FOCUSING ON HEALTH REFORM RAND Research on Health Behavior and Lifestyle Change

There is widespread consensus that making healthy lifestyle choices including diet, exercise, and avoiding smoking, are vital to a healthy population. However, according to the Centers for Disease Control and Prevention (CDC), Americans have a long way to go in attaining these goals. For example, the latest data from the CDC indicates that obesity rates continue to rise. Obesity is a known risk factor for diseases such as Type 2 diabetes, hypertension, cancer and coronary heart disease. RAND work on health behavior has focused on obesity and how the environment affects health through access to nutritious food, opportunity for exercise, stressors such as violence and poverty, and exposure to environmental hazards. In addition, RAND investigators have studied the effect of obesity on health spending, using a micro-simulation model to estimate lifetime cost. We found that there would be savings to Medicare from reducing obesity; this was the only behavior change that resulted in savings for Medicare. Although a strong link between lifetime health care costs and healthy behaviors has not been established, employers and public and private insurers have begun to focus attention on assisting consumers in making lifestyle changes. In particular, states and private organizations have looked to the use of incentives in health insurance programs to promote behavior change.