The Tyranny of Good Health

It's hard to be healthy.   Unless you are young or genetically blessed,  and even then sometimes, it takes lots of hard work to be healthy.  It is work that only gets harder as you age.  As the saying goes, Father Time is undefeated (Tom Brady notwithstanding).

Unfortunately, we live in a society that thrives on convenience, and working hard on our health is one of those things we don't find very convenient.

Just think about what's involved.  You have to eat the right foods, in the right amounts.  You have to get enough exercise, without overdoing it.  You need to get enough rest, but not spend too much time in bed or on the couch.

It helps to have a purpose, whether that is work, an avocation, or something else that motivates you every day.  It helps to have plenty of friends and family, but it takes good judgment and some luck for them to be ones who will help you stay healthy.  And it helps to avoid some things that many find pleasurable, like tobacco, too much alcohol, and recreational drugs. 

The worst of it is that, despite your best efforts, inevitably your metabolism will slow down, your cardiovascular system will become less efficient, your muscles will get weaker, and your bones will grow more brittle.

It's possible that you'll have a middle-age-crisis attempt at living better, so that you'll claim you feel healthier at 50 than you did at 40, but no matter what you do, you'll almost certainly be less healthy at 70 than you were at 20, and at 80 you'll be looking back at 70 enviously.

And, of course, there's no telling when you'll catch some unexpected bug, or the long tail of a genetic defect will come to haunt you.   

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Sadly, the payoffs for good health efforts don't last long.  Slip up on your diet or your exercise, and the declines aren't measured in decades or years, but in months or weeks.

No, staying healthy is anything but convenient. And that is a problem.

In The Tyranny of Convenience, Tim Wu, a professor at Columbia, asserts: "In the developed nations of the 21st century, convenience — that is, more efficient and easier ways of doing personal tasks — has emerged as perhaps the most powerful force shaping our individual lives and our economies."

He goes on to say: "Convenience seems to make our decisions for us, trumping what we like to imagine are our true preferences....Easy is better, easiest is best."  

Think about your grocery store experience.  Sure, you can buy all sorts of fresh fruit all year long, plenty of fresh meat every day, but it is so much simpler to buy something pre-packaged that you can just pop in the microwave.  That those pre-packaged meals and products may be loaded with lots of sugar, salt, or fats -- designed precisely to make us crave them -- is the price we pay for that convenience.

You don't even have to go in the store.  Order online and they'll bring your groceries out to your car!  They'll deliver them to your house!  Not for nothing did Amazon buy Whole Foods.  It's easier than ever to get more calories, with less nutrition, while spending fewer calories acquiring them than ever.

We'd rather microwave something unhealthy (or get it from a drive-through) than to fix something healthy.  We'd rather drive than walk, and we'd rather look at our many screens than drive.

Steve Downs, the Chief Technology and Strategy Officer for The Robert Wood Johnson Foundation put it aptly: "We have created lifestyles that do not suit the species we have become."  He urges that we build health into the "operating system" of our culture.  

Right now, he points out. the easy choices -- the convenient ones -- in our lives tend to be choices that are not the best for our health.  He believes this has to change:

It would mean creating environments where healthy choices are the easy choices. And not just the easy choices, but the desirable choices, even the defaults.  It would mean building a culture where people don't have to think consciously about being healthy, but rather being healthy is a natural consequence of going about your day.  

He outlines some promising efforts that use technology to try to achieve these goals, but admits we are still in early days of making the needed changes.

Until they happen, we may be left with what Professor Wu concluded: "We need to consciously embrace the inconvenient — not always, but more of the time...Struggle is not always a problem. Sometimes struggle is a solution. It can be the solution to the question of who you are."

We can try to better resist the "stupefying power" (as Professor Wu describes it) of the convenient choices in order to make the choices that are right for our health.  

Throughout it all, our healthcare system enables our bad behaviors.  It has become the more convenient choice.

We'd rather go to our doctor to get a pill to address our health problems than to make basic changes to our health habits.  We'd rather complain about our health insurance not paying as much of our medical bills as we'd like than to spend money out of our own pockets on better health habits.  We get surgery when our diets fail or when our backs and knees can't support how heavy we've become.

We look first to our health professionals to get us out of the health holes we've fallen into, instead of trying to get out of them ourselves.

Yes, good health imposes a tyranny upon us.  It requires constant vigilance against all the insidious things that would rob us of our health.  There is a famous quote, oft attributed to Thomas Jefferson, that "eternal vigilance is the price of liberty."  The same could be said about the price of good health.

But poor health choices impose a tyranny of their own.  Making poor health choices can be like the mythical frog who will sit in gradually boiling water until it cooks him.  Before we know it, poor health choices cook us too.

Many people spend much time on innovation and technology to improve the convenience of getting medical care, but we need to focus much more attention on how to make staying healthy more convenient.