As a primary care physician for almost 20 years, I have been humbled by the privilege of being part of the lives of so many.
This experience has given me an opportunity to observe and reflect on the many factors that influence health. Recently, I realized the advantage I have derived from this “insider’s view.”
This column has been an attempt to share some of the details relating to health and health behaviors. Yet, it has become clear to me that there are also a few fundamental general themes that affect health. Allow me to explain.
I believe that health results from a combination of five factors, which are chance, choice, knowledge, opportunity and values. Let’s consider the list in reverse.
Your values influence your health in the sense that they determine your priorities and your goals. By example, consider what premium you place on such things as long life, good physical conditioning, freedom from disease and a general sense of well-being. While it may seem that these are universal values, my experience has been that there are considerable individual variations in the priority placed on each. For instance, contrast those values with the desire for pleasure, comfort and relaxation. In many instances, the two sets of values are at odds.
Opportunity plays an important role in health. Reflect on such important variables as access to clean water, nutritious food, quality medical care and even information about healthy behaviors. Wealth and education are opportunity variables that have been proven in studies to improve health outcomes. Nevertheless, even though the United States is the premier developed nation in the world, we lag significantly behind many other countries in such important health statistics as life expectancy, infant mortality and quality of life. Clearly, there is more to health than opportunity.
Knowledge about health and healthy choices, while related to the variables of opportunity and choice, is an important factor in its own right. In fact, being well-informed is essential to accessing care and making thoughtful decisions that lead to better health. Perhaps the greatest impact a society can have on improving health is not just improving access to care but also improving access to health information.
From my observation and that of many clinical studies, choice may be the most important variable in health, at least in the developed world. The vast majority of the chronic health conditions (and their complications) in the United States are preventable through healthy lifestyle choices. To some extent, choice requires knowledge and opportunity, but perhaps more importantly, it requires discipline and self-control.
Finally, for the unfortunate few, health can be critically, and unfairly, influenced by chance. Whether as a result of a random injury, genetic disease or adverse social circumstances, some do not have the option of choosing good health. Perhaps it is incumbent on us all collectively to mitigate chance. It is also one of the reasons for the ideal of the medical profession “to cure sometimes and comfort always.”
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.