Habits. Another Third Rail of Health Care.

Habits. Good and bad, will be a significant determining factor on how successful we will be in improving health, bettering care and lowering costs. Unless people eat better, exercise more and abstain from unhealthy activities, we will never lower costs no matter how efficient and correct we deliver care. Roughly 60 percent of the population is at risk of slipping into a chronic condition, and although about 15 percent of the US suffers from some form of chronic illness (diabetes, heart disease, etc...), these people account for over 70 percent of our costs. So you can understand how critical it is for us to help folks avoid slipping into a chronic health state.
Currently, there are many freemium apps online and in mobile form that allow people to track diet and exercise, mostly in a self-reporting format. But other than allow people to gather information and suggest diet or types of exercise, no leap has been made to create healthy pathways for people that will help them change their behavior. It's a daunting task, yes, but look at the engagement of Facebook. Social media may be our savior in health as well as our undoing in other aspects of our lives. Studies show that people's behavior is most affected by social media - friends. I'm guessing that pre-Internet, studies would have shown that people were most affected by friends. The social media application simply provides access - and scale - to a process that may have taken significantly longer or may have never happened if reliant on traditional communication tools.
Also, social media isn't necessarily reliant on the newest hardware, although the proliferation of smart phones and ensuing apps have gone a long way in making almost every activity relevant to someone. Facebook is used by almost 100 percent of its relevant market, which means that somewhere people are using dial up connections to access it via IE6 on Windows XP. Others are using iPad2s on mobile broadband. It's that kind of relevance that we in health care must create related to adopting sustainable, healthy habits. As integration of life activities proliferates, we'll share more when it's easy and likely prompted. The trick is driving the behavior, not simply reporting it, and that will require a more clever social media pathway than curretnly exists.
In a recent study regarding prediabetes patients cited in a Los Angeles Times article, encouragement from others regarding diet and excercise was significantly more effective than a drug. The landmark Diabetes Prevention Program study "followed more than 3,000 people who were overweight and prediabetic. Researchers randomly separated the subjects into three groups: One-third took the diabetes drug metformin, one-third received a placebo and the other one-third received intense support to help them get more exercise and lose weight." The results reported in 2002: People receiving diet and exercise coaching reduced their risk of developing diabetes by 58%; those on metformin reduced their risk by 31%.

LA Times article here: http://www.latimes.com/health/la-he-prediabetes-20110321,0,4467777.story