Prakash Chandran (Host): Blue zones are regions of the world where people live significantly longer and healthier lives compared to the global average. These areas are characterized by high concentration of centenarians and low rates of chronic diseases. The concept of blue zones was popularized by a National Geographic Explorer named Daniel Buettner. And today, we're joined by his son, Dan, or Danny Buettner, Jr. And today, we'll discuss what Blue Zones are, how his company's new Ignite Outer Banks Initiative is going to help improve the health and well-being of Dare County residents.

This is the official Outer Banks Health Podcast. My name is Prakash Chandran. And joining us today are Amy Montgomery. She's a Senior Administrator of Operations for Outer Banks Health, and Dan Buettner, Jr., also known as Danny, the Chief Development and Strategy Officer for Blue Zones LLC. Amy and Danny, thank you so much for joining us today. I really appreciate your time. Danny, I wanted to just get started with you. Can you tell us a little bit more about what blue zones are?

Dan Buettner, Jr., JD: Yeah, happy to. Blue Zones started in 1999. Dan Buettner, Sr., circumnavigated the planet with National Geographic, a grant from the National Institutes of Health, to find the fountain of youth. He came up empty- handed on some type of super genetic or some type of herb or honey. Instead, what he found was the five places, five communities where people are reaching age 100 at 10 times the rate that we are in the United States. And they're doing it with a fraction of the disease prevalence that we have in the United States. Basically, best practice is happening for the last couple hundred years in these places for how we can set up our lives, our communities, our rituals, our environments. And it's been a 25-year journey now of studying the world's longest lived people, 350 of them.

There's a great Netflix out there, so I encourage everybody before we come to town, with Outer Banks Health, Outer Banks Hospital, go watch the Netflix, Live to 100, won three Emmys, beat out Days of Our Lives for one of the categories. And so, go learn more, but it's a great story and we're really excited that the story continues in Outer Banks.

Host: That is awesome to hear. And my wife and I actually did watch that documentary and we have been eating more plant-based since. And I was hoping before we kind of move on for you to talk about maybe some of the characteristics that your father had seen in some of these blue zone areas.

Dan Buettner, Jr., JD: So, he went out there with a team of demographers, epidemiologists, MDs. So, this is more than storytelling. This is more than investigative journalism. This is real science, anthropology, epidemiology. It's been longitudinal. And what he found is the same things happening over and over and over again, whether you're in Okinawa, Japan; Sardinia, Italy; Icaria, Greece; Loma Linda, California, or the Nicoya Peninsula of Costa Rica. You see people that are moving naturally all day, every day. They're not sedentary, and then hitting the gym for an hour and then going right back to a sedentary lifestyle.

Three out of five of these places are at or below the poverty line. So, they're not drinking tropical drinks on a Sandals Beach Resort somewhere. They have real stress. They have real problems. But they have strategies to downshift and practice their purpose. So, those are two more. They have a very different diet, so plant-slant, not vegan, but plant-slant. Predominantly, beans, good carbs, fruits, legumes,. They're having a little bit of happy hour, they're downshifting. So, wine at 5:00 is a popular one over a healthy meal and with friends. And, no, you can't save up and have 14 glasses on Friday night down on the beach. It doesn't work that way, at least for longevity purposes.

And then, this sits on a bedrock that all these places around the world have of community of who you hang out with, do you belong and do you find people that you can belong with? We know from the CDC that habits are as contagious as a cold. So, your three best friends have a 156% contagion factor on your health habits, on your lifestyle. So, we don't recommend dumping unhealthy friends. But maybe, you know, if you do have that kind of unhealthy, but maybe augment with some folks that want to go down to the beach and do a little morning yoga or go for a walk or volunteer, et cetera. So, those are some of the nine commonalities that showed up over and over.

And I'll leave you with this because this is a good segue to Amy to what I've learned about Outer Banks, not a single one of these 350 centenarians, 100-year-olds, the world's oldest old, not a single one pursued health, not a single one pursued longevity or pursued meaning or purpose or connection in their life. It ensued. It ensued as a byproduct of the environment they lived in and the community they belonged to.

Host: Wow. That's incredible. And just hearing about some of those attributes, that you were mentioning, it really sounds like Outer Banks is a place that already has a lot of these components. And so, Amy, I'd love to hear from you, a little bit more about having those nine components in the community, what that's like, how awesome this is going to be. Talk a little bit more about this initiative.

Amy Montgomery, MAEd, FACHE: Absolutely. When we're out there talking in the community, we've been having friends at 5:00 events over the last couple of months, just really getting ready for Dan and his team of experts to come in September. And as we're out there talking about blue zones, we're saying, and it's true, we are already a light shade of blue here on the Outer Banks, and we already have so many of these things in common that were found in these cultures in the blue zones.

Our community, the people here on the Outer Banks, I don't think there's another community in the United States that is more supportive of one another. So, the connections, the community support that already exists here really is likened to a blue zone. People really come together, know how to relax, know how to be friends at 5:00, really, we have a great social support network here.

