What Can We Do to Improve Our Health?
- brodavefla
- 10 hours ago
- 10 min read
David Cox RN BSN
Our Health—the News is Not Great
If you asked most people, they would say they’d love to have some improvement in their health. Recent trends in the health of Americans show that there’s a lot of improvement needed! We’re spending lots of money on healthcare, but the results leave much to be desired.
As of the most recent data (2022–2023), the United States spends significantly more per person on healthcare than other high-income, Westernized nations—often nearly double or more. And yet, our health outcomes (real changes in a person’s health due to specific medical treatments) are not as good as those of other nations. For instance, average life expectancy for Americans is a good three to four years less than those other Westernized nations.
Where is all the money going?
Where is all the money going? Why does it seem like we’re not getting our money’s worth for all those expenses? A closer look at some of the data will help explain.
While only 10-20% of health outcomes, including premature death, are influenced by healthcare, 30-40% are caused by lifestyle related issues. And this goes both ways. Healthy lifestyle choices, such as regular exercise and adequate sleep, improve health outcomes, while unhealthy ones, such as smoking and problem drinking, make for worse outcomes.
The Centers of Disease Control (CDC) reports that “chronic diseases—such as heart disease, cancer, and diabetes—are responsible for 7 of 10 deaths in America each year and account for 86% of healthcare costs.” And most of these chronic diseases are linked to what are called modifiable risk factors, activities that are usually within a person’s control, such as tobacco use, too much alcohol use, stress, lack of physical activity, and poor food choices.
A 2018 report by the Milken Institute found that the direct cost of treating chronic diseases due to unhealthy behaviors, like poor diet and lack of exercise, was $1.1 trillion annually. Lost economic productivity (people off work for illness or hospital stays) added another $2.6 trillion, for a total impact of an astounding $3.7 trillion per year.
What To Do?
Anyone who hopes to see people have their best health will have a list of the “usual suspects”—tobacco, alcohol, junk food, and others, things well-known to cause chronic health disease. To stop the chronic disease the bad habit causes, people just need to do the opposite:
o Stop smoking
o Stop eating junk food
o Stop drinking alcohol
o Stop drinking sugary drinks
o Exercise more
o Lower stress levels
Just do a few simple things, change a few habits, and things will get better, right? Seems simple enough. Although all these recommendations are good, and many if not most people are aware of them, this “thou shalt not” strategy hasn’t worked.
People often know what to do, but they have a hard time actually doing what they know they should do. Why is that? There is something in human nature that resists being told what to do. This shows up in people at a very early age, as anyone who has spent a day with a toddler can tell you.
The Ability to Choose
And yet, most of us are not toddlers! We can CHOOSE, including choosing to improve our health by changing the way we live. No one HAS to smoke cigarettes, for instance, and there is much help available in our health system to help people to quit, if they CHOOSE to do so. Also, people who have diabetes or are overweight don’t HAVE to drink sugary drinks or overeat, but can CHOOSE not to.
But, you say, how can I do that? Maybe I like some of those things, even though I know they might be harmful to me in the future. How can I change my beliefs about myself and my health?
No human being is born in control of their circumstances. We first learn how to handle life from our parents or others who have raised us, then from teachers, coaches, or other role models. Some of us learned that we could choose to take charge of certain parts of our lives and shape them to bring about the kind of life we thought best. Others of us learned to always depend on other people to provide and make things happen for us. Still others were taught that whatever happens in life is just a matter of fate and not subject to anyone’s control or influence. It’s easy to see that each of these three life paths can produce big differences in your health, as well as your relationships and your work life.
Another helpful human trait is adaptability. We don’t have to stay with whatever bad habits we’ve learned. We can CHOOSE to improve our health and other aspects of our lives by being self-directed. What does it mean to be self-directed? Basically, it means that we can CHOOSE (there’s that word again!) to follow a different path, a better path, instead of being passive and following the crowd.
If we learned those bad habits, we can in turn learn better habits to replace the bad ones. Being self-directed is a learnable skill. And like any skill, it takes practice. It doesn’t happen at the snap of your fingers! The results are well worth the time and work it may take. But how do you start?
