Changes made from the inside out, rather than from the top down, is the way to make a lasting difference. It’s also an enormous challenge, especially when the aim is to change not a single person, but an entire town.
But that is precisely what the Blue Zones Project aims to accomplish in several Hawaii communities over the next three to four years. On Oahu, the first experiment will take place on the Windward coast, the Waimanalo-to-Kualoa stretch known as Koolaupoko.
Like many communities across the state, it’s endowed with some cultural fixtures that support healthy habits. But public policy tends to have a statewide rather than neighborhood orientation; this, among other disadvantages, present some hurdles.
A “blue zone” is a community where people tend to live longer — and where the latter years remain productive and satisfying. The concept arose originally from reporting for a 2005 National Geographic Magazine piece by Dan Buettner.
The cover story was based on expeditions the writer-researcher-explorer made to far-flung corners of the globe where there was a higher than average percentage of people age 100 or older.
Since then, the mission of the Blue Zones Project is to replicate those communities in places where healthy habits are not so firmly entrenched. This means promoting some of their characteristics — such as a largely plant-based diet, a culture that promotes regular physical activity.
And, Buettner said, it also means enlisting enough people to make personal commitments. The goal for the organizers in a Blue Zone is to get 15 percent of the population to sign a personal pledge to make better choices and create a personal network of companions to support them (for more about the Blue Zones history and method, see Page E4).
“We have a different approach to health care, which is nurturing health rather than making sick people less sick,” he said in a telephone interview after the project launch. “Our approach is setting up nudges and defaults so the healthy option is not only easier but unavoidable.
A “nudge” can be something as small as a school banning eating outside the cafeteria to cut back on empty-calorie snacking. And there’s been success with persuading restaurants to offer healthier side dishes as the default, making fries or other more conventional fare the substitute option. Little changes add up, Buettner said.
“It may sound like a facile approach, but I will tell you, it’s amazingly powerful,” he added. “It amazes us over and over again.”
Change is expected to be gradual, especially during the current first year of planning. Organizers of the project convened a gathering Oct. 16 at Windward Community College to kick off the Blue Zones Project. There were food and fitness exhibitions and activities before Buettner gave the keynote address.
He surveyed the audience to gauge their likely longevity. Among the questions: How many vegetable servings do they consume daily? Are they sedentary or reasonably active? Do they have a sense of belonging, whether to close networks of friends or faith-based organizations?
Health, in the Blue Zones conception, includes having a sense of purpose on the planet. Hawaii’s traditional belief in extended family and elder care can fold in well with this approach, he said.
But there are built-in difficulties with making the community-conversion model work here, even the enthusiastic supporters agree. One, said Jennifer Dang, is that Koolaupoko encompasses areas lacking a cohesive “town” character or local governance.
Dang is special projects coordinator for the Hawaii Child Nutrition Program, state Department of Education, so she’s already on board with much of what Blue Zones advocates.
As a Kaneohe resident, she’s already worked collaboratively with other health and education officials in the area, even before joining the Blue Zones Koolaupoko planning team. Earlier this year they formed the Castle-Kahuku Complex Wellness Team, looking to improve conditions for students in that region.
That momentum certainly didn’t hurt with giving the Koolaupoko application for selection as a Blue Zone.
While the initial plan was to make Kaneohe the zone, it was expanded to span Kailua, Waimanalo and Kahaluu. This, organizers said, put it in the range of population and economic activity that Blue Zones’ national organization requires.
But, Dang said, not all the communities are the same, especially with the way they’re laid out. Where Kailua has street grids, bike lanes and other master-planned improvements more typical of a Blue Zone, that can’t happen as easily in Kaneohe, she said.
“The way that our community was designed, it’s not like Kailua where there are large landowners,” Dang said. “It’s like a patchwork of different landowners.”
Blue Zone planning involves approaching businesses and other employers to implement healthier work environments; reaching out to individuals and families through social media and community events; and changing the physical environment.
It’s this last category that may be more difficult because nothing is entirely under the control of the community. Streets and highways are the jurisdiction of the City and County of Honolulu and the state; community leadership, in the form of neighborhood boards, is advisory only.
Regardless, the idea did appeal to some from these community panels who think it’s worth the effort to bring the myriad parties to the table. Among those working the Blue Zones Project is Bill Sager, vice chairman of the Kaneohe board.
“One of the major challenges is, nationally they work with local communities,” Sager said. “They’ve had to change their operation to reflect the fact they don’t have the same thing in Hawaii.”
Still, there are ways to make the zone more walkable and bike-friendly, said Dan Burden. He is the Blue Zones “director of innovation and inspiration” — alternately described as its “walkability expert.”
Burden is convinced there’s hope even for Kaneohe, which is traversed by Likelike, Kamehameha and Kahekili highways and little connectivity of surface streets.
Reducing speed limits would be one focus, he said, but another would be providing more sidewalks and other provisions for walking and cycling in the school communities. This way, he said, children start early at developing better habits.
“We work with school administrators, identify and fill gaps where sidewalks aren’t built,” Burden added. “Maybe the traffic speeds are too high. We start within the first quarter-mile radius from the school, and get the infrastructure corrected over time.”
Action plans for Koolaupoko are still being drafted behind the scenes. But already there are Blue Zone meetings being held to discuss key topics. One recent forum in Kailua concerned making busy Hamakua Drive safer for cycling, for example.
A scan of the Facebook page (www.facebook.com/bluezonesprojectkoolaupoko) reveal posts on Big City Diner becoming the first Blue Zone-approved restaurant in Hawaii, healthier holiday recipes, notices for workshops on finding your life’s purpose.
Among the workplaces already striving for Blue Zone certification is Castle Medical Center. The center is run by the Seventh-Day Adventist Church, which embraces many of the Blue Zone principles. Loma Linda, the California town with a large Adventist population, was the first U.S. city Buettner and his team identified as a Blue Zone.
“We want to be the first worksite to be certified,” said Nicole Kerr, Castle’s wellness director. “It aligns with exactly what we believe in.”
Sager agreed.
“I believe in this program because the concepts make sense to me,” he said. “The other thing, it’s a grassroots effort. The politicians bring on these fancy projects and they only last as long as the administration lasts.
“Blue Zones has had a good record with all of their programs with establishing a lasting effort that makes changes in the community,” Sager said. “I’ll do everything I can to make this work in Hawaii.”
