Issue Date: October 8, 2006
Be responsible
Poor lifestyle choices can lead to poor health.
Your doctor is right to tell you, "Change your behavior."
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For decades, physicians have been alerting Americans about the health consequences of bad lifestyle habits. So I was dismayed recently to read an article that challenged the effectiveness of those efforts.
Robert Steinbrook's "Imposing Personal Responsibility for Health," in an August issue of the "New England Journal of Medicine," questions the value of some approaches that we doctors use to get our patients to alter habits we deem unhealthy.
Much of what makes people sick stems from behavior: smoking, excess alcohol, physical inactivity, poor diets, casual sexual habits -- the list of poor choices is long. So doctors counsel patients, companies offer incentives, and politicians suggest coercing Americans via government regulations.
Now the cost of treating degenerative diseases is rising faster than our capacity to pay the bill. As a result, "high-cost" behaviors receive the most attention. The big three: tobacco, diet and activity. Public and private organizations try to manipulate employees' behaviors by offering lower-cost health insurance for those who exercise regularly, maintain a healthy weight and don't smoke. Steinbrook wants to know if all this alerting and cajoling pays off. But the answer is not yet clear.
That shouldn't stop us from promoting good habits. Behavior affects how healthily people age. And it's up to us to sound the alarm.
Tedd Mitchell, M.D., president and medical director of Dallas' Cooper Clinic, writes HealthSmart every week.
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