From Health as a Rational Choice to Health as an Affordable Choice

Sedentary, consumption-based lifestyles are placing entire populations at serious health risks; obesity is a prime example. The individual approach to obesity, which targets those at risk, has largely failed because it ignores wider influences on behavior. Although the population-ecological approach is gaining support, it cannot disentangle clear targets for policy change. Consequently, health promotion has been relegated to the mass marketing of healthy behaviors, which is based on a rational notion that informed people tend to behave in their best interest. Creating environments that support behavior change and providing individuals incentives can be more effective to reduce lifestyle-related risks. A paradigm shift from trying to sell health to the public to creating the conditions whereby healthy choices become accessible and affordable is required. (Am J Public Health. 2009;99:2134-2139. doi:10.2105/AJPH.2008.155382)