While some risks for disease like our genetic make-up cannot be modified, many risks are amenable to reduction. The major modifiable risk factors for the modern plagues are outlined: our body mass index and obesity; our levels of physical activity; and degrees of social isolation. While infections spread through a population owing to the transmission of a physical disease agent, research shows that modifiable risk factors like obesity spread via social networks. These modifiable risk factors all arise from modern ways of life. This term is preferred to ‘lifestyle’ which implies that way of life is a matter of individual choice. This chapter looks at the definition of obesity, its prevalence and its transmission through social networks. It considers historical change in the prevalence of physical activity and recommendations on optimal levels of such activity, the rise of social isolation, and the risks that arise from the current modern way of life.

Diagnosis of one of the modern plagues is simply the beginning of the accumulation of disabilities at the end of healthspan. Other long-term conditions – including more than one modern plague - tend to arise after the diagnosis of the first one. Individuals must endure successively increasing numbers of long-term conditions. Diabetes is associated with increased risk of heart disease and damage to nerves, kidneys, eyes and feet. Conversely, smoking, alcohol and pollution are among the risk factors for the modern plagues.

Charting the response by authorities since the 2011 ‘riots’ following the killing of Mark Duggan, Adam Elliott-Cooper assesses the ways in which Black lives and culture have been pathologised as potentially dangerous through the policing of the Nottingham Hill Carnival and drill music. The chapter takes influence from Stuart Hall’s notion of ‘moral panic’ in his 1978 book Policing the Crisis in relation to what was then presented as a specific problem of ‘mugging’ within Black communities by presenting the four stages of moral panic. Taking the reader on a journey through the way the media, politicians and the general public have responded to drill music, the chapter goes through their shock, anger, sadness and finally acceptance of the cost that must be borne by Black communities through increased profiling and policing. While Elliott-Cooper is a scholar resisting racism, he simultaneously cannot escape its violence as he demonstrates how he is expected to condemn his own communities in the process of calling for alternative ways of understanding cultural forms of expression. Although providing a critique of public policy and the development of what the author calls public safety racism, it also operates as an important autho-ethnographic account of the complex ways in which racism operates in the UK.

Implementing Systems Prevention requires a re-examination of the meaning of ‘health’. A positive definition is needed to replace the negative definition (absence of disease) that is common currency. Political philosophy provides this positive definition. Lawrence Hamilton is concerned with the role of values versus the role of needs in democratic discourse. He recognises that human needs change and he describes some basic categories of these needs. He equates ‘health’ with satisfaction of these needs. In this chapter, these needs are discussed using insights from biology and ‘health’ is redefined as the optimal satisfaction of these needs. The needs are contrasted with definitions of health by the World Health Organisation.

Epidemiology aims to understand, prevent and control diseases and conditions that affect populations of plants, animals or humans. Its method rests on observation and action. When applied to a health problem it leads to conclusions on prevention. The father of epidemiology, John Snow, used his observations to advocate actions by government that he predicted would curtail a major cholera outbreak in Victorian London. However, this experimental approach was soon abandoned so that, today, epidemiology has become primarily an observational science. The case is made for the rebirth of epidemiology combining observation and experiment.

The Covid-19 pandemic provides contemporary evidence on the parallels between ending an infectious pandemic and ending pandemics in the modern plagues.

Reflecting on his own personal experiences in being asked to condemn terrorists, Asim Qureshi begins the volume by detailing the psychological and physiological trauma that accompanies these moments. These personal reflections are placed in a wider context of a culture of condemnation – where routinely Muslims and Black gangs are expected to condemn the violence some choose to associate with their communities. The Introduction seeks to enter into a conversation between all of the contributed chapters to identify a few key themes that speak to their collective experience. While the chapters largely focus on the contemporary experiences of the authors, a number of them explicitly reference how the history of colonisation and empire is directly relevant to current discourses, particularly in relation to the ubiquity of ‘Whiteness’ as a system of violence and power. The underlying racism of society has been transformed into a form of ‘public safety racism’ as the authors evidence how communities are placed within a threat matrix. This matrix brings with it an expectation for those very communities to condemn their own, the central concern of all the contributors – who feel caged by this expectation. The chapters highlight how those who hail from these communities at times engage in acts of performance in order to pander to demands of those who expect condemnation – a form of betrayal through public performance – but what these scholars and activists demonstrate through their lived experience is a genuine praxis of resistance.

