Fit for life
A Scottish pioneer in social medicine, and his methodical research, revolutionised the treatment of heart disease and kicked off the modern era of public health, says author Peter Walker
The Scot who linked exercise with heart health
It was slightly over 67 years ago when one of Scotland’s most brilliant and influential 20th century figures, someone who nonetheless remains bafflingly little-known outside academic circles, published the study that would define his career, and change the world.
Dr Jerry Morris, the son of Jewish immigrant parents who fled pogroms in what is now Belarus, taking the surname of the friendly boat captain who brought them to Liverpool, then settling in Glasgow, was the lead author of a November 1953 paper in medical journal The Lancet, with the distinctly sober title, Coronary Heart Disease and Physical Activity of Work.
A pioneer in the emerging discipline of social medicine – how people’s health is shaped by the environment in which they live – Morris had begun five years earlier with a mission to discover why the UK faced a post-war surge in fatal heart attacks. Scientists were baffled, with one theory even suggesting bitumen used to resurface roads amid peacetime rebuilding could be a factor. Morris approached the puzzle in a methodical way, poring over endless medical records, trying to find a pattern.
His breakthrough came as he studied the personnel files of London Transport staff and spotted an anomaly – bus conductors had about half the rates of heart disease of colleagues who drove the vehicles. Their backgrounds and other biographical details tended to be similar, so it must be the job. But how? Morris eventually hit on the answer: conductors were much more physically active, climbing an average of 500 to 750 steps per shift.
To modern readers this might seem blindingly obvious. But amazing as it might sound now, even as recently as 1953, several years after the first studies which linked smoking and cancer, this was revolutionary stuff. Medicine remained dominated by Victorian-tinged ideas about exertion being bad for the heart, not to mention a bit undignified, and Morris delayed publishing his findings for several years to endlessly re-test the evidence.
When the article did appear, it caused a sensation, effectively kicking off the modern era of public health. Decades of further research – quite a bit of it by Morris, who lived to be 99 and never properly retired – has shown staying active not only reduces your chance of heart disease but helps ward off a textbook-worth of illnesses and conditions.
The list now includes type 2 diabetes, high blood pressure and strokes, several forms of cancer, poor lung function, depression and anxiety, diminished cognitive function, poorer sleep and, in later life, Alzheimer’s and other sorts of dementia. Not to mention the big one: reduced chances of early death.
I would probably never have even heard of Jerry Morris if I hadn’t set about researching and writing a book on the subject that dominated his post-1953 career: how everyday physical activity has more or less disappeared from the modern world, and the many consequences this brought.
The book is called The Miracle Pill, based on the parallel often made by those who study activity. Imagine, they say, if you could package the benefits of even moderate daily exertion into a tablet. A Nobel Prize would be as good as in the post.
I’m not a scientist by trade. I’m a political journalist. So why the interest? I wrote an earlier book, on the case for more cycling as transport, part of which involved researching the impact of our sedentary world. I was astonished to learn that scientists estimate illness from longterm inactive lifestyles causes more than five million early deaths a year worldwide, about 100,000 of them in the UK.
Compared to coronavirus this is a slow-motion car crash, but make no mistake, it is another pandemic of poor health, one which has, up to now, prompted little in the way of urgent political action.
Over a third of UK adults now lead dangerously inactive lives. Among children, 80 per cent exert themselves so little they risk growing up with weakened bones and poorlydeveloped cardiovascular systems.
As with Jerry Morris’s bus drivers, early deaths do still happen. But decades of medical advances mean a more common outcome is the modern phenomenon known as comorbidity, people living for decades with a series of chronic conditions in ever-declining health.
Before this feels a bit gloomy, or makes readers start shifting guiltily in their armchairs, let me stress what were perhaps the most vital points I learned.
Firstly, while being inactive is, ultimately, the responsibility of each individual, it’s simultaneously not necessarily their fault. We live in a world carefully, even cunningly, designed against everyday movement. Think about the last time you went into a hotel, or an unfamiliar office block. A row of shiny lifts would have been on obvious display. But the stairs? That might involve a trek down a corridor, a nervous push at a possibly-alarmed fire door, and then the risk of being trapped in a windowless stairwell. It’s not exactly intuitive.
This elimination of movement is happening everywhere, all the time. Even mini-exertions like walking to the cinema or a restaurant, are being replaced by streamed films and the rise of app-summoned takeaways, a process Covid lockdowns seem set to embed.
The other key point is that more or less any activity, however brief or sedate, is better than nothing. The official literature still calls for five
Scientists estimate illness from long-term inactive lifestyles causes more than five million early deaths a year worldwide
sets of 30 minutes a week of what is termed moderate activity, such as walking briskly. But new research advances have shown that bouts of as little as ten minutes bring huge benefits.
This is of all the more relevance in a time when millions of people are, like me, working from home. The book isn’t a self-help guide, but it does have some tips about how you can mitigate the perils of a working life spent between the bedroom and kitchen table.
This could include breaking up extended sitting periods, or improvising a standing desk (I wrote several chapters with my laptop balanced on piles of hefty activity textbooks).
I never met Jerry Morris – he died in 2009 – but I’m sure such interventions would have cheered him enormously. Described to me by those who knew him as a seemingly mild but iron-willed force of nature, he was someone who never lost an innate sense of justice instilled by a Glasgow childhood rich in love and intellectual curiosity.
It’s still too early to know whether Covid will usher in an era in which preventative, population-wide health is taken seriously. But if there is a new focus on this constant, unremarked health crisis, it would be a fitting, if inadvertent, tribute to one of Scotland’s most extraordinary, and under-celebrated, modern citizens.