1. Build Your Self-Awareness—What is Most Important to Me?
Most of us have gotten into some bad habits in life that, if not causing problems today, may do so tomorrow. Not paying your rent or utility bills will keep more money in your account today, but will surely bring big problems in the future.
With your health, you may be someone who has been told by your doctor that if you don’t get your eating habits under control, your diabetes will get worse, and you can look forward to problems with your heart, your blood vessels, your mobility, even your sex life! Or maybe your doctor told you that if you keep smoking, it will worsen your breathing and your heart problems, and you may not live long enough to see your grandkids graduate from high school.
The first step in building self-awareness is to ask yourself, “what is most important to me?” Is it to always be around for your family? Or perhaps to start a family of your own if you haven’t already? Maybe you want to run your first marathon, to take that trip to Iceland you’ve been dreaming about, help with the grandkids, or just to live to a healthy old age. Any of these goals can be important motivators for change. Any of these possible future results may be enough to motivate you to change. Find the ones that pull on your heartstrings the most.
People turn their lives around all the time by CHOOSING to do so. Why not you?
NEXT STEP—Ask yourself: What do I care about? What would I feel really bad about if I couldn’t do it because of my health?
2. Decision Time—what one bad habit am I going to stop, what one good habit am I going to start?
In my days of providing Annual Wellness Visits for Medicare patients, I spent a lot of the time reviewing all existing health issues each patient had, along with maybe learning about some new ones that we didn’t know about. But whether the person I was seeing had one health problem or six, I almost never advised them to go out and work on more than one problem at the same time. I couldn’t go out and do that, and it was not reasonable to expect others to do so. One problem at a time is enough. By trying to take on more issues to work on at the same time, you could easily lose focus and not get anywhere with any of them.
NEXT STEP—Ask yourself: out of whatever is going on with me, what is the one thing that, if I fixed it, would make the most impact on my health? Once you’ve done that, make a decision, then and there, to fix it. It might be helpful to share your decision with someone you trust, who can lovingly help you to stay on the path to success through the ups and downs you’ll probably have on your journey to better health.
NOTE--These first two steps are the most important ones. If you are not clear with yourself about what is most important to you in your life, and are not firm about choosing to work on the one thing you think will help you the most in achieving any of those important things, the rest of this list would be a waste of time for you to do.
3. Remember Your History—where have you already been successful?
Each of us already has worked to change something, some bad habit or lack of understanding that didn’t get us the results we wanted. Neither my wife nor I had learned anything from our parents about how to responsibly handle our finances. Early in our marriage, we looked at our credit cards as “magic cash”, because having them made it possible to have all kinds of things and experiences without having to wait until payday or to be patient enough so save up the needed amount. Needless to say, this caused financial problems for us down the road.
It took a lot of time and effort to dig ourselves out of that big hole. But we were motivated to learn how to fix the problem and not to let it happen again. We had some ups and downs along the way, but had already decided that failure was not an option for us. That’s what kept us going until we got in the clear. From that ordeal we learned better financial habits, and that we could fix a big problem without being overwhelmed by it. Fixing that problem successfully gave us the confidence that we could have similar success with other challenges in life, like raising children and managing our careers. And it just felt good to get out from under that weight by the choices we made.
NEXT STEP—Ask yourself: what bad habits or situations have I already fixed by changing my habits? How did fixing that problem make me feel?
4. Believe You Can Win
Psychological studies show that a significant portion of our daily thoughts, around 80%, are negative, according to Psychology Today. Furthermore, almost all these thoughts, around 95%, are repetitive. This means we tend to dwell on the same negative thoughts over and over again, reinforcing their impact on our mood and perception.
But you don’t have to do that. Once you’re aware that negative thoughts about the changes you’re making are starting to show up, you can CHOOSE to think positive thoughts instead. Remind yourself of why you’ve chosen to make the change you decided on, and that you are going to do it! As the trailblazing psychologist Albert Bandura once said, “People’s beliefs about what they can do affect how they behave.” Believing you can handle any negative thoughts that may show up is the critical first step in handling them!
