Social Determinants of Health – Healthy Eating Again: Higher Household Income vs. Health Behavior Patterns
Income and Healthy Eating. In a prior post, a sample of over 2,000 adult interviews showed a clear relationship between increasing household income and higher odds of healthy eating. This relationship, supported by many other studies, has identified income as a social determinant of health.
The truth is…well, not quite.
Healthy Eating within Higher Income Households. Looking at the odds of healthy eating within higher income households ($75,000 to over $250,000 per year), the Patterns of Adapting to Health (PATH) identified healthy eating odds contrary to expectations. In fact, variation in the odds of healthy eating among adults in higher income households were significantly impacted by the health behavior patterns of those adults. Higher odds of healthy eating were primarily driven by three PATH (Patterns 7, 8, and 9). In contrast, household members conforming to Patterns 1, 2, 3, and 4 actually showed lower odds of healthy eating, in spite of coming from higher income households.
Beyond Social Determinants. Key point: Analysis of health differences across social determinants are likely to mask the true behavioral drivers in operation. It is just as likely that adult conformity to certain naturally occurring patterns of adapting to health drive them to seek social situations and environments that support the expression and goals of their underlying pattern.
The conformity of adult health behavior to identifiable patterns may explain more variation in health than explained by social determinants. #health #diet #income #socialdeterminant #healthbehavior #patternofhealth
Dieting is the most frequently promoted method for losing weight. Just count the number of Jenny-Craig, Nutrisystem, or other diet product commercials on any given day!
But why is dieting promoted far more often than exercise?
The Patterns of Adapting to Health (PATH) offer insight into this question. The PATH show that adult health-related behavior conforms to predictable patterns rather than being entirely unique to each person. What this means is that health-related behavior options a person can actually choose is constrained by the behavior defined by their dominant pattern.
The graph above looks at the odds of using dieting and/or exercise as a health promoting activity in a sample of over 2,000 adults. The odds of choosing dieting were greater than the odds choosing exercise for six of the nine patterns. Adults dominated by patterns 3, 5, 7, 8, and 9 were more likely to choose dieting over exercise. Adults dominated by Pattern 8 were the only ones with extremely high odds of choosing both.
The PATH Effect
This outcome is predicted by the patterns. All the PATH, with the exception of Pattern 8, are defined by lower levels of physical activity or exercise. In contrast, patterns 3, 5, 6 and especially patterns 7, 8 and 9 are defined by higher interest in healthy dieting. The result, is a much larger consumer market for dieting products versus exercise products.
The PATH help explain why dieting products are promoted at a much higher rate than exercise products. Dieting is a health-related behavior option "allowed" by many more patterns while only one pattern, Pattern 8, allows high levels of physical activity or exercise.
The PATH explain why the market is smaller for exercise products. More adults find it difficult to increase and maintain higher levels of exercise because their dominant PATH resist this behavior. It is only a realistic option for those adults dominated by Pattern 8.
#diet #exercise #health #behavior #weightloss
The Research. Three different studies across multiple years (2000, 2012, and 2017) and different adult populations showed that as adult’s health behavior is dominated by Patterns 1, 2, 3, and 9 their delay of health care due to worries about costs is strong. In contrast, as adult’s health behavior conforms to Patterns 6, 7, 8, and to a lesser extent Pattern 4, health care seeking is not delayed over concerns about the expense.
Conclusion. An adult’s increasing conformity to the nine Patterns of Adapting to Health (PATH) is a direct and stable predictor of his or her tendency to delay health care or not because of concerns about health care costs.
Implications. In spite of the changing mechanisms of financing health care delivery over the past 17 years, a person’s decision to delay or not delay health care due to cost concerns have remained stable and reliably predicted by their dominant pattern of adapting to health (PATH), irrespective of changes in the actual costs themselves.
Hospitals and health systems promote their diagnostic services as a strategy for early diagnosis and prevention, but also as a strategy to get potential patients in the doors.
The fact is, only one segment of the adult population really considers diagnostic testing and prescription medications as critical to staying healthy: Adults conforming to Pattern 7 identified by the Patterns of Adapting to Health (PATH).
These adults are consistently linked to the highest demand for both diagnostic testing and the use of prescription medications as health supporting activities.
The tailoring and targeting of marketing promotions to adults with Pattern 7 offers a potentially higher return for health care and hospital marketers in two ways:
Patient satisfaction contributes to clinical outcomes, patient retention, fewer medical malpractice claims, and improved reimbursement. Unfortunately, most guidance given for improving patient satisfaction focuses on improving service delivery and staff-patient interactions. The guidance is basically - get better.
Health Behavior Patterns and Satisfied Patients. Research relating the Patterns of Adapting to Health (PATH) to patient satisfaction ratings over 10,000 patients found that patients dominated by two patterns, Pattern 4 and Pattern 7, had over two times greater odds of giving a “very satisfied” rating compared to patients dominated by the other patterns. It seems that patient satisfaction is determined both by the behavior and culture of providers as well as individual patient dispositions at least partially shaped by their health behavior pattern.
Attracting Satisfied Patients. This gives health care providers another option for raising their patient satisfaction levels: Attract a higher number of patients dominated by Pattern 4 and Pattern 7. This is actually a viable strategy. Research over the past 30-plus years has confirmed that all nine Patterns of Adapting to Health (PATH) exist in every market within the U.S. Those providers that attract a higher rate of those Pattern 4 and Pattern 7 patients within their service areas will see patient satisfaction benefits.
Implications. Many market research studies have confirmed that patient preferences for local hospitals can differ based on patient’s dominant health behavior pattern. Some hospitals may be unknowingly benefiting from attracting and admitting patients dominated by either Pattern 4 and Pattern 7. Other hospitals, on the other hand, may be suffering, relative to patient satisfaction, because of unknowingly admitting fewer of these patients.