Great discussions and debate are occurring over health care costs and the role of government, ultimately impacting the Medicare program. Many say that they want less government, more self-control and they want to make their own decisions. But in reality, how many of us actually take charge and exercise healthy behaviors? Most of us eat too much, don’t exercise, and blame everyone else for things that go wrong – especially the government.
We can, and the Affordable Care Act (Health Reform) has, made policies and programs where healthy options are made available. However, people still have the responsibility to make those healthy choices. People are “empowered” when they have the knowledge, ability, resources, and motivation to make healthy choices. When people are empowered, they are able to take an active role in improving their health, support their families and friends in making healthy choices, and lead the community to healthier life styles and actually make changes.
When we are in the doctor’s office or medical facility, health information is often presented in a way that many of us find difficult to understand, let alone put into action. Research has found that 90% of adults have problems using the health information available to them, if they can even remember it. A person’s decisions are influenced by how choices are presented. For example, a cultural change in nursing homes is occurring because residents are given decision making abilities, which in turn creates happier and healthier residents. Isn’t that what we all want?
So what can we do? Well, decision making is a complex process. It is influenced by personal, cultural, social, economic, and environmental factors, including individuals’ ability to meet their daily needs, the opinions and behaviors of their peers, and their own knowledge and motivation. Information alone is often not enough to change behavior. Communities, workplaces, schools, neighbors, and government organizations can support people in making and sustaining healthy choices by providing tools and information, making healthy choices easy and affordable, and by improving the social environment.
Providing people with tools and information to make healthy choices means keeping it simple and easy for them to make informed decisions about their health. Providing people with accurate information that is culturally and linguistically appropriate increases healthy behaviors. For example, providing people with information about the risks and benefits of preventive health services can motivate them to seek preventive care. Making those choices affordable, as the Affordable Care Act does for preventive services, increases the healthy choices. Providing people with information (e.g., nutrition information on menus and food product labels) can help increase demand for healthy options and may influence supply, because companies are more likely to provide healthy options when they perceive consumer demand for such products.
Promoting positive social interactions supports healthy decision making. Socializing with family members, friends, and involvement in community life have a profound effect on the choices people make and on their overall health. When we enhance our social network and social connectedness (e.g., through volunteer opportunities) we can help ourselves as well as encourage others to be physically active, reduce stress, eat healthier, and live independently. Individuals’ decisions are influenced by how environments are designed and how choices are presented. Small changes to the environment in which people make decisions can support an individual’s ability to make healthy choices. For example, making stairwells more attractive and safe increases their use and placing healthy options near cash registers can increase their likelihood of purchase. Or try going to www.thefuntheory.com on the internet and see what making things fun turns into…healthy behaviors.
We need to engage and empower people and their communities to plan and implement prevention policies and programs. Providing people with tools and skills needed to plan and implement prevention policies and programs can help create and sustain community change. Effective public participation can help ensure that health equity and sustainability are considered in decision making (e.g., community planning). Community coalitions can be effective in raising awareness and attention to a broad range of issues (e.g., alcohol and other substance abuse, cancer prevention and control) and implementing effective policies and programs. Currently Washoe County is developing such a coalition in aging and health services to deal with a major issue facing Medicare persons that are admitted to the acute hospital. About 20% return to the acute hospital within 30 days costing billions nationally. However, the federal government has an initiative to change that by integrating community based services and create better transitional care. The Center for Healthy Aging plans on being an integral partner in that effort.
We can empower individuals and their families to develop and participate in their own health protection and health promotion programs through education and identifying and helping them to connect to key resources. Individuals can participate in developing health information and provide feedback regarding the types of health information that are most useful and effective. They can also provide their clinicians with relevant information (e.g., health history, symptoms, medications, allergies), ask questions and take notes during appointments, learn more about their diagnosis or condition, the red flags, and follow up with recommended appointments.
In order to help empower people, health providers can use proven methods of checking and confirming patient understanding of health promotion and disease prevention (e.g., teach-back method). Involve consumers in planning, developing, implementing, disseminating, and evaluating health and safety information. In addition, they could use alternative communication methods and tools (e.g., mobile phone applications, personal health records) to support more traditional written and oral communication.
All in all, we can empower ourselves to take control of our own health. Medicine and our health system have some great science to help, but when it comes down to “adding life to years”, we have to empower ourselves.