , what does it matter ?

You know , nothing's going to really improve for me anyway , who cares if I die a few years early , I'm going to at least enjoy eating these donuts and watching the tubes , you know , for the little bit of life I have . You know , don't take that away from me . So , you know , I think you really have to kind of get into the person's head a little more .

But you know that's a challenge , but it can also be very rewarding , because when you do it right you can see massive improvements in these individuals , and even more so than in other folks who are , you know , probably doing more things right anyway . So there's less gap to fill , so to speak .

And I think you know my perspective is that , and don't get me wrong , we all have a degree of personal responsibility over our health . But I think that narrative has really been spun up by people who are in quite privileged positions around . You know their health . Like you know , I'm in Ann Arbor , michigan .

I can walk out my door I mean , you're from Michigan , you know I can go on a walk through a beautiful community here not to worry about my safety . I can do it now , or I could do it at 10 o'clock tonight because there's streetlights . It's just not that simple .

So this kind of almost gets into the discussion on , you know , the social determinants of health , which maybe I want to go there in a second . But I'm just I'm curious to kind of hear your thoughts on kind of the whole personal responsibility narrative .

But even if you're of a certain race , it may not be safe to use those parks . If you think about what has happened to some folks in the news the obray that was jogging in a nice neighborhood and he was gunned down . So a nice neighborhood , you can still get gunned down because people were like you must be running away from a crime .

I mean , because who are you , why are you in this neighborhood ? So there can be danger even in places where you say , well , this guy shouldn't have any issue walking outside and getting exercise . But it could not be the case every time it could not be the case every time .

As many of you know , the wellness paradox is all about closing off the trust , interaction and communication gap between fitness professionals and the medical community , and no organization does that better than the Medical Fitness Association . They are the professional member association for the medical fitness industry .

This is the industry that integrates directly with healthcare in many facilities throughout the entire country . The MFA is your go-to source for all things medical fitness . They provide newsletters , webinars . They even have standards and guidelines for medical fitness facilities .

They do events around the entire country and , most importantly , they are one of the more engaging networks in the entire fitness industry . I personally have benefited from the network that I've developed through the Medical Fitness Association , and I highly recommend that all of you that are interested in solving the wellness paradox engage with the MFA .

To find out more about the Medical Fitness Association , you can go to their website , medicalfitnessorg . That's medicalfitnessorg . Now back to today's episode . Yeah , the context does matter , so kind of staying on that . I mentioned this earlier and I guess this is kind of where the conversation is a little bit organically leading on this .

Maybe touch on the you know , your perspective and the social determinants of health , particularly coming from like the lifestyle medicine space , because that's a very interesting space to come from while addressing the social determinants of health . So kind of pull on that thread a little bit for me .

And over time they saw that the black students were dying three times earlier . Premature mortality was three times higher among the blacks than the whites . And the reason this is important for social determinants is because if you think about that class and if you think about social determinants , everyone wants to point to . Well , you know what ?

If people are educated , if people have good jobs , people have the right network , they live in the right communities , they have access to healthcare and healthcare insurance , then all the inequities would go away .

And indeed the research will show you that as you close the social economic gap , that you do close the health equity gap , but you don't get rid of it completely .

And the reason we're looking there's more and more research , and actually out of Ann Arbor University of Michigan , geronimus talks about weathering , and weathering are these microaggressions that cause chronic inflammation and that chronic inflammation over time breaks down the body .

So the microaggressions would be something like you know , running in a great neighborhood but worried about you know , am I going to maybe get shot or you get pulled over by the police , and not just being stressed out about getting a ticket , but am I going to make it home , right , excuse me ?

So these microaggressions over time add up and they affect our health , and so people are saying , you know , like the class of 1970 , maybe this is contributing to this . Now , where am I going with this ? Social determinants of health are important .

They're not the complete answer , and what we need to do is we need to find we're not going to change society , at least not probably in my lifetime . I wish it were different . It's probably not , but there are things we can do , and one of the things we can do is really improve lifestyle to the degree that we can .

There was some good research that came out of the degree that we can . There was some good research that came out of Pittsburgh in 2019 .

