Nearly every morning lately, as I make my daily dart to the metro station two blocks away, I pass a familiar face. She is one of about a dozen women who toil in the local nail salon. She does not live in my neighborhood, yet I see her early most mornings hiking up our hill, long before the salon opens.
Most days I wave and smile. But one recent morning I stopped and asked what she was doing. Her English is so-so and my Vietnamese is non-existent. But she managed to proudly convey, “Ten thousand steps!”
She’s not the only one. I myself have caught the walking bug, egged on by my better half and a Fitbit. For me, the rubber wristband has been revelatory. Given how active I am, I just assumed I was getting 10,000 steps every day. Far from it. Knowing your count – and how far you are from the daily goal – is an effective nudge to get off the metro one stop early or choose a lunch spot that’s a few blocks further away.
Some of the biggest brains in our country today are struggling with how to reduce our nation’s medical tab – and make us healthier. One giant clue: in 2010, 86 percent of all health care spending was on patients with one or more chronic medical conditions such as heart disease, stroke, type 2 diabetes and obesity, which are largely preventable. In other words, if we could all commit to shedding a few pounds, move around a bit more and drink a little less, we’d slash costs and feel better in the process. It sounds so simple, but behavior change has turned out to be incredibly difficult.
My encounter on the street was a stark reminder of the value of little things, especially when it comes to improving health. It’s what Stanford behavioral economist BJ Fogg, PhD, calls Tiny Habits. Begun by Fogg in late 2011, Tiny Habits helps individuals implement practical and lasting change by working with their environment to instigate small, mindful changes. Through miniscule, health-conscious adjustments – like opting to take the stairs instead of the elevator each day – the Tiny Habits method reinforces that a little goes a long way.
And because everyone could use a good partner, community-based health plans are joining the movement.
Capital District Physicians’ Health Plan (CDPHP) in Albany, offers InMotion, a mobile app that allows users to track physical activity and nutritional intake, map training routes and share information with friends. Free for both CDPHP members and non-members and available on nearly every mobile phone, InMotion lets users sync the app with several different wearable devices, including FitBit, Connect, MyFitnessPal, Nike+ and Jawbone.
The Take a Healthy Step program created by UPMC Health Plan of Pittsburgh, lets employers reward employees for healthful practices, such as receiving a flu shot, working with a health coach or undergoing a vision or dental visit. With each healthy step, employees earn points that can be credited toward insurance deductibles or for prize drawings. Employers tweak the incentives as needed.
Based in Buffalo, Independent Health’s Max plan provides an allowance of up to $50 toward a wireless activity tracker for members and their partners. The Max plan has low out-of-pocket costs for primary care visits, urgent care services, some medications and telehealth consultations, all of which are exempt from members’ deductibles. In addition, Max consumers can earn money back by participating in Independent Health’s nutrition and fitness benefits options.
Kaiser Permanente’s Everybody Walk initiative encourages individuals to walk 30 minutes a day five days a week. In addition to an interactive website, Everybody Walk offers a mobile app that lists the health benefits of walking, provides information on walking trails and allows users to track their activity and connect with friends.
The irony of course is that there is no magic, let alone science, behind the 10,000 steps a day mantra. In fact, the 10,000 steps campaign began in the 1960s, when pedometers were marketed as “manpo-kei,” meaning “10,000 steps meter.” The idea took off, and since then studies touting the health benefits of 10,000 steps have proliferated.
But that’s not the point. This is about behavior change and how simple, catchy, achievable tiny habits can become ingrained.
Walking meetings are the tiny habit of choice for Ted Eytan, M.D., M.S., MPH, Medical Director at the Kaiser Permanente Center for Total Health. “Walking meetings are easy and can be incorporated into daily life – they’re infectious. They’re a very catchy and simple behavioral change, rather than a far-off health care goal.”
Even in our own office, one woman lost 27 pounds over 6 months armed only with a good pair of sneakers and a Fitbit. She’s organized an online community for our ACHP walkers and like Eytan is a major proponent of walking meetings.
Let me be clear, this isn’t a product endorsement. You don’t need a fancy gizmo on your wrist to walk more, although those Tory Burch bands sure are stylish. But if a device or coupon or buddy helps get us moving, maybe our health care challenges aren’t so insurmountable.