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Sheila Quinn: Pepsico May Be Moved by Taxes, But For People, Health Has to Be FOR Something PDF Print E-mail
Written by John Weeks   

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."  
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Integrator columnist Michael Levin's article suggesting that the behavior of Pepsico may be a guide to how to change health-related behavior stimulated Integrator adviser Sheila Quinn to this response. (See Columnist Michael Levin: Pepsico May be Our Guru on How to Reduce Behavior-based Healthcare Costs, April 15, 2009.) Levin had proposed that it is economic incentives, rather than mere information, which will, literally, tip the scales. 


Quinn, a national leader in policy related to integrated health care most recently co-authored a highly-regarded document on health reform published by the Institute for Functional Medicine, 21st Century Medicine: A New Model for Medical Education and Practice. Quinn is the chair of the Integrated Healthcare Policy Consortium.
______________________________

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


- Sheila Quinn

Image
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
______________________________

 
Comment:  I know from the grapevine that Obama recently brought together a group of experts on health and productivity management to look at some options for a progressive approach to health benefits among federal employees. These discussions often bridge into how to incentivize positive choices. One would hope that the White House - if it hasn't already - will soon be inviting a top-level group of experts to a specifically address Quinn's suggestion that we "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." These are essential discussions if we are to move, as US Senator Tom Harkin likes to put it, toward becoming "a genuine wellness society."
  



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