[Originally in Health Beat, Richmond Register, January 2014]

Buses and obscure uncles come up a great deal among those people who like to argue against efforts to live a healthy lifestyle.  You know the folks I’m talking about, I’m sure.  They’re the ones who see you eating baked instead of fried chicken, and who then try to convince you that you shouldn’t deprive yourself of the greasy goodness, because after all, no matter how healthy you try to be (say it with me now), “You could always get hit by a bus tomorrow.”  Alternatively, you may get the comparison to Uncle So-and-So, “Who smoked and drank his entire life, and lived to be a hundred!”

I find these comments usually come from individuals who have a rather passive view of health and healthiness.  Their personality style is that of the external locus of control, a topic I’ve written about before.  Rather than assume responsibility for their state of health, they find it easier to cite the most extreme statistical outliers to support their beliefs (like that mythical uncle).  When their own health doesn’t fit with this passive view, they attribute everything they suffer to genetics or something in their environment.  I’ve evaluated many people who will hack and cough all through the session, talking at length about their family history of asthma or the chemicals their irresponsible employer used around them, all the while ignoring that they’ve been a two-pack-per-day smoker for the past quarter century.

There are two mistaken beliefs built into this worldview:

Mistake #1.  Indulgence equals happiness.  This is the belief that a state of happiness can only be gained by eating whatever one wants, and seeking comfort (sic: indolence) at every opportunity.  The idea of gobbling a hot fudge sunday while resting in a hammock, or sipping margaritas on the beach is the gold standard of relaxation for a great number of people.

The reality is that we tend to habituate to constant indulgence.  People who eat “naughty” foods more often, for example, tend to find such foods lose their zest, become boring.  Saving them for special occasions tends to keep them more savory.  Further, there is a history in the West and East of ascetics, monks who deny themselves creature comforts most of us take for granted.  These individuals report no less quality of life.  In fact, they are often more energetic and productive than our own population, in which a third of us are overweight and tired all the time.  Indolence too, doesn’t seem to fit with the research.  Being inert on the beach may sound nice, but more people report a good experience when they go hiking on their vacation, or tour a museum.  Unstructured time tends to be boring and a little depressing.

Mistake #2.  Lifespan is the goal of health practices.  If you had the choice, would you rather live in good health for sixty years, and then die suddenly, or make it to age 80, but feel miserable and useless for 40 years of it?  This question brings out the difference between the LIFEspan and the HEALTHspan.

Many Americans have the mistaken view that the goal of healthy lifestyle choices (self-deprivation as they would see it), is to have more years in their life.  So it’s easy to find contrary evidence of that person who “exercised every day, and then got hit by a bus.”  But the *true* goal of healthy choices isn’t a longer life, but a better one.  To a proactive, health-conscious person, a shorter, healthier existence is better than a longer, sicker one.  To feel good and productive for as much of one’s life as possible.

You notice no one ever tells you what Uncle So-and-So looked like for most of his life, and they don’t describe his daily activities?  Maybe he won the genetic lottery and could be that one in 10,000 who could get away with abusing his body for a century.  More likely, he looked like a wheezing, upright, shambling cadaver, and probably felt about the same.  If asked, would he recommend his lifestyle to anyone else?

Would YOU?