It was led by a good friend of mine , dr Michael Parkinson , sponsored by the Ardmore Institute of Health , and they brought together all of these researchers in lifestyle medicine over a three-day period and they concluded that inflammation was really the nidus for a lot of these chronic conditions that we suffer from that also are contributing to health inequities .

They also concluded that lifestyle , including exercise , for our listeners today can actually reduce the impact of that chronic inflammation . It can actually reduce it impact of that chronic inflammation . It can actually reduce it and counteract , counterbalance the negative impact of that . So that's the good news and I want your listeners to know that .

Yeah , health social determinants are important . They're part of the equation . But what they're doing every day out there getting people to move , more blue zones , we encourage people to move naturally , and so those things can counteract this chronic inflammation that also contributes to the health inequities .

I don't know if she used that exact term , but it was just fascinating the impact of that and that's something that was never on my consciousness before . She provided that information there and I just think it's such a fascinating physiological phenomenon that obviously has knock-on effects as you go through life . It does .

But I do want to kind of circle around to something you said earlier , because the inequities that exist in our world we're certainly not going to solve on this podcast , nor are we probably going to solve in your lifetime or maybe mine , although we can hope . Are we probably going to solve in your lifetime , or maybe mine , although we can hope .

But I think sometimes these things seem so big and so unwieldy that you almost just want to just kind of throw your hands up and say what do I do about it ? You know , it's kind of just that level of frustration For our audience the frontline exercise professionals that are in the trenches .

They're working with people of varying ethnicities , races , socioeconomic backgrounds . I mean there's a diversity of people we work with . What would be the things that you could tell them about what we just talked about , to not be frustrated and actually think they can do something to make a little bit of a dent in the universe on something like this ?

Do wherever you can , and then you know , one of the things that we do you know I'm associated with the Blue Zones is that to the extent that we can change these environments , we can make a tremendous difference . You know , the Blue Zones people aren't really thinking about when do I go to the gym , you know ?

Do I wake up and am I going to be happy today ? And how do I , you know , be happy ? It just happens naturally . That's the beauty of it . It doesn't really take a lot of discipline or perseverance because it just happens right .

I mean , if you grow up in a community where all the food is pretty much grown and is healthy and is local , I mean that's what you're going to eat and there's not a Burger King on every corner , so that's kind of the secret to it as well .

So if we can encourage our communities to make walking more accessible , those kinds of things , that really can make a difference , and then you know , and then what it also does is . So you know our participants on this call our audience will work with individuals to really motivate them to do certain kinds of things right .

I'm not saying that , you know , just walking in a park you know is going to . You know , do everything that you need to have happen . But the point is they do the things that you know just walking in a park you know is going to .

You know , do everything that you need to have happen , but the point is they do the things that you know might be in a gym or whatever the their coaches or exercise professionals , having them do the park and those other opportunities now support .

Yeah the progress that they have made with their professional , and so that can really be and that keeps them on path and on track , and so that can be really powerful .

And that's what I have seen and that's what I would encourage them to do Work where you are , but also try to think about the bigger environment that's going to nurture and support the work that you've started .

They are seem to be everywhere , but it's the environment and the thing I think about as an exercise professional is for someone who's not moving at all and we know that's a large portion of the American public saying you need to start exercising that's a massive gap to go from no movement to exercise in a gym and I think what starts to close off that gap is

just physical activity in your life . That is easy because it's in the environment and I think that's you know . Blue zones do that organically , you know as well as anything . That's right , that's right . We actually don't even use the term exercise . We call move naturally , because that's what these folks are doing . Right To your point .

They're not going to the gym , yeah . But I'm sure you as a physician I know myself as an exercise professional . I've heard more people tell me that they are not an exerciser than they are an exerciser , but I've never heard anyone tell me they're not a mover , Like I'm not interested in moving .

So I think that the word natural movement that you use there , I think is an important language point for our audience .

But yeah , any improvement should be celebrated .

Before we get into the final couple of questions , I'm curious just for you to maybe give our listeners some insight of some of the work that you're doing at the Blue Zones right now that might be of relevance to our audience , I feel like , because exercise is not as formally emphasized in Blue Zones .

