“The No. 1 driver of mortality isn’t alcohol, nutrition, smoking or physical inactivity, it’s social stress, … and that’s predominantly driven by isolation,” says James Maskell, founder of Evolution of Medicine and creator of Functional Forum—the world’s largest functional medicine conference. “Everyone seems to agree that it’s a problem, but it’s not accompanied by any sort of real solution.”

According to Maskell, we are all living through the most socially isolated era in human history, and it is driving lifestyle-driven chronic disease—long-lasting health conditions, such as autoimmune diseases or Type 2 diabetes—that make up 86 percent of health-care costs in America. Pair this rise in chronic disease with a pharmaceutical-first approach and poor lifestyle habits, and it’s no wonder Americans are struggling to pay for or get to the root cause of these preventable illnesses. Thankfully, Maskell is determined to provide a solution to America’s health-care crisis.

Maskell was born on a commune in Loveland, Colorado, and grew up in communities in England and South Africa, where his parents were from. And while he admits that his upbringing may have been a little unorthodox, what he realized through his early-life experiences was that being an active and engaged member of a community actually keeps you healthy.

“All the way through my health-care endeavors, community has been the No. 1 theme,” Maskell says. “We see that most people are lonely, and that’s such a strong factor in disease, eventually they end up in the medical system. … The cross section of functional medicine and community is where I’m really passionate, and that’s where I think the biggest transformation can happen in health care.”

After receiving a degree in health economics in the U.K., Maskell returned to the United States on a mission to transform the health-care system. Recognizing that the problems occurring under the current health-care paradigm are systematically insurmountable and unsustainable, Maskell is attempting to flip the system on its head through functional medicine and a new way of delivering it … in groups.

Functional medicine, Maskell explains, is a different way of viewing the patient-doctor relationship. In conventional medicine, oftentimes patients are given a prescription for an ailment without knowing the cause of the issue and follow the doctor’s orders. But with functional medicine, doctors have been trained to look for the root cause of the symptoms, employing a more holistic approach to the diagnosis process, which ensures that the patient is the most important person in the room, charts their whole health history and empowers them to take charge of their own health and participate in reversing their condition. Just last month, a landmark study came out in the Journal of the American Medical Association showing, for the first time, functional medicine has better outcomes than conventional family medicine.

“Typically, there is an empowering moment where a health practitioner finally listens to them, fully,” Maskell says of functional medicine practices. “What I realized is that if we could facilitate this experience for everyone, true transformation could occur.”

Maskell’s first business, Evolution of Medicine, helps health professionals to implement community-focused functional medicine in their practices. This came off the back of creating the Functional Forum, the world’s largest functional medicine conference with more than 400 worldwide meet-up groups watching his monthly livestreamed web show.

More and more quickly each year, functional medicine is catching on (there’s a functional medicine practitioner in every ZIP code in America, thanks in part to Maskell’s efforts), yet there still remains the problem of cost and access because most of these practitioners don’t take insurance, nevermind Medicare or Medicaid.

In 2015, Maskell gave a TEDx talk with a theme that “community, not medicine, creates health,” showcasing a very new concept—the “functional medicine group visit.” Imagine that instead of doctors seeing a new diabetic patient every seven minutes all afternoon, why not put them in a group of 20 and spend 90 to 120 minutes with them all together.

After a visit last year to the Cleveland Clinic’s Center for Functional Medicine, where he saw them running a new 10-week group program called “Functioning for Life” and doing it all on insurance, Maskell realized this was an idea whose time had come. Now not just small practices could adopt that, but whole health systems also could jump on board.

This year, Maskell spent a year interviewing everyone in medicine who had run group visits for a special series on his podcast, and he is now turning it into a new book called “The Community Cure: Transforming Health Outcomes Together” (Lioncrest Publishing), which comes out January 14, 2020.

This idea isn’t totally new. Groups have been used in addiction for decades, but there’s a “special magic when you deliver something empowering like functional medicine in a group setting,” Maskell says. Participants not only make new friends in the group with people suffering with similar issues, but it also provides the right accountability structure for participating in health—what you eat, how you exercise, how you combat stress and more. Beyond that, people will often open up more to others with the same condition than to a professional.

“Whatever is worth doing for yourself, it’s much easier to sustain if you can do it as a community,” Maskell says. “That’s why going to gyms, knowing other people in the gym and working out together is such a powerful force. And that’s why the future centers for health creation, I believe, will be gyms. … That’s where health is actually being created, not in a doctor’s office.”

Although the medical system is the right place to start to roll out these solutions, Maskell believes the most exciting models are happening outside health care—in churches, homes, gyms, offices, community centers—where people actually are.

“We need more health,” he says. “That’s why it’s up to communities to deliver that, not doctors. And that’s why it starts with empowered consumers.”

Photo credit: Todd Cribari, inspirostudio.com