Newsletter | Translation Error

“The ‘CVD patient’ is no longer a discrete clinical category but a statistical norm.” This characterization is one of the conclusions from a provocative new paper from Gaetano Santulli, a professor of medicine at City University of New York, who reviews the 2026 American Heart Association Heart Disease and Stroke Statistics Update and puts it in perspective.

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Steve DownsComment
Speculative Design | The Value of a Commute

Does your mode of commuting reflect your values? How might it be different if it did? What could that time spent commuting offer you? And why is the healthiest choice so rarely the easiest choice? Our new speculative design project — The Value of a Commute — explores these questions.

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Steve Downs
Newsletter | An Inoculation Against Modern Life?

There are three options for dealing with the mismatch between our genomes and the modern world we’ve created: 1) marshal the resources of our vast health care system to treat all the resulting illness; 2) change the environment such that it doesn’t exploit our genetic misalignment by design; or, behind door number 3 – change the humans so that we are less vulnerable to the toxic environment we’ve created.

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Newsletter | Use Your Words

People speak, on average, nearly 13,000 words a day. That seems like a lot, but, according to a new study, it actually represents a 28% decrease from the nearly 16,000 per day we spoke in 2005. The authors found that we’ve been going through a steady decline – losing 338 words per day each year – from 2005 to 2019.

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Steve Downs
Newsletter | Should Dunkin’ Be Generally Recognized as Safe?

HHS Secretary Robert F. Kennedy, Jr. went viral recently when he suggested that he was going to ask companies like Dunkin’ (nee Dunkin’ Donuts) and Starbucks for safety data proving that it’s “okay for a teenage girl to drink an iced coffee with 115 grams of sugar in it.” When a Boston Globe reporter picked up the comment and ran a story on it, New Englanders rebelled. After all, Dunkin’ is, for better or for worse, a New England institution.

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Newsletter | Do Nudges Even Work?

Remember when we thought all it would take to fix society’s problems was a little nudge, here and there? 

Want to boost recycling rates? Make the recycling bin bigger, and label the garbage one “LANDFILL.” Want to reduce obesity? Use smaller plates and put salads first in the buffet line.

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Newsletter | New Food Guidelines: The Steaks Are High

The much anticipated update of the federal Dietary Guidelines for Americans came out earlier this month. There was much to like, such as stronger language on added sugars and a caution against eating "highly processed” (read “ultraprocessed”) foods, much that’s been controversial (more protein, more meat, and more saturated fats) and even some puzzles (one can’t actually meet the protein recommendations without straying afoul of the recommended saturated fat ceiling).

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Steve Downs
Newsletter | How to Better Spend $5 Trillion

We all know the statistics. The United States spends $5 trillion on health care each year - and 80% of it passes through private and government insurance into patient care, hospitals, and prescription drugs. This is the disease business, and it is a staggering monument to misplaced priorities and reactive inefficiencies.

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Newsletter | Get on the Bus

Jarrett Walker describes the history and the reasons behind why we, in the US, have let transit survive – but never thrive – over the years and makes the case for why we should support it. From our perspective, looking at the environmental contexts that shape health, public transit is really important. The benefits include greater physical activity and less obesity, more social interaction, and access to groceries and needed health and social services for its riders, and less pollution for all.

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Newsletter | Overthinking Health

There is something surreal about Tad Friend’s profile of the longevity movement “How to Live Forever and Get Rich Doing It” in The New Yorker. Told from the perspective of shadowing Peter Diamandis, one of the movements best known gurus and entrepreneurs, it’s a tale starring many of today’s A-list concepts: AI, billionaires, effective altruism, colonizing space, achieving immortality through longevity “escape velocity” and/or achieving immortality by uploading our minds to the cloud.

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Steve Downs
Newsletter | Do We Have Freedom of Choice?

Among the iconic phrases that best evoke the spirit of America - “Just Do It," “I’m Luvin’ It” - “Freedom of Choice” is surely up there.

In just three words, Freedom of Choice expresses the ideals of American liberty, where individuals are empowered to forge their own path. 

The idea dates back to the early years of the republic, when Alexis de Touqueville noted that American individualism was a new and powerful force that might rival the common good of democracy. But the phrase really took off in the consumer age, in the bountiful days after World War II.

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Newsletter | The Curse of the Systems Thinker

The curse of the systems thinker is that one is always seeing patterns, always searching for the fundamental forces and dynamics that underlie a system and give rise to the peculiar results one sees. One is always – as we like to say in public health – looking upstream, for the root causes – and even their root causes. It’s hard to stay focused on the immediate problems at hand, when there are deeper, more fundamental causes of those problems that are – most perplexing to the systems thinker – so deeply embedded that they are rendered nearly invisible, or at least taken for granted. They are the givens, the fixed conditions that exist outside the solution space.

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Newsletter | How Do We Build Healthy Places to Live?

Last month, San Francisco’s new mayor, Daniel Lurie, proposed a new zoning plan for the city that he dubbed “family zoning”: a place “with space for more families, more workers, and more dreams.” Behind the family-friendly spin, the new plan is recognized as a textbook upzoning. It will hopefully change the west side of the city, which added just 4,000 homes over the past 20 years, into a more fertile place for housing.

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Steve Downs
Newsletter | Go Outside, Often

Spending time outdoors. It’s one of the five behaviors we use in our Building H Index framework to assess how products and services influence the health of their users. But let’s be honest – it’s not one of the more recognizable health behaviors like diet and physical activity. Yet we care about it because it does have significant health impacts. Spending time outdoors – and in nature – has been linked to a growing list of health benefits from lower blood pressure to avoiding myopia.

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Podcast | Steve Downs on Public Health On Call

Our co-founder Steve Downs joined Dr. Joshua Sharfstein, the vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health, on the popular podcast Public Heath On Call. They discuss the Building H Index: what it covers, which products scored better than others, how we did it, and — importantly — why we created the Index.

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Steve Downs
Newsletter | Putting the H into ESG

As regular readers know,  Building H developed a rating system — the Building H Index — that measures the affects of products on their consumers. It’s a 1-100 scale where 50 and above can be considered a “good” score - a net positive for human health - and below 50 would be a “bad” score, or a net negative for health.  We released the last index this past October, and we’ve been looking for ways to make it even more impactful. One idea: Might our Index be something that investors might use in evaluating their portfolios - especially so-called socially responsible investing?

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