What does it take to make you shake it up, to alter your lifestyle in a direction you and your loved ones know has to be done….or else?
This rhetorical question is always on the mind of healthcare professionals, from personal trainers to physicians. How can we help you make the small but significant lifestyle changes necessary to improve health and reduce morbidity and extend mortality?
A Canadian study confronted this head on. The results are discouraging.
For example, let’s follow this summary of collected data on more than 45,000 Canadian adults. Remember, these folks have a national, single-payer health program making access to preventive medicine easier and cheaper, but….:
- 73.6 percent reported there was something they should do to improve their health.
- 90.7 percent of those identifying a specific change indicated they wanted to quit/reduce smoking, exercise more, lose weight or eat better.
- 81.1 percent desiring a change said they intended to improve their health in the coming year.
- 17.7 percent at greatest risk (5 or more risk factors) did not feel a need to improve their health.
With 3/4 of the respondents, all of whom had many cardiovascular risk factors, acknowledging they could do “something” to reduce their risks, you could say public health statements are getting through. On the other hand, you could just as easily argue that 25% are either unaware or choose to be unaware of how they can improve their own health.
At 25% of 45000, we’re talking about 11000 people who just don’t know they should do anything to improve their health. Managing heart disease by medications and surgeries can add up really quickly if you consider that this is just a small portion of a much larger population of adults susceptible to heart failure.
We could go down the list but I want to skip to the last one: almost 18% of those at greatest risk for heart disease simply don’t care to do anything to reduce that risk by making lifestyle changes. That’s almost 20%, one-fifth!!! Essentially this small minority is holding the rest of their fellow citizens – millions of Canadians! – hostage to their lack of motivation. And this is not specific to Canadians.
In fact, the study showed that it was younger and minorities who were more apt to be complacent about their health, while older white people were more interested in making change.
Now I could riff on these results for hours, all to no avail. As a personal fitness trainer, a professional with an advanced degree who reads several health newsletters each month, I am fully aware of how uninterested many of my well-educated, financially-successful clients fit into the categories that seem to be not just self-defeating but also socially-devastating. Those on medications to manage their blood pressure, high cholesterol, type 2 diabetes, they are often of the mindset that says they are effectively taking care of their risk for heart disease. It astounds me even after 30 years in the business. I can’t imagine what their doctors feel as they dispense both prescriptions and advice.
This is the million dollar question and unfortunately the researchers did not have any better answer than this: “Effectively convincing people to adopt and sustain healthy lifestyle changes requires a better understanding of what makes them tick”
Thirty years of working one on one with hundreds of clients with all kinds of issues, diseases, risk factors and goals, I have concluded that ‘effectively convincing people’ is not ours to do. Throughout human history, not just in the modern era, there are doers and not-doers, people who will go headlong into what the circumstances demand and others who will work around those circumstances, rationalizing and justifying even in the face of impending disability…or death.
This is not to malign these folks as many are quite powerful and successful in their own rights. Given other circumstances they might be the ones to rush headlong into the battle.
But given the circumstances of their own health, it appears either courage, self-efficacy, pride or shame keeps them from doing what they know needs to be done.
It’s just that I or most trainers and other healthcare providers will have to come to grips with these realities and continue doing what we know and do best: offering support, guidance, assistance and motivation knowing ultimately each person is answerable only to him- or her-self.