One thing that it really illustrates that is that we have more than 100 non-profit organizations on the Outer Banks. And we're a community of less than 40,000 permanent residents every year. And so, over the years, as we have discovered a community health challenge or just a challenge in general, community comes together, forms a group, raises some money and just really attacks the issue and solves the problem. And I'm hearing from Danny that these cultures around the world didn't really pursue health, but I will tell you that Outer Banks Health and our partner, the Dare County Department of Health and Human Services, we are pursuing well-being and longevity for the people who live here.

And that's why we are engaging with Blue Zones, our partner. We are really on a mission and it's part of our mission to enhance the health and well-being of people who live here. Really how we came, you know, why Blue Zones now? That really stems on the heels of having just raised $6.4 million for a cancer center. So, many of you listening to this podcast know that we've been out in the community for the past two years, or really since 2020. During COVID, we started raising money for a cancer center. We've built the cancer center. It's beautiful. The community support was just amazing. And at the end of that campaign, we really want to keep going. Our development council who raised money for that project is also behind Blue Zones.

So, when we finished the cancer center, we said, "Well, what's next? "And we think it's the right thing to do, to work in both the spaces, right? So, longevity and well-being, prevention. Is there a way that as a health care organization we can influence environments, lifestyles, all those things and keep people out of the hospital, keep people away from our cancer center, as well as be working in the space where people with chronic disease, other diseases, cancer, emergencies, tragedies, where we can take care of them. So, we're really excited to be working with Blue Zones and just be working in all of the spaces, and improving the health and longevity of people who live here.

Host: Yeah. I think it's amazing to hear about, and you often hear the term, you know, lifespan, and more people are starting to talk about healthspan. And Danny, you know, to your point, in a lot of these communities, it seems like it was just a natural part of their living. But I think especially here in this country, there's not always the awareness. We are in this sedentary lifestyle. So, it really seems what Outer Banks is starting to do is to build that awareness around what it takes to have that health span in your life. So Danny, I wanted to actually move to you and just maybe have you explain what the Blue Zones Ignite Initiative is and how it aims to improve personal well-being on the Outer Banks.

Dan Buettner, Jr., JD: Yeah. First of all, I salute everything that Amy and the team and the community and the community partners are doing, because you do have to pursue that aspect of it. Well, when I say longevity and health in the original blue zones ensues, it ensues for the individual. Because they're lucky enough to be born in an environment where the healthy choices are the abundant choices. But in the United States, you drive down a highway, you walk through a checkout lane at a gas station or a grocery store, you go to the vending machine at the job or in the cafeteria at the school, it's not the healthy choices that are the abundant choices. You know, ubiquity is the unhealthy choice in this country.

And so, you need leadership, like healthcare, like policymakers, like school superintendents and residents, the straws that stir the drink, people that are going to pursue making the healthy choice the easy choice. And that's what Blue Zones has had the privilege of partnering with over 90 American cities over the last 10 years.

So, part one of Blue Zones is the original research and story that continues, but part two is we have over 200 people at Blue Zones that partner with American communities that are on this journey of improving quality of life, or ZIP code effect, or well-being, whatever you want to call it. It's about shifting the locus of metrics towards a common North Star metric that lifts all boats from community health to economic development to exposure to celebrating what's already being done in the community. And so, our model that we partner with communities, we don't do it to communities, they got to do it to themselves, which is why we do this assessment phase, this Ignite phase, is to use evidence-based approach to taking the onus off the individual. Everybody still has some responsibility for the health. But if we can create a silver, not a silver bullet, but a silver buckshot to the schools, the restaurants, the grocery stores, the faith-based community, giving them free, cost-neutral ways to join a movement, a local OBX movement, to make the healthy choices the easy choices, the prominent, the celebrated choices, the affordable choices. Working with people to engage around Blue Zones and Power Nine and other things that are going on in OBX around well-being and purpose and plant-slant move naturally.

And then, finally, policy, making sure that we're advancing built environment, food system policy that is, of course, the invisible hand. And the amazing thing here is, if you can have amazing clinical care, and this is where I got to really salute Amy and her team, you'd have the best clinical care in the Outer Banks, in the East Coast, but if you're discharging people back into environments that aren't very good for them, you're never going to get the outcomes that we want.

What determines health is about 10% access to care, 10% genetics, and the 80% is lifestyle and environment. So, imagine the power of getting somebody both great clinical care, access to experts, resources, tools, but then also helping them with lifestyle and then promoting good behaviors in the environment. That right there is how humans move the needle mentally, metabolically, and spiritually, and as a whole. So, the Ignite process is a dating process, where we're getting to know OBX, OBX is going to get to know Blue Zones. We're going to do big keynotes, which by the way is sold out. So, we're working on overflow.

