Personal Responsibility #2

Jason-

Good and timely post...big topic. Really big topic. I am guessing that we will spend some time on this topic, so let me just attempt to respond to your two direct questions with this post.

1. How do you feel about employers mandating healthy behavior (such as company that will not employ smokers)?

I have no problem with employers mandating evidence-based healthy behaviors, and I think it would be wonderful if that included some yoga and meditation time as well as mandated healthy working hours and a living wage for all employees...but that might be for another blog post.

One thing that comes to mind immediately is the actual capacity for effective and sustainable change. I tend to think that employers have a tendency to "mandate things" poorly, regardless of their good intentions. Mandating certain behaviors as part of the initial hiring expectations is generally much easier to do than to introduce new mandates for existing employees. It can be done, I just do not see much of it done very well.

I used to work for a healthcare system that decided to go "tobacco free"...no smoking or use of tobacco products at any of their locations (for employees, patients or visitors) and no smoking or use of tobacco products during working hours for employees regardless of location. Might seem like a no-brainer for people working in healthcare, but this was highly unpopular with many employees. The organization did a very good job of implementing this change though...they started talking about it at least a year in advance, they pushed out a lot of information about the change, why the change, when the change, etc. including good, authentic use of internal blogs for real and candid dialogue. They also provided extensive smoking cessation programs for employees and spouses and other incentives.

So, I think this was an example of an organization doing a really good job of implementing a new mandate, but I think it is rarely done that well. Organizations are not good at change in general, and I think that most will really struggle with new mandates, especially mandates of this nature.

We also do not like to be told what to do or what is good for us. Even if we know it to be true, we do not like others telling us what to do. I used to be a smoker. I never had any confusion about the negative impacts of smoking, and I knew that I needed to quit. I also hated being told this by others. Not sure if it is a cultural thing or a human thing, but we are very resistant to the direction of others.

2. What do you think is going on as it relates to personal responsibility and the behaviors impacting our health?

Hmm...that is pretty complicated I think. Part of it is simply the fact that this is one of those things that has a big choice-consequence gap. For example, I may know that eating a quadruple cheeseburger wrapped in bacon and smothered in ranch dressing (I think my cholesterol just went up from typing that) is not "good for us" in the long run. But I can eat it, get some immediate gratification with the consequences being several years away. It is not likely to cause me any great hardship tomorrow or next week. It is hard to work against that delay. It is easier to get serious about our personal health after some of that has started to catch up with us. But even then behavior change is really hard. I have seen data on people who have had life-saving heart surgery showing that one year after surgery, the majority of them have not changed their behavior in any way to reduce their risk for future problems. Behavior change is hard and poorly understood.

I also think that we are failing our children in this area right now, I think that the fast food industry is not our friend and we have tip-toed, and continue to tip-toe around the issue of smoking. I think that we are just beginning to educate ourselves on what is actually healthy and what is not healthy. And businesses lead with what is profitable, rather than what is best for our wellbeing. If I can make a killer profit on the super-jumbo-mega-supreme nacho platter, I am less likely to push apples and oranges...which limits choices and it is a vicious cycle.

And, maybe...maybe there is something bigger going on with personal responsibility in this country. I have seen some pretty horrible data about personal and family debt in this country. I have seen data indicated that many and possibly most Americans are not really happy with their job, yet do not do anything about it. Maybe part of what we are facing is actually a crisis of personal responsibility.

-joe