Healthier by Default

What is an optimal default?

In the context of obesity and chronic disease prevention, it’s about creating opportunities to help people choose a healthier behavior in ways that are easier, if not automatic.  Here’s a great example:

To help make healthy choices the automatic and easy option for parents and millions of young children, McDonald’s recently pledged to promote and market only water, milk, and juice as the beverage in its Happy Meals.  Parents still have the option to request a soda as a substitute for the healthier choices.  The fast food giant has committed to implement the new default in 30 percent to 50 percent of its 20 major markets within three years and 100 percent of the 20 markets by 2020.

There is growing recognition among total health advocates that optimal defaults can have a dramatic influence on nutrition and physical activity decisions.  Optimal defaults are an important part of a new focus on healthy environments—where people live, work, play, and learn—as the foundation for effective prevention efforts.  A focus on optimal defaults is also a departure from the traditional view that blames obesity and chronic disease on a failure of personal responsibility and individual willpower in isolation from environmental and social factors.

Optimal defaults can address in many ways the behavioral, environmental, and attitudinal variables that influence energy intake and expenditure, which in turn influence obesity and related chronic diseases.  Here are just a few examples:

• Making cycling a more practical and convenient transportation option by increasing bike racks and safe bike routes
• Encouraging city planners to design walkable, centrally located neighborhoods, rather than sprawling outer suburbs
• Offering vegetarian meal options on “Meatless Mondays” in hospitals and other large-scale food service establishments
• Being able to use food stamps at local farmers markets
• Implementing “exercise as a vital sign” in health care delivery

The multifaceted nature of obesity and chronic disease makes it extremely unlikely that any single clinical intervention, wellness program, community resource, or optimal default, by itself, can promise a sustainable solution.  Experience from other epidemics suggests that multiple strategies in multiple settings are needed.  Optimal defaults for healthier choices are clearly an important part of the multi-setting, multi-strategy line of attack that seems to be gaining traction.

For more information on this topic, check out Kaiser Permanente Institute for Health Policy’s report “New Ideas and New Action on Obesity.”

Source: http://centerfortotalhealth.org/healthier-by-default/

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