In practice, you’ll find it’s much easier than you might have thought. For instance, if your brain tries to tell you that drinking sugary drinks isn’t all that bad, you can remind yourself of how much better how much weight you’ve lost or how much lower your blood sugars are since you stopped.
NEXT STEP: choose to believe you’ve got this!
5. Be Kind to Yourself--Start Small
One of the best ways to avoid being overwhelmed by any problem is to start with a goal that’s easily achievable. That way you start to build confidence that you can be successful with larger parts of your ultimate goal.
To get out of the financial hole my wife and I dug for ourselves, we started by paying off the smallest debt first. That gave us a sense of achievement—we took a step in the right direction! It was easy to do, and now we had one less debt to worry about. For people with blood sugar problems or who are overweight, a similar goal might be to quit drinking sugary drinks like regular cola or sweet tea. That’s a small thing that can really have big effects!
NEXT STEP—Ask yourself: What small thing can I easily do that will get me a little closer to my goal?
6. Handle Challenges Along the Way
New habits are said to take three weeks to form, and a lifetime to follow. You are bound to make a mistake or two along the way. That’s OK! You’re human, it happens. Just get back to the good new habit you’re building. It’s as simple as that. Besides, a mistake can be a great learning tool for you on your journey to better health.
Some bad habits involve joining with others who have the same habit. For instance, if you’re trying to cut down on drinking alcohol, you may wind up losing the friendship of people who you drink with. That might mean that they weren’t really friends with you, they were friends with your habit. In times like this it’s good to remember what your highest priorities are and keep your commitment to the goal you’ve chosen to pursue or protect by ending the old bad habits.
7. Get Help From Other People
When you tell your family and close friends about the new habit you’re building, and why it’s so important to you, most likely they’ll be pleased for you and will offer any support they can. Also, now you’ve made a commitment to someone important to you—that’s a powerful motivator!
One of the reasons that 12-step help programs like Alcoholics Anonymous are so successful is that each group is full of people trying to stop the same old bad habit. They understand what you’re going through and can be a good source of support on this great journey you’re starting on.
If you’re starting a new healthy habit, like healthy eating for diabetics, your primary care provider may be able to refer you to a support group or group teaching series.
8. Take Responsibility for the Outcome—Positive or Negative
With your best efforts done consistently over time, it won’t be too long until you see the results you wanted. Your blood sugar or blood pressure are running lower now. You can fit into clothing you couldn’t wear just a few months ago. How are those numbers now compared to three months ago?
But, if not, it’s time to look back. Are you still committed to the goal you set? Have you run into problems getting the things you need, like healthy food or the medicine your provider prescribed for you? Once you know what the barrier has been, then it’s easy to break it down by changing your efforts to what will work best for you and your unique life situation.
Conclusion
At the beginning we asked, “what can Americans do to improve their health?” Looking at the numbers, we saw that many health problems can be improved or totally fixed by CHOOSING to change some bad habits we’ve picked up by learning better habits. And best of all, now we know that anyone can start those better habits, if only they CHOOSE to do so!
References
OECD Health Statistics 2023; Peterson-KFF Health System Tracker https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/
McGinnis, J. Michael, Pamela Williams-Russo, and James R. Knickman. “The case for more active policy attention to health promotion.” Health Affairs 21, no. 2 (2002): 78–93. https://doi.org/10.1377/hlthaff.21.2.78
Centers for Disease Control and Prevention (CDC), 2022https://www.cdc.gov/chronic-disease/data-research/facts-stats/index.html
Waters, H. & Graf, M. (2018). The Costs of Chronic Disease in the U.S. Milken Institute. https://milkeninstitute.org/sites/default/files/reports-pdf/ChronicDiseases-HighRes-FINAL.pdf
Bandura, A. (1997). Self-Efficacy: The Exercise of Control
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78. https://doi.org/10.1037/0003-066X.55.1.68
Zimmerman, B. J. (2000). Attaining Self-Regulation: A Social Cognitive Perspective
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