I feel like exercise professionals aren't maybe always aware of what's going on . So I think this would be a good opportunity for you to give us a little bit of a state of what's happening in the Blue Zones world .

So it has smog , it has congestion , it has all the stress that we all suffer from that live near big cities , and yet it's a blue zone . So it just tells us that it can be intentional and movement is one of those things .

As I mentioned , one of our power nine you know there are nine elements that seem to be common among all of these longevity spots is to move naturally .

You know , sometimes we get caught up on the food but , yeah , there's a food component too , but moving is there and it's actually one of our core four , even if you start going , you know , broader from the power nine . So it's there , but it is moving naturally .

And the other thing that we have found that if you can combine that movement with purpose , it really becomes powerful , right ? So a lot of these folks are moving naturally because it has purpose , right , it might be part of what they do because they're herding sheep up the mountain or something .

So that's kind of how that works as well , but it is an important part . And what we also find is that things act synergistically . So you don't want to do something in a vacuum . If possible , you want to combine it with some good food , combine it with doing it with other people right , Make it more pleasurable , or with purpose as well .

So those are some of the things that we have found . What we've also found and just using Loma Linda as an example is that in that particular population they were doing routine SF-12 well-being surveys and they were looking at both physical and mental self-reported data , and we know that there's been that gap .

And what we found in the blue zone is the gap actually flips and that the black participants were doing better than the white participants . So it tells you that you know , as others have said , like Tony Eaton out of the California Endowment , you know zip code is more important than genetic code .

It's all about where you live and what you're exposed to , and epigenetics talks about this as well . So you know it's all important and , just like anything that's complex , you've got to figure out where the synergies are and how everything works together .

I was , as you were , talking about moving with purpose and , and you know , moving I was thinking of probably a mutual acquaintance of ours , Melissa Sunderman , Dr Sunderman , who will tell you , you know , do physical activity outdoors and garden at the same time and then eat the food you've gardened .

And there's , there's the , there's the synergy of many of those different pillars .

We just announced , a month ago , our partnership with American College of Lifestyle Medicine , which is very , very exciting for me , having been a past president of ACLM , to now see two organizations that I've been closely attached to coming together . It's really exciting . But , yeah , a lot of good things are happening . We're in a lot of communities .

We're also launching a food line , blue Zones Kitchen , named after the book , so you'll find those new SKUs in a lot of different grocery stores frozen meals and they're taste tested by Dan Buechner himself , who's a real foodie , if you don't know him . He really loves food , so they're delicious and yeah .

So check us out , go to the website , and there's a lot there and a lot more coming .

I mean talk about synergy . I think that that's a really , really great relationship , so congrats on that .

So before we finish , I'm going to end the podcast on the final question that I always end the podcast on and I love asking this to lifestyle medicine professionals in particular , because you guys have a very unique vantage point but I consider the wellness paradox to be the trust , interaction and communication gap that exists between fitness and wellness professionals

and medical professionals broadly , with all your experience , if you could distill down one piece of advice for the fitness professional who's listening to close off that gap , what would it be ?

I want to get my private pilot's license and while you know , as a private pilot I will use the laws of physics just like a Top Gun maverick , might you know .

The movie had just come out and I was sort of using this analogy and I said you know Top Gun , you know they're using the aerodynamics , they're using the same laws of physics that I will be using as a private pilot , but we have different missions . You know , they have a mission , they have an objective . They're going to go do that .

I have a mission as a private pilot to do something else , but I still use the same rules , the same laws of physics , and so that's kind of how I see . You know physicians that are doing lifestyle medicine in a continuum . They've got a mission , they're trying to do some things . We have the health professionals and the physical exercise folks , professionals .

They have a mission . We're all using , like exercise , we're all using , you know food , but we have different missions . But I see it more as a continuum and we all play an important role in that , and so we shouldn't be dismissive or think one is better or different . They're really all pretty much related and it's just where are we playing in that spectrum ?

That's how I see it .

Those shares make a big difference for us . Any information we'd like to share with you from today's episode can be found on the show notes page , that's by going to wellnessparadoxpodcom . Forward slash episode 129 .

Please be on the lookout for our next episode when it drops in two weeks , and don't forget to subscribe through your favorite podcast platform Until we chat again next , please be well .