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November 28, 2007

Asymmetric Paternalism to Improve Health Behaviors

Author Affiliations

Author Affiliations: Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (Dr Loewenstein); Aetna Inc, Hartford, Connecticut (Dr Brennan); Center for Health Equity Research & Promotion, Philadelphia Veterans Affairs Medical Center, Department of Medicine, University of Pennsylvania School of Medicine, Department of Health Care Systems, the Wharton School, University of Pennsylvania, and Leonard Davis Institute of Health Economics, Philadelphia (Dr Volpp).

JAMA. 2007;298(20):2415-2417. doi:10.1001/jama.298.20.2415

Individual behavior plays a central role in the disease burden faced by society. Many major health problems in the United States and other developed nations, such as lung cancer, hypertension, and diabetes, are exacerbated by unhealthy behaviors. Modifiable behaviors such as tobacco use, overeating, and alcohol abuse account for nearly one-third of all deaths in the United States.1,2 Moreover, realizing the potential benefit of some of the most promising advances in medicine, such as medications to control blood pressure, lower cholesterol levels, and prevent stroke, has been stymied by poor adherence rates among patients.3 For example, by 1 year after having a myocardial infarction, nearly half of patients prescribed cholesterol-lowering medications have stopped taking them.4 Reducing morbidity and mortality may depend as much on motivating changes in behavior as on developing new treatments.5

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