It’s hard to believe that it’s been nearly a month since the new year dawned. New beginnings – an opportunity for change.
The only thing more germane to this January holiday than “Auld Lang Syne” is the tradition of the New Year’s resolution. It is a time-honored tradition of personal change for the better. Guess what the most common theme of the New Year’s resolution happens to be? Living healthier.
In the context of a lovely social evening this past holiday season, I had the opportunity to explore the perspectives of two friends on the topic of personal change. As a primary care physician, I am fascinated by this topic since so much of the potential impact of what I do is rooted in the mysteries of how to motivate and encourage choices for better health.
Each of my two friends offered a perspective – one unique to the individual and one unique to the environment. Let me share.
The first reflected on the magnitude of change, musing that change by increments lends itself to a greater likelihood of success. The second drew from a wealth of accumulated evidence in the field of behavioral economics, from which the concept of a “nudge” reflects the influence of an environment more conducive to good choices. Let’s consider both.
The philosopher Voltaire is credited with the adage that we should not let the perfect be the enemy of the good. The concept of incremental change fits this perspective. While clearly a pack-a-day smoker will benefit best from total discontinuation of tobacco products, one can hardly argue with the health benefits of reducing smoking volume by one-half or even one-quarter. Likewise, the diabetic eliminating dietary sugar benefits best, yet he who reduces the frequency and portion size of dessert and soda benefits nonetheless.
Another term for this is harm reduction. My friend was right. If faced with an unhealthy habit of personal choice, incremental change may start you on the right path sooner and more effectively than the total change you are not yet able to undertake.
Then there is the concept of engineering our environment for better choices, which my second friend advocated. Examples include the rumble strip on the road, which encourages drivers to remain in their lane, or more classically, the “opt-out” employer retirement plan, which has been shown to improve workers’ savings rates in a way which benefits employee financial security.
Likewise, public policy can positively influence healthy lifestyle, such as by creating inviting spaces for physical activity, healthier food choices in public places and (like it of not) smoke-free zones. While not eliminating choice, such environmental interventions may help “nudge” us to adopt the healthier lifestyle to which we wish to adhere.
Don’t give up hope if the best-laid plans of your New Year’s Eve have already gone awry. Resolve anew to incremental change, allowing for occasional failure, and seek an environment that “nudges” you toward your goal.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.