Sheila Quinn: Pepsico May Be Moved by Taxes, But For People, Health Has to Be for Something

Summary: In Michael Levin's controversial perspective in a recent Integrator column he wrote: "Pepsico knows the truth:  taxes, not education, reduces (poor lifestyle choices)." His column provoked Integrator adviser Sheila Quinn to this thoughtful look at the obstacles to good education penetrating our thinking, and shifting our habits. Quinn's conclusion is also that mere education is limited: "Health has to be FOR something." Quinn, recently the co-author of 21st Century Medicine: A New Model for Medical Education and Practice, urges that we as a community, together with our policy-makers, spend more time exploring the carrots of positive incentives rather than merely the sticks of higher taxes. Could be a key step toward U.S. Senator Harkin's new "wellness society."  

Why We Aren't More Responsive to Information
in Making Behavior Changes, and a Solution

- Sheila Quinn

Sheila Quinn

I think none of us can doubt the fact that information alone rarely changes behavior. An exception might be when people receive the information in a moment of great fear (i.e., following a heart attack or the premature/preventable death of a loved one).

Perhaps economic incentives can improve the behavioral response rate to information, but it seems extremely important to me to seriously explore WHY we aren’t more responsive. It’s not enough to place all the responsibility (or blame) upon the individual; we must also look at how society reinforces unhealthy behaviors and makes it hard to change. Here are just a few examples:

• Advertising is a potent force. It envelops us continuously—radio, newspapers, the internet, television, movies, billboards, flyers, brochures, signs, in-store ads, and marketing calls. If advertising weren’t effective at changing behavior, you can bet that retailers and marketers wouldn’t invest so heavily in it. It might be very productive for the public health community to look at effectiveness research from the advertising world in order to fight fire with fire, but it is SURELY true that it is very difficult for an individual, by him/herself, to counteract all of these pervasive influences.

• The dominant part of the food supply is represented by fast food, junk food, and (only slightly lower on the list) denatured food, by which I mean food that is far removed from the living plant or animal, heavily processed, and full of additives. These foods are not only the most readily accessible (and often the cheapest), but in stores they are placed in the most obvious places and many small groceries or convenience stores can’t afford to stock anything else.

• 	Health has to be FOR something "I hope we (collectively) spend some time and money exploring what are the positive incentives for healthy behaviors and what are some effective ways of changing our environment to encourage and empower those healthy behaviors. - Sheila Quinn

  For people who are poor, there are often very few healthy choices—no fresh (let alone organic) food in reasonably priced supermarkets near home; few sidewalks and limited safety for exercising outdoors; parents often working multiple jobs just to survive; crippling emotional stressors; no budgets for gyms or classes or sports (or arts events, which feed the soul). In fact, the people at greatest risk for chronic disease are often the people least equipped to respond to information about healthy living.

• Fragmentation of family, friends, and communities. The mobile society has produced many economic benefits and some significant social costs. The lack of an extended family or community structure nearby means increased stress in times of illness and economic hardship. Loneliness and isolation drive many unhealthful behaviors.

• Loss of spiritual connection, whether it is to nature, community, or religion. Time for reflection and connection can be very limited. While it may be counterproductive to seek momentary relief in yet more valueless stimulation (television, movies, alcohol, sweet and salty foods), it takes tremendous discipline and commitment to demand of oneself a different way and live by it—all for the sake of some possible long-term gain.

Much more could, and should, be said. Everyone can add their own examples. My point is simply to emphasize that it’s not useful to expect most individuals to change their behavior (even for money) in the face of pervasive societal influences that converge to make those changes extremely difficult, particularly when considered in the context of what seems to be a natural human tendency to more readily form habits than to break them. I am reminded always of what my wise and wonderful friend, Cathy Rogers, ND, said to me many years ago: “Health has to be FOR something.” I hope we (collectively) spend some time and money exploring what are the positive incentives for healthy behaviors and what are some effective ways of changing our environment to encourage and empower those healthy behaviors.

Sheila Quinn
Freelance Medical Writing and Editing Services
Gig Harbor, WA 98332