Article Summary

• We deserve quality health span, not just quantity in years.
• Our lifestyles can prolong our lives and make us healthier and happier.
• By prioritizing what we value and consciously aligning our actions, we are more likely to succeed in maintaining healthy habits.

The idea of not just living longer but living full, healthy lives with the capacity to engage in what matters to us is quite appealing. Life span is recognized as the number of years from birth to the end of life. Quality health span, in contrast, is the number of years across the life span that are healthy, without chronic disease and disability.

Although the pillars of health seem to be promoted in every media outlet, across sectors, and by public officials, it remains difficult for millions of Americans to stay on track with their health. Why is that? To explore, let’s apply what we know from adult learning theory:

• We, as adults, are self-driven. So, to change behavior, it needs to serve a purpose for us. It needs to matter to us!
  • What would it mean for you to have more years feeling “healthy” (whatever healthy means to you)?
• Adults also want to learn and apply the knowledge immediately, solving the problem at hand.
  • If you adhere to a healthy lifestyle, what are things that would change for you today? What concerns about your health could be minimized? What would you do more of if you could?
• Adults need to be able to plan their learning and evaluate the experience. This means many of us prefer not to be told what to do or how to do it. Rather, we want to partner in developing a plan we can use to monitor the impact.
  • What types of behavior changes are you willing to make? How do you measure success?

Focusing on What Matters to You

A Shift in Paradigm: What Matters to You Verses What Is the Matter with You?

In 2012, the New England Journal of Medicine published an article by Dr. Michael Barry and Susan Edgman-Levitan introducing the concept of healthcare providers asking patients, “What matters to you?” in addition to asking, “What’s the matter?”

Since then, some health organizations have changed their dialogues with many of their patients. Regardless of their health needs, they have to center around what matters most to the patient. The health plan then follows. This is not uncommon in health coaching, but it’s a new way to look at how we engage in our own health to improve motivation and behavior change. What if you looked at what matters to you most, what brings you purpose, and then thought about the health behaviors that let you do more of it?

Changing the Conversation: Ben’s Story

Ben is 55 years old. He has struggled to keep his weight in a healthy range his entire life. He’s been told repeatedly by healthcare providers, as well as his wife, that he needs to eat healthy, reduce stress levels, and exercise more. He wants to be “healthy.” Yet, he’s prediabetic and struggles to keep up on family vacations. He’s also sometimes envious of the other parents at soccer games, whom he sees running from end to end of the field to watch their kids.

It wasn’t until a doctor changed the way he interacted with Ben that Ben was finally able to create a plan to regain a state of health and focus on his quality health span. The session went like this:

• “Hi Ben, it’s great to meet you. I’m Dr. S. I want to know more about you before we get into the discussion about what brings you in. What are some important things in your life?” Ben was confused by the question. This wasn’t like any doctor visit before, but he answered, “I love my job in accounting. The people I work with are amazing. But it’s often a lot of work, and I find myself working long weeks. I love my family, and spending time with my kids outside is probably my favorite thing to do. Even though I fought my wife on it, I love that we finally put in a pool at the house.”
• S. responded, “It seems like you have a very full life. How does your health impact doing the things you love?” Ben replied, “Well, because of my work, I sit a lot. This makes me tired. I enjoy going outside, but I get very hot. The pool has been fun, and I wish I could use it more often.” The provider validates what Ben has shared. Then he gets into Ben’s prediabetes management, and the standard required encounter takes place. However, this time, everything is centered around what matters to Ben.

Then, Ben is asked to make a plan using SMART goals (i.e., Specific, Measurable, Achievable, Relevant, and Time-Bound). Ben is in the driver’s seat. The discussion centers around how and when he can use the pool to exercise. He also decided to take up the offer at work to install a standing function on his desk. Ben decides he will see if, by making these small changes, he feels more capable of keeping up during his family vacation in two months.

It was the first time Ben felt seen for himself and not just his lab results. The follow-up discussions centered around his engagement in things that matter to him, and the lab results were secondary.

Now, think about yourself in a similar situation. What would this discussion look like for you? How would the conversation progress about your meaning and purpose? What would your SMART goals consist of?

Support on Your Quality Health Span Journey

Once you recognize the motivation that your meaning and purpose can have on engaging in healthy behaviors, you can begin to make your own SMART goals and change the paradigm of your health. A general understanding of factors that impact health across the lifespan can support you on your journey.

• Genetics: It’s wise to avoid overlooking the role genetics can play. For instance, they may increase susceptibility to certain illnesses. However, the MAIN contributing factors to developing chronic diseases are related to lifestyle choices and other environmental factors.
• Epigenetic Change is how the environment can influence our genes. The study of epigenetics aids in our understanding of why disease happens and potentially how to treat it. For instance, what we eat can impact our genetic predisposition to disease as well as speed progression.
• Environmental Factors also influence our health. For instance, exposure to toxic chemicals, air pollution, food additives, and climate change can all affect quality health span. In many cases (such as food additives), if we understand their impact, we can limit our exposure.
• Chronic Preventable Diseases: According to the Centers for Disease Control and Prevention (CDC), “Five of the top 10 leading causes of death in the US are, or are strongly associated with, preventable and treatable chronic diseases.” Plenty of supporting research exists that indicates modifying behaviors and our lifestyles can help prevent most cardiovascular diseases, type 2 diabetes, colon cancer, and smoking-related cancers.

Modifiable Behaviors: These are behaviors we can control to improve and maintain health span:

• Good nutrition can help prevent chronic disease. Nutrition refers to behaviors such as drinking enough water, eating a healthy plate, getting enough protein, and consuming a rainbow of essential nutrients from vegetables and fruits. Good nutrition also includes limiting alcohol intake. This doesn’t mean you may not be able to have a drink at a party, but it does mean being responsible and limiting consumption. When we think about good nutrition, think about whole foods, foods closest to their natural form, and that vegetables should be part of every meal. If what we choose to eat doesn’t nourish us, it’s probably a good idea to explore other options.
• Daily physical activity, including moving the body every day, avoiding prolonged periods of time sitting, and moderate-intensity aerobic activity (about 150 minutes a week) as well as some form of resistance training to maintain or even gain strength. Physical activity aids us in maintaining a healthy weight, which supports our joints and organs, strengthens our muscles (which can help stability and limit potential fall risks), and improves cardiovascular health.
• Avoid Tobacco use and other harmful substances. This includes direct and second-hand exposure, such as being in places where people are smoking.
• Stress Management. I can’t stress this enough. Our minds and bodies are connected. Chronic stress can negatively impact mood, quality of life, relationships, immune and digestive system, and cardiovascular health. Giving stress as much attention as we give an open wound will serve us from head to toe!

To reiterate, think about what matters to you. Why is it important for you to have a long, quality health span? Then, build your health behaviors around it. It is time for a paradigm shift and for all of us to live longer and healthier lives!