The renowned Canadian physician Sir William Osler once remarked, "A good physician treats the disease, a great physician treats the patient who has the disease." But in truth, the best physician understands that health extends beyond the individual, encompassing their entire environment. Humans are direct reflections of their local, sociopolitical, sociocultural, and ecological surroundings, and those surroundings are the result of our collective actions and interactions.
The structures of our modern society, with all its ostensible progress, has come to embody both the source and sustainer of our collective ailments. The conveniences and comforts that we’ve constructed—sedentary lifestyles, nutritionally barren diets, hollow social media connections, and superficial spirituality—are at odds with the natural conditions under which Homo sapiens evolved. We inhabit a paradoxical reality where our technological and medical advances often deepen, rather than alleviate, our suffering.
What if the surge in mental health crises, chronic diseases, and even pandemics stem from a common root cause? Rather than merely treating symptoms, we must confront the unsettling possibility that modern society itself is the root cause that fuels our collective decline. This idea calls for a shift beyond the reductive philosophies that have governed science and medicine since Descartes and Newton. We need a nuanced, holistic approach that considers biological, psychological, social, and spiritual dimensions if we are to understand the true origins of our modern afflictions.
Just as gerontology has shifted its focus from treating individual age-related diseases to addressing the entire processes of aging itself, we must ask not only how we can treat disease but how we might prevent the conditions that lead to all diseases. Our current state—a life of constant stress, shallow connections, and relentless pursuit of material gains—reflects a profound disconnection from our evolutionary roots. Only by realigning our lives with our natural needs can we break free from this self-sustaining cycle of disconnection and disorder and begin the journey toward true health and wellness.
The Evolutionary Mismatch of Today’s World
Our modern environment is an aberration—a manufactured landscape that bears no resemblance to the world for which our species evolved. This evolutionary mismatch—that is, the discord between the environments our ancestors adapted to and the radically different world we inhabit today—permeates nearly every facet of our lives.
Our genes, shaped over millennia to thrive in small, close-knit, egalitarian hunter-gatherer societies, now struggle to adapt to the rapid changes wrought by technological and sociopolitical advancements. The root cause of our contemporary suffering—from soaring rates of mental illness, addiction, and suicides to climate change, political instability, and environmental degradation—can be traced to this very mismatch. Our modern existence, with its concrete jungles and pervasive individualism, is a poor fit for the beings we were naturally selected to be.
Let’s first dispel the myth that our ancestors endured anything close to resembling a short, nasty, or brutish life. Contrary to the narrative that paints the past as a Hobbesian nightmare, anthropological data shows that those who made it past childhood often lived well into their 60s or 70s. In fact, recent data from the U.S. suggests our lifespans are now stagnating, if not declining, for the first time in modernity—a troubling statistic for those who champion modernity as the peak of human progress.
Equally misguided is the assumption that prehistoric humans were perpetually starving. Studies of hunter-gatherer societies reveal that food was abundant and more nutritious than the highly processed fare of today. Mark Nathan Cohen, in Health and the Rise of Civilization, points out that even the most impoverished hunter-gatherers enjoyed better diets than many in urbanized societies today. The prevalence of high-calorie, nutrient-poor foods in our modern diets has given rise to a different kind of plague: obesity, diabetes, and heart disease. What once was a survival mechanism—our craving for calorie-dense foods—has become a liability in an era of overabundance.
Then there’s the matter of physical activity. While our ancestors might have spent a few hours each day engaged in active pursuits such as hunting, gathering, and preparing food, we now spend our days seated in front of screens, motionless and disconnected from our natural environs. James Suzman’s Work: A Deep History highlights that early humans only “worked” for about two to three hours a day, and much of it was physically rewarding, unlike the sedentary slog of modern cubicle life as best exemplified in the movie Office Space. The stark contrast between these dynamic, meaningful activities and the sedentary drudgery of modern labor is enough to drive any human to smash a thousand dysfunctional printers, let alone trigger an explosion of chronic diseases—from cardiovascular issues to musculoskeletal disorders—that our ancestors would hardly recognize if they were alive today.
Our disconnection from the natural world extends to our health in other ways. Non-communicable diseases like cancer and heart disease, which are rampant today, were virtually unknown to our ancestors. As psychologist Christopher Ryan argues in Civilized to Death: The Price of Progress, many of the diseases that plague us now are the direct result of modern lifestyles. Consider the case of breast cancer: today’s women experience far more ovulatory cycles than their ancestors, not because of changes in our genetic or epigenetic chemistry, but due to societal changes in diet, reproduction, and chemical exposure. Hormonal fluctuations caused by modern pollutants, including microplastics and endocrine disruptors in our food, water, and household products, have spurred rates of breast cancer previously unheard of.