But we're going to present, we're going to share, then we're going to get the community feedback, give you voice. There's quantitative analysis around data. We partner with Gallup. There's qualitative listening sessions that Amy will talk about. And at the end of the day, we want to get a sense of, which we already think is the case, is this a good partnership? Is there existing muscle and competency in OBX doing similar work that we can harness and together go tell not just a remarkable national story that can be celebrated, but show that we're moving the needle on some of these intractable health issues.

Host: It's amazing. And I think what you said is so powerful just around, you know, there's obviously the clinical health, but if you're discharging people into an environment that doesn't support that healthy lifestyle and health span, you kind of run into this vicious cycle. So when you spoke about not the silver bullet, but the silver buckshot, Amy, I'm curious, like what does that silver buckshot process of Blue Zone Ignite look like in OBX?

Amy Montgomery, MAEd, FACHE: Yeah, absolutely. So, you know, I received two emails this morning of people already engaged, already interested in that buckshot effect. Our Dare County Extension group reached out to us this morning, you know, the local tennis association, how can we get involved? How can we promote the garden that we're growing? How can we promote our sport in terms of more organic activity, those types of things. And so, you know, even before Danny and his team are here on site, you know, they're coming September 10th, our event, like he shared, is already sold out. And really, the trigger has been pulled and the buckshot effect is already taking place. People were really adopting the concepts and leaning all in and saying, "How can we get involved? How can we spread the message even further?" And it's really exciting and we're just so energized by the community's excitement. And it's only going to get even more exciting as we grow closer to September 10th and Danny and his team are here.

So, we are having that community event. And that's a keynote address at Jeanette's Pier. It's 250 people. We have 250 chairs and maybe a little standing room in the back. But like Danny said, it's already sold out. And we're a month, a full month from the event. But we're going to have other opportunities for people to engage. So, we'll be doing a CEO roundtable. We will be doing keynote interviews or key informant interviews. Those focus groups that are focused on many of the topics that Danny spoke about, you know, the food supply as well as the built environment, and those types of things. And so, those invitations will be going out later this week, early next week. And we probably have about a thousand people already on a list of individuals receiving emails. And then, we have about 500 people total being specifically invited to participate in the events, September 10th, 11th, and 12th.

Another thing I forgot to mention that's part of this process are windshield tours, and I know it's really important to people in the Outer Banks that every location in our community is represented. And I want people to be assured that we are going to be in every community. We're having events in every community, including Hatteras Island, Roanoke Island, the Northern Beaches, here in Nags Head. We're really going to travel the community with events and the windshield tours. And we will be doing a specific event on Hatteras Island as well.

So, we're going to cover some ground and hear from our local community. And, as Danny shared, some of the next steps will be what are some opportunities? Where can we start to change the environments and then engage individuals in living a Blue Zones lifestyle?

Host: Yeah, that's amazing. And even if the keynote event is sold out, it sounds like there's going to be so many different resources, which leads me to my last question as we begin to close, just around what the future hold, and if people listen to this and they're feeling inspired by everything that we're talking about, what they can start to do. So, Danny, let's start with you. How would you answer that?

Dan Buettner, Jr., JD: Yeah. I mentioned earlier we don't do this to communities. This is really about communities taking inventory of what they're really good at, what we're really good at, where they want to get to, and can we get there faster, louder, better together. And so, it is critical that people show up, lean in, come in with curiosity. And if they're inspired and believe that this is a good fit, that there's a story here at the end of the rainbow, not a Blue Zone story, but an Outer Banks story, a new iteration of our model, not 91.0, then they're going to have an opportunity to hire their own team, to have their own steering committee, to have their own subcommittees around schools and food and built environment and faith-based and a whole host of other categories and get to own it.

So, that's just to underscore the importance of the community, sinking their teeth in and seeing if they like what they taste. And I'll tell you that in addition to this, check out the website, which I believe we're going to have at the end here for them to access. Amy, what would you add to that as far as ways to get involved?

Amy Montgomery, MAEd, FACHE: I would just add that we are being inclusive, not exclusive. And so, you've heard me give examples of individuals who have already reached out. And so, we're doing an assessment. You know, we will receive a transformation plan. And there are a million different ways to get involved and be involved in Blue Zones.

If you can dream it, engage with us about it, and we're interested in hearing your ideas and supporting you and involving you with what we're doing. Because as you heard Danny speak about, Blue Zones is all about connection. A big part of well-being is all about connection. So, let's connect and we're just really excited. So, thank you.

Host: Well, I think that is the perfect place to end. Danny and Amy, thank you so much for your time.

Amy Montgomery, MAEd, FACHE: Thank you.

Dan Buettner, Jr., JD: Thank you, Prakash.

Prakash Chandran (Host): That was Amy Montgomery with Outer Banks Health and Danny Buettner from Blue Zones. For more information about Ignite Outer Banks, you can head on over to www.bluezones.com/ignite-obx. My name is Prakash Chandran, and this has been another episode from the Outer Banks Health podcast. Thank you so much.