‘It’s not the Negro problem, it’s the white problem. I’m only black because you think you’re white.’ – James Baldwin It is the age of the ‘Muslim problem’ which connotes the multitudinous ways the dress, eating habits and sexual preferences of Muslims have come to represent an immediate and present threat to Western civilisation. Pre-emptive counter-terrorism policies invite Muslims to take responsibility for acts of violence committed by others and to reform their communities under the mighty weight of state security apparatus and the judgement of wider society. However, it is James Baldwin’s insistence on the disease of Whiteness that mutilates and stunts the lives of African Americans – and what his words can teach us today – which is the point of departure for this chapter. In 1963, Baldwin wrote a letter to his nephew on the one hundredth anniversary of emancipation imploring him to recognise the reality of being rejected by the society into which he was born and to resist internalising the reasons for the vicious degradations White America visits upon its Black populations. This chapter continues in this vein. It was written following an attack by a White supremacist on two mosques in New Zealand, who ended fifty Muslim lives. It is written for the people who Nadya Ali thinks of first when violence is unleased against Muslims: her nieces and nephews. The chapter is a howl against this inheritance bestowed upon them and from which we, their elders, cannot seem to protect them. It is also a manifesto of resistance of how to live and thrive in a world which despises, shuns, incarcerates and kills Muslim life. It is about the centrality of love for survival and possibilities for political transformation.

By considering health as the status of an individual when their needs are optimally satisfied, it becomes apparent that health cannot be the responsibility of a specialised arm of government. It needs to be the driver of public policy as a whole. This general principle finds its roots in Cicero and has been endorsed by political philosophers of the Enlightenment. The limited successes are discussed of an untheorized Systems Prevention in some modern institutions (Public Health England, the Health and safety Executive and the NHS Health Check). Research projects that might be the basis for Systems Prevention are described. The authors describe their own research experience that underpins the plea of this book to deliver Systems Prevention consciously. This experience includes work on developing the infrastructure required for health improvement.

This chapter summarises the book’s messages and proposals for change. The Health Society relies on a consensus that ‘your health is my health’. Achieving that consensus requires the countering of objections. These are considered and their weaknesses exposed. Synergy is noted between health as needs-satisfaction and action against global heating.

This chapter takes a personal and historical account of Cyrus McGoldrick’s evolution on the issue of condemning Muslim violence. He looks back at ten years of appearances in American and international media, and how his confidence and strategy shifted as he studied Muslim history and as history was made around him. Breaking onto the scene as a newly reverted hip hop artist, he was such a novelty that the media treated him gently, not even analysing his lyrics. As he began organising New York’s Muslim communities against government surveillance and war, the media came to treat him with increased interest and suspicion. His advocacy for Muslim political prisoners was construed as showing sympathy for terrorism, turning him into an open enemy. The last decade of McGoldrick’s life has been focused on learning, practising and teaching. As he has tried to maintain his community work, and study, he expresses an understanding of the lived and narrative weaknesses underpinning the political naivety of Muslims in the Western world. Rather than respond reflexively or even defensively to the pressure to condemn Muslim violence in the world, might it be possible to take the opportunity to convey our message with clarity and confidence? In the end, after all, it is Allah who condemns.

This chapter illustrates how observational epidemiology has recognised the breadth of sources of risks to health. This breadth is captured in the word ‘exposome’: the sum total of exposures to sources of risk. The development of concepts is described as to how living systems maintain their equilibrium and how this equilibrium may be disrupted. This equilibrium – or homeostasis – is illustrated by considering the role of glucose. Research in understanding mechanisms for homeostasis is described but caution is expressed on the limited value of genetics in addressing disruption of equilibrium.