The surprising reasons Americans are so unhealthy

Wellness is within our grasp and yet the United States is among the unhealthiest nations in the world.

Not only did the USA not make USA Today’s Healthiest Countries in the World List, it ranked 28th! Yet America spends more money per capita on healthcare than any other country in the world.

How is this possible with our huge access to information, treatment and medication? In my estimation, there are two main reasons for this: First, a perverse medical system based in illness… and second, a lack of patient follow-through on the wellness directives they’ve been prescribed.

An “illness model” of health

So that’s an oxymoron: an illness model of health. And if you just consider it for a moment, the statement doesn’t even make sense. And why would it? But, the fact is, the American model of healthcare is based in illness. That is to say, patients have been taught to seek care after you are ill or sick or in pain.

The medical approach to the patient approach is to then label the illness and diseases based on the presenting symptoms, and then treat those symptoms. If you see the doctor for a bout of eczema, they treat the eczema. If you get a fever, they work to reduce the fever. Sounds great, but it’s the reverse of good healthcare and does not work, because treating symptoms as they present doesn’t treat the disease at the core. That’s just part of the reason why our medical model places us beneath 27 other nations, while countries like Qatar, Iceland and Singapore made the top 10!

What we need is a wellness-model of health, which looks to create, restore and maintain wellness as its goa, instead of simply removing illness symptom by symptom.

The ancient way

The ancient way of health care, at least in China, was that the physician would be paid to keep his patients well. This included instructing them in breathing exercises, meditative techniques, calisthenics, and in the use of herbs for adding into the diet when specific symptoms would arise. And when a household member would fall ill, the physician would not be paid and might even be banished from the family or town or county for being ineffective.

Now, that approach is unreasonable today but the concept is more valid than ever. And I assert that we must all be our own physicians and keep track of our own health and wellness goals and needs. Easier said than done.  But even when we rely on a physician or other healthcare provider for medical advice and help, it is often not followed. And this lack of compliance or non-adherence to the regimen is the second issue causing our nation to be so unhealthy.

Compliance and adherence issues

When it comes to the use of “compliance” and “adherence” in medicine, it most often refers to medication. That is, patients taking (or actually not taking) the correct amount of their prescriptions at the correct times. This is important because the prescribed dosing and frequency of the selected drug is proven to work best (according to clinical trials).

Patient adherence (compliance) has created a big problem in terms of efficacy of treatment and financial burden on the system. Adherence is measured as the degree to which patients correctly follow the dosing directions. And the more often a drug is prescribed, the greater the deficit in adherence. According to the Key Stats on Medication Adherence, “75% of adults are non-adherent in one or more ways” and “the economic impact of non-adherence is estimated to cost $100 billion annually.”

In short: drugs don’t work in patients who don’t take them as prescribed.

Consider antibiotics. Sometimes there is no other way to stomp out an infection. But not adherence to taking antibiotics as prescribed has put all of us at great risk: antibiotic resistance is the direct result of both miss-use and over-prescribing.

Now, it may seem odd that I am writing about prescription drugs, since I am not a fan. Although I completely understand the need for them in their correct time. However, the issue of non-compliance and non-adherence is pervasive in all realms of health and wellness, and I’d like to look at it now in terms of alternative medicine.

Natural wellness is a DIY approach

What differentiates medical wellness and natural wellness, most notably, is the do-it-yourself (DIY) approach. In many cases, you are taught how to change your diet, or how to stretch, or how to meditate and what herbs or supplements to take, but the doing of all this falls on the patient. Given the above-noted statistics on non-adherence on something so seemingly simple as taking a pill, it’s no wonder the natural approach appears less successful. But actually, it is more an issue that people are less successful in seeing the natural wellness model through because it is so individual-centric. It’s easy to see how non-compliance is the biggest reason for failure here.

This can all change, with some guidance, I hope. Here are five guidelines to help with compliance in following the natural wellness approach…

5 tips for successful wellness

  1. Trust in the resource

The first element for a successful outcome is to trust in the resource. This could mean developing trust in your doctor or therapist or dietician. This trust allows you to be open-minded and to believe that what they are telling you can work if you do it and so is worth the effort.

The resource could also be a website or a book or a podcast, in which someone is teaching a new meditative technique, offering new dietary advice or showing you how to do yoga. Trust in your wellness resources is a necessary foundation to wellness success.

  1. Belief in the method

The second element for a successful outcome with any health-related treatment, therapy or modality, is believing in that method. If you don’t believe acupuncture can help because its theories are so foreign to your way of thinking, then while you may “try” acupuncture, you are not likely to attend all the required sessions. You will then quit and say, “I tried everything; even acupuncture and it didn’t work for me.” A better statement could be, “I didn’t work for acupuncture,” meaning that your outlook or disposition was not well-matched with such a treatment. You must believe in what you are doing before you begin for your effort to be successful.

  1. A motivated “can do” attitude

With trust in your resource and belief in the wellness modality you need next to bring motivation and a “can do” attitude to the table. Because natural wellness methods require that you personally do much of the “work” you must bring your A-game to the table. Motivation is key here, to do what you need to do, when you need to do it. This is where many fall off natural programs that require some time. Even simple things like “close your eyes and meditate for 1 minute each hour” or “stretch your hamstrings for 30 seconds, three times a day” become difficult for many maintain. Being motivated and believing in yourself to carry through goes a long way to success.

  1. Having a support system

Even among those who are self-motivated, failure comes when a support system is not in place. If you are embracing a new diet for yourself that requires whole, fresh organic foods (for example), then you absolutely need the support from your family or loved ones to be successful. They need to support you in your food choices, not put their food choices or desires before yours, and not insist or guilt you into eating meals out in restaurants that don’t serve organic food. Similarly, if you need to meditate twice per day to reduce stress, anxiety and blood pressure naturally, then you need the support of your family to allow you that time, uninterrupted. In all cases, those around you must support you in your goals and needs or they are a derailing force in your wellness success.

  1. Patience and time

Finally, success with any natural wellness program takes time. A new diet takes times to create changes in the body. A new fitness routine takes time to show more range of motion and strength. A course of acupuncture can take two sets of 10 treatment sessions to see results. Herbal medicines take weeks and months to create visible lasting changes in your body because they are gentle and non-toxic. You need to have patience and give natural wellness its due time for best results. Consider how long it took for your health problems to develop. They don’t disappear overnight.

Let’s really think about how it’s possible that we rank so low in the health index of nations. Shifting our focus from an illness model to a wellness model is the way forward. But given the low adherence rate in healthcare, it will take effort and changes in how we think about our health to improve it.


Dr. Mark Wiley

By Dr. Mark Wiley

Dr. Mark Wiley is an internationally renowned mind-body health practitioner, author, motivational speaker and teacher. He holds doctorates in both Oriental and alternative medicine, has done research in eight countries and has developed a model of health and wellness grounded in a self-directed, self-cure approach. Dr. Wiley has written 14 books and more than 500 articles. He serves on the Health Advisory Boards of several wellness centers and associations while focusing his attention on helping people achieve healthy and balanced lives through his work with Easy Health Options® and his company, Tambuli Media.