K M Venkat Narayan: Is health simply organized kindness?

My big public health hero (who is a hero to many) Dr Bill Foege once said that, “Civilization is organized kindness,” and my three days in Copenhagen made me feel that the Danish have mastered this principle as a fine science and art.

When you arrive in Copenhagen, it is hard for a visitor to miss the big, proud sign on the wall by the baggage claim: “Welcome to the World’s Happiest Country.” Indeed, Denmark ranks number one as the “happiest country” in the world—and scores high on several indices: with great healthcare and health, parental leave policies, prioritization of gender equality, active promotion of social capital, low crime rates, high levels of education, emphasis on equality, low corruption, terrific public transportation, and a welfare state at large with considerable social solidarity and collectivism backing it. In many ways, Denmark is a remarkable example of the practice of the lofty idea of “organized kindness.”

Even on a dark, wet, cold, December day, it is hard not to notice the beautifully illuminated Tivoli Gardens, the swarming crowds moving about in such an orderly manner, or the amazing organization of traffic. Neat pedestrian and bike paths, with social policy and law always favoring pedestrians and bikers over cars and trucks—a clear and welcome departure from the “might is right” law of the jungle!

When it comes to biking policy and culture, Denmark has much to teach the world. Fifty per cent of its citizens commute by bike every day, and there are more bikes than people in the country. Denmark prioritizes its bike culture, and road planning always preferentially includes dedicated and comfortable bike paths even before the motor roads are built. The country has over 400 km of bike path, and one can cycle anywhere in Copenhagen or across Denmark on bikes without having to fight dangerous cars. Traffic laws clearly empower the cyclists. This bike culture is also a great social equalizer: everyone—young and old, men and women, rich and not so rich, students and professors, and even 63% of the Members of Parliament—cycles regularly.

The idea of cycling as a major means of transport clearly offers huge health benefits at a time when the world is struggling with the growing concerns of obesity, diabetes, and cardiovascular disease. Biking as transport seems such a natural way to exercise, and can also be such a stress reliever. Furthermore, it reduces pollution from traffic and is eco-friendly. Denmark is also a very environmentally friendly country, and 47% of energy in the country comes from waste and garbage use (something that a country like India might learn from).

Countries around the world, especially the rapidly growing economies, have much to learn from Denmark on how to organize social policy in a way that promotes health, social capital, a good environment, and happiness. Modernization does not have to mean loss of physical activity, more crime, environmental pollution, huge socioeconomic divides or social conflicts, or having to fight one’s way each day through heavily congested motor traffic. This is what Denmark teaches us, and one hopes that politicians the world over would learn from this small country’s wonderful experience and achievement in shaping wellness and happiness in a modern aesthetic context.

As someone who grew up in chaotic, multi-religious, multi-lingual, multi-cultural India, and who now lives in a dynamic, powerful, diverse, market oriented, and trendsetting country like the US, seeing the stable and socially planned system in Denmark was quite a contrast. Both India and the US—and for that matter, most countries—could learn much from the Danish social experiment and their way of “organized kindness.”

Denmark seems such a perfect society. Yet some things worried me about this paradise. Have they (the Danish people) got too used to a comfortable and stable way of life, one set and created in a largely homogeneous, mono-cultural mindset against the backdrop of hundreds of years of traumatic history? How will Denmark navigate the mega-forces of globalization?

Talking to some taxi drivers, I heard some resentment toward the growing number of “them foreigners” (largely people from Eastern European or Islamic countries)—who some natives perceive as taking away local jobs, or indulging in crime, or simply not becoming “Danish” in their ways. I also heard that a sizeable minority (almost 20%) of Danish people support ultra right wing politics, and don’t want the Danish culture to accommodate new immigrants.

The country’s irreligious secular fabric can sometimes interfere with religious freedoms (for example, there is a serious move to “ban” male childhood circumcision, something practiced by observant Jews and Muslims). Intriguingly and somewhat ironically, the bikers, who have gained so much from the country’s policies to empower them against cars and trucks, seem to have developed their own intolerant habits: just try being a slow or new cyclist, and see how rude the good cyclists can be! Perhaps, even the most harmonious societies need to keep vigil on signs of intolerance, and take steps to shape tolerance through innovative policies.

My three days in Copenhagen have been wonderful, and I will go back with great memories. The tension between the chaotic, dynamic, multi-culture of an India or a US and the peaceful, stable, mono-culture of Denmark strikes at the heart of globalization. The world has a lot to learn from the Danish people about how to create health and happiness through “organized kindness.”

But Denmark too might need to realize that the future of the world is a diverse and multicultural one, and that they may have to begin to redefine the Danish identity in a more plural and somewhat mosaic fashion—welcoming and integrating the new cultures brought by immigrants to its shores. The world is too small, and all people and all cultures belong to all countries—we are but a global village. Diversity is a gift to humanity and, surely, diversity and social solidarity can co-exist in a happy way.

A happy New Year to all my readers.

K M Venkat Narayan is Ruth and O.C. Hubert professor of global health, and professor of epidemiology and medicine at Emory University Atlanta. He is a product of three continents, having lived and worked in India, the United Arab Emirates, the United Kingdom, and the United States of America.

Competing interests: The author has no competing interests to declare.

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  • Srinivasan Kadayam Lakshmana I

    intresting..srinivasankadayamlakshmanaiyer