April 07, 2020
The scourge of the coronavirus has tested the resiliency of Americans like few events before it. Despite the anguish of rapidly multiplying positive cases and deaths, Americans are responding with spirit and innovation as they cope with new routines and daily rituals — our new normal.
Now while we’re all anxious to see the kids back in school and the economy get on track, I believe that there’s an important lesson to be learned, particularly as we consider the health of our nation after COVID-19.
Prior to the onslaught of the virus I was writing about another plague on our nation, one that received some attention, but nowhere near the concentrated scrutiny of COVID-19. My advocacy was focused on the alarming growth of obesity and the residual impacts on the health of Americans.
Pointing to studies from the U.S. Centers for Disease Control that classified 70% of American’s as either obese or overweight, and a Harvard study that predicted that nearly half of the U.S. population will be obese by 2030, I argued that traditional approaches to public health had failed. As evidence, I cited statements from medical experts acknowledging that behavioral factors were a major influence on the state of American health and that they hadn’t found the right approach when it came to their ability to spur physical activity, healthy diet and weight loss.
The core of my advocacy, based on my research on the health behaviors of men over 50, was that the answer to the growth of obesity is more likely to be found in the social sciences – not in medicine’s traditional reliance on the natural sciences. I called for a new model grounded in the motivation of our social relationships. An approach that leverages the power within these relationships. A pathway that recognizes that the adoption of a healthy lifestyle is, at its heart, all about behavior change and the ability to sustain new habits, routines and rituals.
And this is the intersection where obesity and COVID-19 meet. The corner of behavior and change.
At its core, the U.S. response to COVID-19, albeit by necessity, is anchored in behavioral change – the requirement that Americans employ social distancing and change their habits. Whether restaurants shifting to take-out, teachers delivering instruction online, or e-commerce providing our basic needs, it's all an exercise in behavioral change. It's proof of concept that, when pushed, Americans can indeed change! Think about the significance of this lesson and the implications for moving our nation to a healthier state of affairs post-COVID-19.
The significance of the COVID-19 experience begins with a recognition of just how hard it is to change behavior. The statistics I cited earlier bear witness and the experts agree.
According to a report from the National Institute for Health, “a persistent challenge to the field is that sustaining behavior change is not easy."
Also, the journal FPM indicates that “encouraging patients to change their health behavior is a critical skill for primary care physicians."
Now, I’m not suggesting that anything in our lives compares to a pandemic and the motivation for behavioral change spurred by the possibility of infection or even death. No question.
That said, think about the structure of what we’re experiencing and the cultural dynamics in play. If the same institutional forces and cultural responses could be commandeered, even in a smaller dose in a post-COVID-19 environment, consider how Americans, men and women of all ages, could be moved to live a healthier lifestyle. A lifestyle, by the way, with the potential to strengthen an individual’s ability to fight off a future virus.
Setting aside what is a small and inevitable amount of politics, COVID-19 has created a rare configuration of aligned and powerful institutional forces with a focused message. Government, medicine, the corporate sector, and certainly the media, have almost an exclusive focus on the virus, the need for social distancing and various preventative and health care measures.
With 24-hour news cycles, daily press briefings and stories from around the nation, I’d argue that the cultural response is unprecedented, but also a product of the model that this configuration represents. While the war with the coronavirus is far from over, if the behavior change of Americans so far is any indication, the model is proving effective. It represents how the power of a unified approach and focused messaging can reshape our thinking and ultimately the behavior that impacts health.
Americans have witnessed such successful public-private efforts at behavior change in years past, though not on the scale of COVID-19. Among the most notable: smoking cessation and seat belt use. With these successful templates and the more recent experience of COVID-19, there’s certainly cause to believe that, with a concerted effort, Americans could tackle obesity and the general state of unhealthiness among us.
The Washington Post headline says it all “The coronavirus is killing far more men than women.” The article explains that evidence from Italy, China and South Korea shows a greater level of male deaths than women. It also advances the point that women live longer than men, and that men in these countries tend to die more frequently from heart disease, cancer, diabetes and respiratory diseases between ages 30 and 70. These facts cause experts to conclude that being male is a risk factor for severe outcome. Still, other reports have more directly linked the lifestyles of men to their increased susceptibility to COVID-19.
With American men exhibiting many of the same characteristics as their counterparts in China, Italy and South Korea – a higher death rate than women, a greater level of chronic disease, and poor health behaviors – the implications are clear. Behavior counts and an unhealthy lifestyle counts even more under the purge of a pandemic. When put under the microscope, whether to examine the impacts of a pandemic or simply to understand everyday public health outcomes, men exemplify the need for behavior change.
At some point, the COVID-19 crisis will pass. What remains a mystery is how much of our new normal we’ll maintain or how quickly we’ll fall back on old habits. Will we learn from this experience? Will our institutions – government, business, medicine and the media – pay more attention to the state of American health in the future? If nothing else, COVID-19 has shown us that, when necessary, we can change our behavior.
It was necessary before the advent of COVID-19. It remains the case looking ahead.
Louis Bezich, senior vice president of strategic alliances at Cooper University Health Care, is author of "Crack The Code: 10 Proven Secrets that Motivate Healthy Behavior and Inspire Fulfillment in Men Over 50."