A recent brief article summarized the secret to a healthy life as being based on four main "pillars" (see: Few Americans Follow 4 Main Pillars of Heart Health). I quote it below:
Most Americans know that a heart-healthy lifestyle includes eating a healthful diet, not smoking, being physically active and keeping weight and body fat down. But a new study found that fewer than 3 percent of American adults could claim all four healthy elements. Only 2.7 percent of the Americans in the study were nonsmokers who ate a reasonably good diet, including eating plenty of vegetables and whole grains and avoiding saturated fat; got at least 150 minutes of moderate exercise a week; and had a healthy percentage of body fat, defined as up to 20 percent for men and 30 percent for women....The study, published in Mayo Clinic Proceedings, was based on data gathered from the National Health and Nutrition Examination Survey from 2003 to 2006 and included a nationally representative sample of 4,745 Americans. Eating habits were self-reported, which can be unreliable, but other measures were based on objective tests, including blood samples to verify smoking status, a sophisticated X-ray test to determine body fat, and accelerometers to measure physical activity.
I admit that I was surprised to learn that only 2.7% of Americans consumed a healthy diet, did not smoke, were physically active (at least 150 minutes of moderate exercise a week), and maintained low body fat (up to 20 percent for men and 30 percent for women). I began to ponder ways that one might develop a program to increase this percentage. There is a body of research that the most effective incentives to persuade people to lead a healthier life are financial. Based on this concept, I came up with the following idea:
- Health insurance companies would offer an insurance discount (30%. for example) to all adults who successfully attain these four goals. The discount would obviously need to be significant enough to attract subscribers to the program. Many of the first to enter would undoubtedly be those who already meet the criteria but the idea could spread to others. Also, many people are provided health insurance by their employer but the incentives could be used to offset the cost of high deductible plans that are now common (see: Trouble Ahead For High Deductible Health Plans?).
- A key issue that needs to be addressed for this proposal to succeed is how the insurance companies would validate the claim on the part of an interested person that he or she meets the four "pillar" criteria. One idea would be that the insurance companies could contract with medical clinics to validate the non-smoking requirement with, say, a finger stick, point-of-care test for cotinine (see: PTS DetectTM Cotinine System) and calculate the body fat requirement during a brief physical exam. Here's one example of a fat calculator based on body measurements (see: Body Fat Calculator). Physical activity of an applicant could be measured by a wrist monitor like Fitbit.
- How would one check an applicant for a healthy diet? Perhaps some blood tests could be used in this regard but lab testing could be supplemented by a smart phone app that the individual could use to periodically record his or her diet. It wouldn't be a daily log but some kind of overarching dietary overview.
I am sure that this idea is far from perfect it could be worth a try on a small scale. We need to attempt some novel ways to encourage a more physically fit population and financial rewards have proved in the past to be the most successful.