From health as a rational choice to health as an affordable choice

Am J Public Health. 2009 Dec;99(12):2134-9. doi: 10.2105/AJPH.2008.155382. Epub 2009 Oct 15.


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.

MeSH terms

  • Health Behavior*
  • Health Policy
  • Health Promotion / methods*
  • Humans
  • Life Style
  • Motivation
  • Obesity / etiology
  • Obesity / prevention & control
  • Physical Fitness
  • Public Health
  • United States