Today’s Stress, Tomorrow’s Co-Pay
You make a bunch of choices every day that affect your health. Did you get enough sleep last night? Will you do work today that feels meaningful? And it’s not just your choice of actions, but how you feel about what happens around you. Will the traffic on the way to work stress you out? Will you appreciate the picture your daughter drew for you? The answers to these questions don’t just affect how you feel, but your body’s inflammation levels and, therefore, your health.
The science tells us that within weeks, heightened stress can trigger inflammation and overwhelm the mind and body, ultimately overflowing into the healthcare system as headaches, chest pain, stomach upset, and more. This is especially true if you’re in a state of low resilience. Over time, if inflammation goes up more often than it comes down, you’ll be on the same path to chronic disease as millions of others. When you consider how your own daily life affects your health, imagine what it’s like for people with more stress, lower resilience, less money, and worse relationships. It’s no surprise that disease rates and healthcare costs are spiraling upwards.
The inflammatory process is highly responsive to psychological constructions of how you experience, interpret, and interact with the world, for both good and ill.
Jin, H., Li, M., Jeong, E., Castro-Martinez, F., & Zuker, C.S. (2024). A body-brain circuit that regulates body inflammatory responses. Nature, 630(8017), 695–703.
Maladaptive social circumstances and interactions can culminate in significant mental health issues, with stress and inflammation as mediators.
Slavich, G.M., & Irwin, M.R. (2014). From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychological Bulletin, 140(3), 774.
A huge majority of people suffering from stress-related problems seek help through primary care, sometimes constituting up to 70% of physicians’ caseloads.
Stahl, J.E., Dossett, M.L., LaJoie, A.S., Denninger, J.W., Mehta, D.H., Goldman, R., Fricchione, G.L., & Benson, H. (2015). Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. PLOS One, 10(10), e0140212.
Systemic chronic inflammation is driven by unhealthy lifestyle habits around diet, physical activity, and stress, which all can increase risk for chronic disease.
Furman, D., Campisi, J., Verdin, E., Carrera-Bastos, P., Targ, S., Franceschi, C., Ferrucci, L., Gilroy, D.W., Fasano, A., Miller, G. W., Miller, A.H., Mantovani, A., Weyand, C.M., Barzilai, N., Goronzy, J.J., Rando, T.A., Effros, R.B., Lucia, A., Kleinstreuer, N., & Slavich, G.M. (2019). Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 25(12), 1822–1832.
Dialogue Is a Pre-Requisite for Change
Almost every choice you make starts with a dialogue: most often in your head, sometimes with others. You talked to yourself while you were picking an entrée off the menu. You talked to a friend before taking that new job. These conversations, internal or external, have a huge impact on not just your health, but your life.
Nearly all of our choices—and thus nearly all of our health—can be traced back to the conversations we’ve had. So, what if you had a way to make sure you were participating in helpful and healthy conversations as much as possible—ones that built up your resilience? And what if the solution didn’t just help you, but everyone, including people who are struggling even more than you?
This is Lore.
It's common for people to be full of good intentions to improve their lives, but most of the time they need something more to turn those good intentions into actual change.
Sheeran, P., & Webb, T.L. (2016). The intention–behavior gap. Social and Personality Psychology Compass, 10(9), 503-518.
The simple act of verbalizing what emotion we’re experiencing can reduce threat-response activity in our brains and calm our nervous systems.
Lieberman, M.D., Eisenberger, N.I., Crockett, M.J., Tom, S.M., Pfeifer, J.H., & Way, B.M. (2007). Putting feelings into words: affect labeling disrupts amygdala activity in response to affective stimuli. Psychological Science, 18(5), 421–428.
Words don't just influence our emotions—language processing engages the brain in ways that regulate the cardiovascular system and even primes the body for action.
Van der Ploeg, M.M., Brosschot, J.F., Verkuil, B., Gillie, B.L., Williams, D.P., Koenig, J., Vasey, M.W., & Thayer, J.F. (2017). Inducing unconscious stress: Cardiovascular activity in response to subliminal presentation of threatening and neutral words. Psychophysiology, 54(10), 1498–1511.
Pulvermüller F. (2005). Brain mechanisms linking language and action. Nature reviews. Neuroscience, 6(7), 576–582.
The spread of information and behavior between community members can facilitate shared health outcomes, in much the same way the spread of infectious pathogens can spread health outcomes.
Zhang, J., & Centola, D. (2019). Social networks and health: new developments in diffusion, online and offline. Annual Review of Sociology, 45(1), 91–109.
Social isolation and loneliness are at the heart of numerous health-related problems. Often, meaningful progress on health issues isn't possible until loneliness is addressed.
Cacioppo, J.T., & Cacioppo, S. (2018). The growing problem of loneliness. The Lancet, 391(10119), 426.
