A new survey, commissioned by GE Healthcare, turned an age-old political question into a national check-up. 50% of respondents said that other people's health "was going in the wrong direction." Physicians were even more pessimistic: 92% gave the American public a C, D, or F grade for health.
Never underestimate American optimism, however. Only 17% of survey respondents thought their own health was going in the wrong direction.
What's going on here?
I suspect part of the answer lies in the fact that Americans have a supersized sense of independence. And why not? This nation was founded on a declaration of independence. We like to believe that our decisions and our fate lie in our nothing but our own opinions, ambitions, and choices. But as researchers Nicholas Christakis and James Fowler have documented in the recent book Connected: The Surprising Power of Social Networks, your community's norms can quickly become your fate, whether it's rising obesity rates or the contagion of depression. But ask the typical man on the street how susceptible he is to social influence, and he will claim to be in total control.
The sense of immunity extends to the well-documented effects of advertising, portion sizes at restaurants, or food prices on eating. Most people agree that others might be swayed, but they themselves are like Teflon: these environmental pressures slide right off them. Nothing sticks. Meanwhile, they load up on processed foods because-well-they really want to? That's how it feels, or that's how we want to feel, so we don't feel so out of control.
Then there's the difference between what we know other people need to do to stay healthy, and the standards we hold ourselves to. One of my favorite statistics in this new survey reveals this discrepancy: 95% of those surveyed said that it was important to see their doctor on a regular basis, but 70% said they avoided their doctors, relying instead on such classic strategies as "hoping their health problems would go away on their own" or "asking a friend for medical advice instead." Partly this is because we treat other people's health outcomes as an actuarial problem: if they don't follow the "health rules" now, they're at increased risk for getting sick. But we tend to focus on our own well-being in this moment, and predict it will continue, regardless of what we do now.
Of course, it's always possible that the 83% who think their health is headed in the right direction are accurate. Are we Americans unnecessarily critical when we look at the health of others? After all, your own body is the only one you have full knowledge of. And it can feel good to think you are doing better than the average citizen. So perhaps the survey respondents weren't looking at themselves with a positive illusion, but at others with a negative bias.
Other statistics argue against this interpretation, however. The current generation's lifespan is expected to be shorter than their parents', an unprecedented prediction. Rates of obesity and smoking are rising, while the numbers of Americans getting adequate exercise and nutrition are shrinking. Mental illness is becoming more common, and comprehensive healthcare more rare.
If this blog post sounds like a sermon for increased personal responsibility, it is and it isn't. Yes, we each need to be proactive about our health and think about our choices. But at the same time, it's ridiculous to blame individual Americans for growing waistlines and the frightening rates of depression. When an entire country is getting sicker or dying sooner, blaming individuals for their lack of willpower is illogical and unethical.
If you believe the most gloomy statistics about health behaviors and risk factors, our nation's health future is like a sinking ship. Most Americans can see it sinking, but mistakenly think they are safe on shore watching the disaster unfold.
We're actually all on board, in desperate need of life preservers. We don't know right now what will keep us afloat, and what will ultimately rescue us. But it almost certainly will take both personal responsibility and the willingness to change our health environment and culture.
To the concerned citizen who sees the nation's health "heading in the wrong direction," there are two things you can do. First, support policies intended to lift the health of the nation. Many Americans view regulation or legislation as an attempt to rob them of the right to choose what environmental pressures have convinced them that they want. It is very difficult for us to see that we are all already being influenced, and our health choices are not as free as we think. The very impulse you feel to argue against this suggestion is as American as apple pie -- as in, the apple pie that, if indulged without restraint, will carry you right to cardiovascular disease.
Second, we can all turn that concerned eye towards ourselves. Making healthy choices is a viable trickle-up strategy for improving the nation's health. Your neighbor's health is not separate from your health; your health is not separate from your child's heath. This means that your own health choices will be not just a life preserver for you. They may be a life boat for those around you, who whether they or know it or not, are also under the influence of some very powerful social forces.
