May 10, 2020
Why healthy behaviors need to be the path of least resistance for people with chronic disease
Recently there has been quite a bit of attention paid to the determinants of health–and there are several. Social and environmental factors, comorbidities including mental health, and genes all play significant roles in determining the risk for developing conditions, the risk for complications from those conditions, cost and mortality. Racial and social inequities are major drivers of health disparity. There is no question we need to address these, and most stakeholders recognize this and are making changes to address them.
In nearly all cases, however, the proximal causes of chronic disease exacerbation are behaviors. Behaviors drive far more of the risk from chronic conditions than genetics for the majority of chronic conditions. Take diabetes, for example–a study this year in Diabetologia3 found that genetics increased the risk for developing diabetes 2-fold. In comparison, obesity increased the risk 6-fold.
“Solving the crisis of chronic disease begins and ends with behavior change.”
Durably changing behaviors is extremely difficult. Even though it seems like they should, digital tools and connected devices alone have generally not worked to improve health4. So, the problem is not simply educational, and it’s not simply a matter of access to measuring capabilities–we shouldn’t expect these to work alone any more than we should expect diet books and scales alone to reduce America’s burgeoning obesity problem5.
Solving the crisis of chronic disease begins and ends with behavior change. It requires understanding the whole person, not just their diseases but their motivations and fears, and the use of digital tools enhanced with human connection. It demands answering one simple question with absolute precision for every individual: how to make the right thing to do the easiest thing to do. Only when we make healthy behaviors the path of least resistance will we durably change the trajectory of this immense issue.
- Raghupathi, Wullianallur, and Viju Raghupathi. “An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach.” International Journal of Environmental Research and Public Health, MDPI, 1 Mar. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876976/.
- “Health and Economic Costs of Chronic Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Mar. 2020, https://www.cdc.gov/chronicdisease/about/costs/index.htm#ref1.
- Minerd, Jeff. “Obesity More Important Than Genetics for T2DM Risk.” Medical News and Free CME Online, MedpageToday, 15 April 2020, https://www.medpagetoday.com/endocrinology/diabetes/85979.
- “Scripps Wired for Health Study Results Show No Clinical or Economic Benefit from Digital Health Monitoring.” MobiHealthNews, 19 Jan. 2016, https://www.mobihealthnews.com/content/scripps-wired-health-study-results-show-no-clinical-or-economic-benefitdigital-health.
- “Products – Data Briefs – Number 360 – February 2020.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 27 Feb. 2020, https://www.cdc.gov/nchs/products/databriefs/db360.htm.
The articles provided on this website are for informational purposes only. In addition, it is written for a generic audience and not a specific case; therefore, this information should not be used for diagnostic or
medical treatment. This site does not attempt to replace the patient-physician relationship and fully recommends the reader to seek out the best care from his/her physician and/or diabetes educator.