Blake, I wonder if I can gently push on this a bit...for the sake of discussion?

Is behavior change the fullest aspiration? What about all the things that get in the way of good behavior or influence unhealthy behavior? What about community and social conditions? Individual behaviours and choices are structured and constrained by the socio-economic determinants of health, including income, housing and environment, early childhood development, employment and working conditions, food security, social support and connectedness, and others. Furthermore, even if the behaviors were healthy, even if people make "correct" choices -- don't smoke, exercise well, eat what you're supposed to eat, etc. -- they're still likely to have poorer health than people with more material means.



Hey Scot and Blake,

I have found that wanting to change people is very appealing because many of us have indeed made choices that have helped us improve our well-being. Therefore, it's very tempting to project our own experiences onto other people. However, for some people, there are community and family conditions, beyond their control, that condition people to engage in undesirable behavior, for themselves and for society at large. In my view, the strong belief that people can make better choices if they want to is deeply rooted in our society. It is deeply rooted because of many reasons. Two come to mind: 1. if we change people we don't have to change the environment and rock the boat, and 2. there are many religious and cultural traditions that make us belief in the power of the individual (the Protestan ethic, capitalism, consumerism). While I wish all of us could change our behavior to improve our wellness and the wellness of society at large, there is too much scientific evidence pointing to the fact that our health and wellness choices are often conditioned by factors external to ourselves such as social class, educational (lack of) opportunities and peer pressure. This is why we have to create positive social norms, reduce inequalities and offer equal educational and occupational opportunites.