Lore: The Right Conversation, the Right Change
Lore gives people a way to preemptively care for themselves through therapeutic conversations that make it easier for them to take control of their choices, build resilience to stressors, and improve their overall health. Here's how it works:
- Solution-Focused: Lore uses Solution-Focused Brief Therapy (SFBT), a proven approach that helps people identify their strengths and create solutions. By fostering agency, Lore empowers people to take charge of their well-being.
- Engaging: Lore is user-friendly and enjoyable, turning the process of self-care into a natural conversation with a personal AI reflection partner and other people in the Lore community.
- Rewarding: Positive feedback shows people they’re on the right path. Lore rewards users with points convertible to cash, bridging the gap until their hard work pays off.
- Dynamic: Lore adapts to each person’s unique journey through personalized conversations. Available 24/7, LoreBot serves as a sounding board for tackling whatever’s going on.
- Value-Based: 100% of Lore—including all cash rewards—is paid for via the reduction in the healthcare costs of its users. If healthcare costs are not reduced, Lore refunds all fees.
The feeling of well-being is a more expansive way of thinking about health, and the components of well-being—awareness, connection, insight, and purpose—are not fixed and can be cultivated through training.
Dahl, C.J., Wilson-Mendenhall, C.D., & Davidson, R.J. (2020). The plasticity of well-being: A training-based framework for the cultivation of human flourishing. Proceedings of the National Academy of Sciences, 117(51), 32197–32206.
Eudaimonic well-being—which is based on meaning, self-realization, and connection—has powerful effects on mental and physical health and the ability to pursue and achieve personally important goals.
Ryan, R.M., & Deci, E.L. (2001). On happiness and human potentials: A review of research on hedonic and eudaimonic well-being. Annual Review of Psychology, 52(1), 141-166.
Solution-focused therapy can improve fatigue, quality of life, and medical costs for people faced with chronic disease.
Vogelaar, L., Van't Spijker, A., Vogelaar, T., van Busschbach, J.J., Visser, M.S., Kuipers, E.J., & van der Woude, C.J. (2011). Solution focused therapy: a promising new tool in the management of fatigue in Crohn's disease patients psychological interventions for the management of fatigue in Crohn's disease. Journal of Crohn's & Colitis, 5(6), 585–591.
Small changes make a big difference. For example, even among people who don’t deliberately exercise, short bouts of vigorous physical activity throughout the day are associated with reduced cancer risk and mortality.
Stamatakis, E., Ahmadi, M.N., Gill, J.M., Thøgersen-Ntoumani, C., Gibala, M.J., Doherty, A., & Hamer, M. (2022). Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality. Nature Medicine, 28(12), 2521+.
Developments in artificial intelligence make care models viable that would previously have required an impractical number of human experts.
Yu, K.H., Beam, A.L., & Kohane, I.S. (2018). Artificial intelligence in healthcare. Nature Biomedical Engineering, 2(10), 719-731.
Scientific Advisory Board
Amy Abernethy, MD, PhD
Russ Altman, MD, PhD
Nick Christakis, MD, PhD, MPH
Isaac Kohane, MD, PhD
Amy Abernethy, MD, PhD
Hematologist/oncologist and palliative medicine physician who co-leads an organization focused on dramatically accelerating timelines for understanding what clinical interventions work for whom and when. Her areas of research and expertise include cancer data, real world evidence, clinical trials, healthcare policy and regulation, health services research, patient reported outcomes (PROs), clinical informatics, and patient-centered care. Amy was professor of medicine at Duke, principal deputy commissioner of the FDA and chief medical officer at Verily and Flatiron Health.
Russ Altman, MD, PhD
Researcher focused on using computational methods (AI, data science, informatics) to address problems relevant to medicine with a focus on understanding drug actions at molecular, cellular, organism, and population levels. Russ helps lead an FDA-supported Center of Excellence in Regulatory Science & Innovation and is the Kenneth Fong Professor of Bioengineering, Genetics, Medicine, Biomedical Data Science, and (by courtesy) Computer Science at Stanford University.
Nick Christakis, MD, PhD, MPH
Physician and Sociologist who conducts research in the areas of social networks and biosocial science. He is the Sterling Professor of Social and Natural Science at Yale University, where he directs the Human Nature Lab. He is the co-author of the book Connected, a foundational work on social networks and their influence on our everyday lives, and the New York Times bestseller, Blueprint: The Evolutionary Origins of a Good Society. Nick’s portrait is based on a photo courtesy of Big Think.
Isaac Kohane, MD, PhD
Clinician who develops and applies computational techniques to address disease at multiple scales: from whole healthcare systems as “living laboratories” to the functional genomics of neurodevelopment. Zak is Chair of the Department of Biomedical Informatics and the Marion V. Nelson Professor of Biomedical Informatics at Harvard Medical School.