Tag: health decisions

Immediate Risk

We often speak in general terms about health priorities without discussing immediate risk. But when caught in a moment that requires a swift choice to survive, talk of other health priorities seems less than important. And the choice to avoid immediate danger at the expense of something that could put us at greater risk in the future doesn’t really feel like a choice at all. Health decisions are often like that.

Standing in an underground concrete box filled with spider webs and strangers a couple of nights ago, I felt like spiders were crawling on my flip-flop clad feet. Would they bite me? Would I have an allergic reaction? Was that guy’s sneeze an indication of a contagious virus or a response to dust? The thoughts ran through my head, but I was sure my priorities were right.

At 2:40 in the morning, I would rather have stayed in bed. I was concerned about spider bites and potential exposure to illness in an enclosed space. But I was staying in an RV. Radar showed three rotating storm cells in the area. General health priorities took a back seat to the decision to avoid the immediate danger of being hit by a tornado.

In retrospect, the decision was sound. A 1500 yard wide 145 mph tornado proceeded on a 20-mile path about two miles away. It killed 4 people. Seeing twisted, collapsed buildings on my route the next morning reinforced my belief that the danger was real. Another camping area in the path saw RVs much larger than mine flipped onto their tops.

Not everyone in the RV park came to the shelter. Did the others know more than we did or were they more comfortable with risk? Were they more concerned with feeling claustrophobic than with being safe? Did they value the comfort of their RV more than temporary discomfort? Did they talk themselves out of a belief they were in danger? One guy started driving around in his truck. Perhaps he thought he could outrun the storm.

We all assess things differently. It’s often difficult to understand why a friend or relative makes the health decisions they make. But what seems clear to me may not be clear at all to someone else. Or they may have a concern that supersedes physical risk.

It can be helpful to think of health decisions in a timeline – immediate risk must be addressed first. After that, it may be harder to determine order. You can always start with what will make your life more pleasant.

For me that’s for my stomach not to hurt, my joints not to ache, and not to feel like my blood sugar is dropping. That means avoiding gluten, eating a low histamine diet, and keeping my mealtimes regular.

It’s easy to view avoiding gluten as making your life less pleasant and it does require an adjustment. But the inconvenience is worth it to me because I feel so much better. I also know I’m increasing my life expectancy. Together, that’s a powerful argument for making dietary adherence a priority.

Next up, I feel better when I move. I don’t have to do anything herculean. Yoga, gardening, swimming, lifting weights, and chasing grandchildren get me away from the computer. As long as I include them on a regular basis, I feel good and stay flexible.

And so it goes. When making health decisions, I try to look at both the big picture and the immediate risks. That clarifies many decisions for me. Perhaps a similar approach can help you prioritize as well.

Is Bias Affecting Your Decisions?

Ever wonder how bias is affecting your decisions? It’s hard to make healthy decisions, especially these days. We have access to a ton of information. We also have access to a ton of disinformation. Bias enters the picture to add further complication.

We can carefully vet our sources, but even information from credible sources may be biased. And once we absorb information, it is subject to our own bias.

All of us are biased. Our brains use prior experience as a shortcut to form a perception of reality in the moment. If bullets have pelleted my home in a drive-by, my perception of the sound of gunfire may be quite different from someone who has only heard that sound at a gun range. Or, if I’ve only heard gunshots on TV, I may perceive a gunshot outside my home as a car backfiring.

We often remain unaware of our biases or those that have long persisted within our culture. This is as true in healthcare as it is in other areas of life.

For example, you may have had a health professional recommend a low-fat diet to improve heart health. This sounds logical, reasonable, and is a widely issued recommendation. It is easy to assume that research backs up this advice. And yet, that’s not the case.

According to a study published in 2015, a relationship of causation between fat consumption and coronary heart disease was never established. In spite of that, guidelines for fat consumption were established as if causation had been established. The guidelines were included in the 1977 McGovern report and persist in many doctors’ practices today.

Bias in policy and decision making has been on daily display during the pandemic, resulting in a mishmash of barely discernible pieces of fact-based guidance. In fact, public health guidance has been such a nightmare to navigate that I’m not going to try to decipher it here.

Instead, let’s focus on personal bias. Here are a few things to watch for when attempting to determine whether bias is influencing a decision:

Judging Yourself – Judging yourself may prevent you from recognizing bias. It can be difficult to isolate personal bias if you judge all bias as bad. Remember, bias assists your brain with processing information quickly. We are wired for this. That doesn’t mean you shouldn’t interrupt the circuit. Some bias creates real harm. Still, having bias is not, in and of itself, inherently evil.

Feelings of Danger – There is no real danger in questioning beliefs. Questioning is how we progress and grow, but when we hold a belief so closely it feels like part of our internal workings – part of what makes us, us –  it can feel dangerous to question that belief. If we look too closely, we may find our sense of reality shaken. It can feel better in the moment to turn away from danger rather than face potential bias.

Lack of Perspective – Without perspective, we may not be able to turn an issue around to observe whether our view is informed, balanced, fact-based, or reasonable and whether it affects us in a positive or negative way. Further, we may not be able to see the effect our position on an issue has on others. It is hard to gain perspective from the middle of something. That’s why we have the cliché – you can’t see the forest for the trees. We must sometimes invent a way to increase distance from an issue so we can see it more clearly.

Defending the Status Quo – Discovering personal bias requires internal examination. Sometimes when we feel uncertain, we ask for another person’s opinion. External observations may be helpful when exploring the layers of a belief but substituting another’s opinion for your own assessment won’t necessarily result in ferreting out bias. In fact, relying on someone else’s opinion of your process or position may tempt you to defend the status quo.

Allowing the Past to Prevent Progress – Bias is often defended overtly and tacitly by explaining that we do things according to tradition or the way they’ve always been done. Using the past to determine the future can feel grounding and safe. And there’s no denying it’s important to learn from the past. But holding onto beliefs just because they’ve been around a long time and are widely accepted can perpetuate unhealthy bias and prevent progress.

Human nature urges us to present ourselves in the best light. Discovering bias in our beliefs and/or actions may require some detective work. It can also help us determine whether bias is influencing our decisions.

Ultimately, recognizing and eliminating bias can lead to healthier life.