Will we be a healthy bunch in 2050?

Could this really be the life that lies ahead just 45 years from now?

If we look at trends in the health of our community there is no doubt that much has improved. However, there are some problems that we can't just sit on our hands and wait to happen. There are three areas that have to be addressed now. They are declines in our sense of connection and belonging, declines in our incidental activity and the growing inequality between the haves and the have-nots.

The number of socially isolated people in Australian society is growing and the consequences are dire. We know that those who are socially isolated die at two to three times the rate of those with good social networks.

We need to reaffirm existing clubs, associations and organisations and look to establishing new ones that provide greater opportunity for those that have the most need for belonging and participation.

We need “take away” sports and recreation for those that don’t have time or the inclination for more structured sport. We need more inventive opportunities for those with disabilities to participate.

The second area that requires our attention is the activity that we use to carry out our daily lives. It is diminishing. But it disappears silently. There is no fanfare.

Technology has reduced the need for us to exercise, to use calories. We are a highly car-dependent nation, so we take the car from home to office, use remote controls to operate appliances at home and out-source menial but energy expending tasks at home. As in Colin and Britney's home, life will be virtual - no need to go walking in the neighbourhood - you'll be able to do it on a treadmill at home surrounded by one of 3,000 downloadable landscapes.

Britney is worried that her great-great-great grandchildren will look different. She predicts they will all have pin-heads, big bottoms, and over-sized index fingers to drive all the new technology.

For the first time in human history, children are becoming sedentary. They are driven to school because of concerns about safety, they play computer games, and they are less likely to engage in spontaneous activity in the schoolyard and neighbourhood streets. A case in point is the high degree of association between television watching and obesity in children. I say throw away the remote control and bring back the knob on the television. Better still, we could introduce “pedal television” - it both reduces the amount of television watched and reduces obesity.

The third, but no less important area requiring our attention is the increasing gap between the haves and the have-nots. Although we would like to think otherwise, we are by no means an egalitarian, nor are we a classless society.

Those in areas of greater socio-economic disadvantage rate their health more negatively, and have higher rates of sickness and death, as well as higher risk factors such as smoking, high levels of alcohol and low levels of exercise. They have lower life expectancy and make more use of primary care services but less use of preventive health measures.

There is an inverse care law - that is, those with less get less, and those with more get more. The inverse care law can be implicit in public policy, such as the provision of public transport and public sporting, cultural and recreational amenities. It can also be apparent in private sector policy, such as the availability of healthy food, the placement of supermarkets and investment in private housing.

Those with poorer health are often blamed for it, but there are in-built biases at work. It is often a less than subtle form of exclusion and marginalisation, which we know all lead to poor health.

As we look to the future, there is much to be optimistic about. But to justify that optimism we need the political and civic leadership to focus on the symbolic and real organisational changes that enhance our social cohesion. We need leaders who will strive for a more productive Australia at the same time as striving for a more equitable distribution of our collective resources. And the reason is not political or even moral - it’s about having good health.

We need a philosophy of tolerance and inclusion, so that when we talk about being a networked community there is more than fibre-optic cables joining us together.