I've got some bad news. Most Americans know what we're supposed to do for better health. We should eat better; we should exercise more (and we surely shouldn't smoke). But almost none of us actually follow through. A 2004 study found that just three percent of Americans followed four basic healthful behaviors: not smoking, maintaining a healthy weight, not drinking too much, and getting regular exercise.
Just three percent.
It's the most damning statistic about public health I've ever seen, and it shows how formidable the social - not just political - problem of healthcare is in this country.
This paradox leads directly to bad health. We all know what this looks like: it's the 70 percent of Americans who are overweight or obese. It's the majority of Americans who'll die of a chronic disease. For some reason, even though each of us has the opportunity to engage in our health and live better, we make choices that leave us unhealthy, and often enough unhappy.
So what's behind the paradox? Why don't we do what we know is good for us? Part of what may be going on here is that we lack a sense of agency in our health - we don't feel like we're actually in control, or that our engagement will matter much. Because the stakes are so high, and because healthcare - in the form of medicine and insurance and hospitals - can be both intimidating and unpleasant, we disengage. We leave our health up to doctors and insurers. We forsake our role as the stewards of our own health.
That's the bad news. Now for some good news: It turns out that when we do engage in our health, our health gets better. In fact, simply paying attention to our health leads, directly, to improved health. Mindfulness matters.
There's ample research to back this up. A decades-long study in the U.K., called the Whitehall Study, showed that people who have a sense of control over their lives tend to have significantly better health (and it showed the opposite, too - people who lack control tend to have worse health, such as double the rate of heart disease). Another study, published in the Journal of Family Practice in 2000, found that when individuals were involved in their own care - when they engaged in their own health as active participants rather than passive patients - they had better emotional health, faster and improved recovery, and a staggering 50 percent fewer diagnostic tests and referrals. In other words, they needed less medical care and had better results.
So if taking control of our health has such a clear upside, why do so few of us bother to try? This, of course, is the million-dollar question. Part of the answer may be just spreading the word that there is an upside - that paying attention to our health yields immediate benefits. And part of the issue, I think, is that so few of us feel welcome to engage; the healthcare system doesn't privilege the patient. And finally, many of us just don't know how to engage - taking control sounds great, but where do we start?
I suggest we can all start by following these three simple principles:
1) Choose to Care
Before we can see the benefits of engaging in our health, we have to stand up and act. Engage. When you go to the doctor, ask her to repeat what her advice until you can repeat it back to - and have her write it down. And when she orders bloodtests, make sure the lab sends you a copy of the results directly. You may not understand all the numbers in there, but you should consider yourself the central player in your own health.
2) Decide What to Care About
If you're like most people, we all have a few things nagging at us about our health, whether it's a sore back or a few extra pounds. But until things get bad enough to shake us out of our routine, we're slow to act. That's passive thinking, and it's no way to seize control. Instead, put those nagging things out on the table: Make a list of the two or three things you know you should do for your health. Then think about the two or three actions you could take to address each one - whether it's getting a little more exercise or making an appointment with a specialist. And then start to do them. Make a list. And take some action.
3) Know There's No Such Thing as Perfection
This works on two levels: First, no one is going to behave perfectly, all the time. Everyone on a diet slips now and then; everyone on a fitness program misses a day at the gym. The goal isn't perfection; it's to improve the trajectory of our behavior and engagement. And second, realize that even if we do everything letter-perfect - get plenty of exercise, eat oodles of fruits and vegetables, get regular checkups - perfect health isn't the inevitable result. The fact of life is that, for most of us, something will happen, sometime. But by engaging in our health, we can improve our odds, we can improve our outcomes, and we can improve our health.
And that, after all, is the whole game: To stay healthy and happy for as long as possible.