We hear a lot about prevention in our conversation about health care. So much so that’s it’s become a buzzword — one that we no longer really hear and that masks our acceptance of the status quo. Just look at the numbers. According to the Centers for Disease Control and Prevention, 75 percent of our health care spending goes toward the treatment of conditions that can be prevented, like heart disease and diabetes. When you include mental health, it goes up to 90 percent. And for all of our universal praise for prevention, at the end of the day, it gets only 3 percent of our health care dollars.
At the same time health care spending continues to skyrocket. In 1960 it accounted for 5 percent of our economy. By 2016, it was up to nearly 18 percent, and according to the Centers for Medicare and Medicaid Services, by 2026 it will be nearly 20 percent, at $5.7 trillion. And to top it all off, our life expectancy is falling.
With three-quarters or more of our health care spending treating problems that are lifestyle related, it’s clear that if we don’t change this reality, we’re never going to change outcomes — or the direction of these trend lines.
That’s why at Thrive Global, rather than continue the focus on downstream harm reduction, the core of our approach has been to go upstream. That’s where it’s possible to truly change outcomes by focusing on the root causes of chronic and stress related illnesses. Nearly 150 million Americans are living with at least one chronic condition, and, according to the CDC, 7 out of 10 deaths in the U.S. are attributable to chronic disease. And yet 80 percent of the risks for chronic diseases are, as a study from the Cleveland Clinic put it, “related to environmental factors, primarily lifestyle factors.”
So how do we change those lifestyle factors? There’s been a lot of skepticism in recent years about whether we even can. Books on changing habits are perennial bestsellers — and yet we don’t seem to be very successful at it. A study from Washington University in St. Louis tracked over 1,000 overweight men and women who had suffered heart attacks. After a year, the average weight loss was only .2 percent. And the rest of us don’t fare much better. A study from the University of Scranton found that 92 percent of people fail to keep their New Year’s resolutions. Another found that 80 percent have already failed by the second week of February. A not insignificant percentage have probably failed before the hangover has even worn off.
The problem is how we’re going about trying to make those changes. At Thrive Global, we know behavior change is possible — but only though what we call Microsteps. These are small, incremental, science-backed steps we can take to make immediate changes in our daily lives.
Too many of us are trying to change our lives through sheer willpower, simply deciding to make major changes and then feeling guilty when, inevitably, our habits don’t all follow along with the new directive from the top.
Microsteps are about making changes that are too small to fail. It’s not that we can’t get to where we want to go, it’s that we can’t just magically teleport there. But making very small changes in a clear direction can lead us to a very different destination over a long journey.
Over time Microsteps accrue, and become new habits, which in turn become healthier and more thriving lifestyles. But we need to do it one step — one Microstep — at a time. As another fan of upstream thinking, my fellow countryman Aristotle wrote, “One swallow does not make spring, nor does one fine day.” But one swallow after another and one fine day after another do make spring. And one Microstep after another does make new and healthier habits that dramatically change health outcomes.
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