“Somewhere in the course of our daily lives, though, most of us do exhibit behavior that suggests at least some disregard for our health. We don’t change our diet, though we know we should. We don’t floss, take medications as prescribed, or get the screening tests we’re supposed to.”
He knows multiple complex causes exist for this and questions whether being diagnosed with a chronic condition motivates people to improve health behaviors exploring whether the delay between health behaviors and health outcomes contributes to unhealthy behavior. After looking at attrition rates in a diabetes self-management program, he concludes:
“It calls attention to a key distinction behavioral psychologists like to make in explaining human motivation: there’s a difference between awareness of the need to act, and the volition to act.”
What is the leading cause of death in the United States? Heart disease? Cancer? No, it’s smoking. Smoking? Yes, depending on how you ask the question.
In the early 90s, McGinnis and Foege turned the age-old question of what people die of on its head by asking not what diseases people die of but rather what the causes of these are. Instead of chalking up the death of an older man to say lung cancer, they sought to understand the proximate cause of death, which in the case of lung cancer is largely smoking. Using published data, the researchers performed a simple but profound calculation — they multiplied the mortality rates of leading diseases by the cause-attributable fraction, that proportion of a disease that can be attributed to a particular cause (for example, in lung cancer 90 percent of deaths in men and 80 percent of deaths in women are attributable to smoking). Published in JAMA in 1993, their landmark study became a call to action for the public health community.
When looked at the conventional way, using data from the 2004 update of the original study, heart disease, cancer, and stroke are the leading causes of death, respectively. This accounting may help us understand the nation’s burden of illness, but does little to tell us how to prevent these diseases and improve health. Through the lens of McGinnis and Foege we get the actual causes of death (e.g., the major external modifiable factors that contribute to death). This analysis shows that the number one cause of death in America is tobacco use, followed closely by poor diet and lack of physical activity, and then alcohol consumption. Read more »
If you own a Nintendo Wii, have played World of Warcraft, or seen James Cameron’s cinematic spectacle, then you probably know what an avatar is. And because an avatar is simply a representation of yourself that you design, your avatar’s attributes could be as similar or different to you as you wish. [This editor’s avatar is 6′ 8″, has six-pack abs, wears only fine European clothing, and has the voice of YouTube sensation Ted Williams.]
Do online avatars have any influence on their real-world counterparts? Researchers at the new Virtual Human Interaction Lab (VHIL) at Stanford University think so. According to VHIL, while avatars tend to be idealized versions of their users, evidence has suggested one’s virtual avatar does indeed influence a person.
In one experiment, a female student’s avatar was shown losing weight by running and gaining weight when standing still. As a result, it motivated this student to exercise more over a 24-hour period. In another experiment, watching a student’s avatar progressively age caused him to want to save money instead of spending it on partying.
With advances in technology continually making the world more and more connected with itself, avatars will continue to evolve also. According to Jeremy Bailenson, creator of VHIL, “avatars will soon play an even bigger role in our lives online. How we shape our own avatars and how we interact with others could have profound influences on our behavior.”
According to Marshall Becker, PhD, MPH, a one-time professor of mine and prime mover behind the Health Belief Model (HBM), four things must be in place for health behavior change to occur. I am paraphrasing here:
A person has to know that they have a particular health condition.
A person has to believe that having said health condition is bad.
A person must perceive the benefits of behavior change to outweigh the difficulties of behavior change.
There must be a “call to action” to spark the change.
Absent any one of these steps and the likelihood that behavior change will occur is diminished. Read more »
Every year it happens: people come to me telling of what they are going to be doing different in this fresh new year. People are going to stop smoking, start exercising, and (especially) lose weight. This year, I am among the resolvers.
Every year, most people fail.
Which makes me wonder what it is about us humans that allows us to act against what we know is best. Why is it that educating people is rarely enough to fix a problem? Why should we have an obesity “epidemic” when very few people really want to be obese? Read more »
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