Infectious diseases, too, are a product of our overcrowded, domesticated modern existence. While zoonotic diseases (e.g., coronavirus, cholera, plague, tuberculosis) are a constant threat in today’s densely populated cities, they were virtually nonexistent in prehistory. Our nomadic ancestors who lived in smaller groups simply didn’t face the same risks of widespread contagion as we do today. The rise of zoonotic pandemics like COVID-19 is a direct result of the evolutionary mismatch between our biological heritage and our current way of living. As global population sizes soar past sustainable limits, we can expect pandemics to become more frequent, not less.
And then there’s our mismatch between the sociopolitical landscape of our ancestors versus the bureaucratic BS that we have to tolerate today. Our ancestors lived in small, egalitarian groups where social bonds were vital to survival. In these communities, prosocial behaviors flourished, while antisocial or sociopathic behaviors were easily discarded by the selective sieve of the group. Today, we live in atomized, anonymous societies where disconnection has become the norm. As war journalist Sebastian Junger points out in Tribe: On Homecoming and Belonging, modern individualism has left us more isolated and alienated than ever before, and this sense of disconnection is at the root of our spiraling mental health crisis. The expansion of our social structures from small close-knit egalitarian societies to vast nation-states has eroded our communal bonds, leaving the lone individual feeling more helpless than ever before. And despite the hallow promises of digital connectivity in our increasingly globalist world, our social relationships are often shallow and unsatisfying, lacking the depth and emotional intimacy that defined human interactions for most of our evolutionary history. We, as a species, are running out of emotional and mental capacity because we’re forcing ourselves to do things individually that were meant to be done as a collective.
Yet perhaps the most insidious of all our evolutionary mismatches is spiritual. Our ancestors’ spiritual practices were deeply intertwined with the natural world, offering a sense of meaning and connection to natural forces that were greater than ourselves. Today’s spiritualities often feel commercialized and fragmented, disconnected from our natural predilections to view all life as kin. It’s no surprise that many of us are left with an aching sense of emptiness. The spiritual void of the modern world is a deeper and direct reflection of our disconnection from Nature over the past 12,000 years, and without a return to more authentic, ecospiritual practices of our ancestors, we will continue to feel this alienation—this sense that something is profoundly missing in our modern lives, wherever we go, wherever we look.
The evolutionary mismatches that define modern life are not isolated quirks of our time—they are the very foundation of our current malaise. To understand the root causes of our suffering, we must acknowledge that the world we have created, in all its technological glory, is simply not the world we were built to thrive in. If we are to heal, both individually and collectively, we must reckon with the ways in which modernity has strayed from the paths our ancestors trod, and find a way back to a life more in tune with the species we evolved to be.
Introducing The Bio-Psycho-Socio-Spiritual Framework: A Holistic Approach to Medicine
If the root of our modern maladies lies in our collective disconnection from our evolutionary heritage, then the remedy must be equally comprehensive. Enter the biopsychosociospiritual framework—a holistic approach to medicine that integrates biological, psychological, social, and spiritual dimensions of human illness and disease. This perspective offers a more nuanced and pluralistic understanding of health, one that recognizes the complex interplay between our physical bodies, mental states, social and natural environments, and spiritual lives.
A biopsychosociospiritual approach demands that we reconsider our lifestyles, societal structures, and spiritual practices. It calls for a return to more authentic ways of living—ways that honor our evolutionary design and promote a balanced, fulfilling existence. This means adopting diets that align with our ancestral frames, stressing social connections that are genuine and supportive, rebuilding our communities and renovating our unnatural social systems, and embracing spiritual practices that resonate with those of our ancestors (i.e., ecospiritual traditions maintained in extant Indigenous populations today).
The audacious quest for a Theory of Everything in modern medicine is not merely an intellectual exercise but reflects a necessary paradigm shift in thinking about the complete causal field of human illness and disease. Big, long-term solutions require big, long-term thinking. By identifying the root causes of our modern afflictions, acknowledging the profound evolutionary mismatches that abound in modern society, and embracing a holistic framework for medicine, we can begin to address the underlying issues that perpetuate our collective suffering across cultural and national boundaries. Such a comprehensive perspective offers not just a remedy for our ailments but a path to a more harmonious and meaningful existence lived in harmony with the rest of life. Yet the challenge before us is not merely to treat symptoms but to fundamentally realign our lives with the essence of what it means to be human. In doing so, we may yet find a path to true health and well-being in a world that is becoming more unrecognizable and unfamiliar with each passing day.
