One of the most fascinating and important areas in life is surely the fine line between wanting to help, and being wary of, those around us. It’s a tension woven deeply into policy, and into our humanity.

I had one of those afternoons on the day of the People Powered Health event where an accident of meetings and agendas seemed to tell this story especially well. I found myself on a panel alongside Edwin Fisher. Edwin works on peer- to-peer support groups and gave examples of groups from across the world, including China, the US and Latin America where people help each other to preserve health on their terms. Holt-Lunstad et al’s famous (2010) meta- analysis also featured, that social isolation has negative impacts on life- expectancy equivalent to smoking 15 cigarettes a day.

We considered how human-centric principles should be baked into the design of health services’ modus operandi. ProjectRED in Boston, for example, uses ipads to explain better to those leaving hospital how to manage their medication and conditions – allowing more time and detail than a busy clinician may have. Those who experience this programme have reduced readmission rates – down by 30 per cent in the 28 days after discharge.

We also talked about how clinicians are humans too: hence how patient charts can be designed to reduce clinical errors (Dom King’s wonderful trial), or how we can help clinicians to raise sensitive lifestyle change issues with their patients, such as around losing weight, exercising more, or moving to more suitable accommodation later in life. In trials, such as that of Susan Jebb in Oxford, where GP’s tried specific prompts to encourage patients to try specific weight loss programmes (with great results, incidentally), less than one in 100 patients felt this was uncomfortable or inappropriate (asked independently of the GP). Strange then, that clinicians get so little training in how to raise such issues with their patients.

With an obesity strategy due out in a few weeks – and Britain being the most overweight nation in Europe – obesity and lifestyle evidently came up quite a few times at the People Powered Health event, not least in a forthright speech from Simon Stevens, the Head of the NHS. It also came up in the discussion on behaviour change and the future of health. Peer-to-peer networks and social action need to move upstream to address the causes of ill-health, not just support existing patients to cope better with conditions.

With respect to obesity, this will surely involve seeking to reshape the obesogenic environment which in turn shapes us, literally in this case. For example, consumers in the UK are not particularly loyal to supermarkets, which in turn fiercely compete with other. Imagine a group of healthminded consumers, armed with a Wansink-style checklist scoring the healthy-promoting vs obesogenic profile of local supermarkets – covering what’s on promotion, at the end-of- aisles, aimed at kids etc. If such action encourages just a small minority of consumers to switch to the healthier alternatives among their local supermarkets, it will prompt restocking, reformulation and marketing decisions to help us all be healthier.

But the tide of the day was not all in one optimistic direction. At breakfast I’d met with a leading nutritionist to discuss the rise of obesity in other countries, noting that economic growth of 10 per cent in developing nations is associated with reduced childhood stunting of 6 per cent, but also increased maternal obesity of 7 per cent. It’s a reflection of the high calorie, but often nutrient- poor diets that are spreading across many countries; an echo of our own recent histories in the UK and USA (he highlighted just how fast the USA went from obesity rates of circa 10 per cent in the post-war boom to circa 50 per cent).

But we shouldn’t attribute these statistics just to a wave of Anglo-Saxon junk food. Many culturally specific diets have poor underlying nutrient profiles. You see a glimpse of this in the ethnic differences in lifestyle diseases even within Western countries, as prosperity enables different groups to indulge their culinary preferences: Sicilians can choose healthy Mediterranean diets every day; Eastern Europeans can have endless red meat; and South Asians can indulge a taste for sweet and carb rich meals.

Lunch was combined with a meeting on health data and the thorny question of how to balance the power of data to unlock so many questions about what treatments work for who and when, with the public understandable desire for privacy and security. It was an issue wrestled with by the Caldicott Review and that rumbles on, not least how to explain to patients the sheer complexity of the modern NHS while asking them how they want their data to be used within it. Britons all know they are soon to be asked about if they want to stay in Europe, an obviously big question, but most will also soon be asked how they want their health data to be used. It is a question that could be as least as impactful on the lives and longevity of their children and grandchildren than that of our fate in Europe. Behavioural insights can help shape such questions, but ultimately they rest substantially on how we balance our desire to help, versus our distrust of, others.

After the session with Edwin, my day ended with a seemingly very different discussion in the Lords, hosted by Lord Lindsay and chaired by Professor Ragnar Lofstedt from the King’s Centre for Risk Management. It was a small but impressive group, including figures such as Paul Slovic famous for his work showing how people typically respond much more strongly to a single death or image, than to reports of thousands dying. He noted, for example, how donations for Syria that had flat-lined as the death toll had climbed through the 100,000s, but shot up 17-fold in response to that tragic child on a beach. It’s a statistic that itself seems to encapsulate something deep about the human condition, and how we evolved to think about those around us (our feelings don’t do numbers…), sometimes for good, and sometimes not – cause for despair, or hope?

But let me conclude on a really interesting, and I thought uplifting, result that was presented at the Lords event. Molly Crockett, a researcher at Oxford described an experiment comparing how much people would pay, or be prepared to profit from, getting an electric shock (what is it with psychologists?), versus a stranger getting the same shock. It turns out to be a rather elegant, if painful, test of an economic versus social psychological worldview. Most economic models would surely see this as a ‘no-brainer’: of course subjects would rather profit from a small pain administered to someone else than to themselves. But no: it turns out subjects strongly prefer profit from pain to themselves, not to others. Indeed, putting subjects into a brain scanner while the choices were made showed that there was no activity in brain’s pleasure centres associated with gain at another’s expense (unless, by the way, the gain flowed to a good cause – that’s a whole other conversation).

We have a deep desire to help and support each other, and certainly not to profit from the pain of others. Yet, as the refugee donations example illustrates, as that link becomes more abstract, this desire can easily get lost. It is a key challenge for those in shaping healthcare, whether patients, relatives or clinicians, to build a system that can harness and foster this capacity to help ourselves and each other – of ‘realising the value’ that our common humanity and connection can bring.