Wellness

Individual behavior is the biggest determinant of health. It is estimated that over 50 percent of one's health status and health care costs are driven by their behavior, or lifestyle. That means that more than half of our health problems are of our own making and are preventable. This knowledge has led to a burgeoning wellness movement in the past couple of decades, led mostly by employers, who pay the lion's share of Americans' health care costs.

The wellness movement has grown more sophisticated and branched out into diverse directions. But at its core, wellness initiatives have in common that they seek to engage, empower, and motivate people to achieve better health outcomes. State-of-the-art wellness programs target the full spectrum of health status, which consists of the chronically ill, acutely ill, at-risk, and healthy. They do so while addressing four components of behavior change: knowledge, skills, motivation, and opportunity.

Such programs start with individual health risk assessments to identify each individual's risks. This is followed by personal health coaching, and usually includes financial and other incentives for participation (e.g., discounts on health insurance for not smoking and maintaining a healthy weight).

Not surprisingly, the most frequent targets for wellness intervention and behavior change are tied to the largest drivers of disease and rising health care costs:

* Obesity and overweight

* Smoking

* Lack of physical exercise

* Poor nutrition

* Excessive and/or poorly managed stress

* Alcohol abuse

But it doesn't have to stop there. Some wellness initiatives include:

* Safety and prevention, e.g., use of bicycle helmets and seatbelts, prevention of Lyme disease, avoidance of skin damage from the sun, becoming a hard target for criminals, etc.

* Getting recommended health screenings, e.g., mammograms, colorectal and cervical cancer screenings, blood pressure and cholesterol checks, glucose levels

* Disease management programs to encourage people with chronic health conditions to adhere to best practices for treatment and maintenance

* Getting flu shots and other immunizations

* Learning how to get a good night's sleep