Garlic and Vampires and Interventions

Let’s have a thought experiment.

Suppose we knew with 100% certainty that eating garlic would keep cancer away in the same way that it inhibits vampires. As long as you eat a clove of garlic every day you would not get cancer or vampire bites. Would people still get cancer? Would vampires go extinct?

I’m going to bet that you said yes some people would still get cancer. Some people would fail to implement the intervention as simple as it is.?

In my mind, there are two camps of people who could end up with cancer in the garlic situation.?

Group 1:

The first group includes most of us.

• We want to eat healthy, but dang it, that donut is calling my name. And what’s the best diet anyway?
• We want to work out, but between the job and the kids and the new season of Vampire Confessions just came out, where did the time go?

In the garlic example, we might run to Costco and stock up or get a Garlic Club membership. But the myriad of factors in life - from our busy schedules to the ease of not being resolute with our convictions, to the abundance of access to unhealthy things? - results in a sloppy track record.?

We don’t eat garlic every day. We miss a few days. We may miss weeks at a time. Discouragement and guilt set in and we may throw our hands in the air and say why bother?

Many of the critics of wellness programs and screening interventions cite this human propensity to get distracted and our tendency to find the path to least resistance as evidence that investments in prevention aren’t worth it. Too many people will fall off the wagon.?

I haven’t studied the evidence in depth, but I wonder if attrition is the wrong kind of measure of success. Instead, can we look for those who did find a way to stick with it? Can we celebrate the select few who took on the challenge of behavior change and succeeded? Even if it was one person who kept the vampires away, that is a success in my mind.?

But what about the rest of us? How can we save our lives??

I don’t have all the answers and there are tons of people who study these issues in depth.

Collaboration has to be part of the solution.

• Can insurers bring evidence to the table to show what works with wellness?
• How can the insurance industry influence the environment around us such that it is conducive to better choices and not detrimental to them??
• What other actions can insurers take to reduce the number of barriers to health?

As a last, but important, thought, there is a subset of people who face more adversity beyond a lack of willpower.?

Whether societal, economic, or some other externality, a strong desire for health can be stymied by a very difficult obstacle. Improvements to access to healthcare, food, and safety will need to be addressed to make meaningful progress in saving lives.

Group 2:

But there’s also a second group of people who are going to end up with cancer.

These are the rebels.?

These are the individuals who reject the hypothesis. Who said garlic keeps vampires away? Probably Big Garlic.?

The rebels will rub it in your face that there are 110-year-olds smoking cigarettes and drinking booze and soda. Grandpa Tom just turned 113 and he’s never been bit by a vampire, and he doesn’t eat garlic!

They may be stubborn, proud, scared, or all of the above.

Maybe a more subtle form of rebellion is denial. It won’t happen to me.??

Rebels may seem like they want a fight, but maybe they need empathy.?

In the recent pandemic, the whole world had to deal with public safety protocols. Perhaps some of the resistance to them was merely childish tantrums ‘You can’t make me.’ But there are more difficult issues as well, including liberty, privacy, social stigma, economic consequences, and personal beliefs.?

Maybe you identify as a rebel. You at least probably know someone like this.?

If we are truly serious about saving lives, we have to listen to the rebels. Maybe a few could be converted to garlic eaters, but it will take a lot of energy and effort to persuade them.

Instead, we need the rebels to help us push the envelope for different ways to address the issue.

Maybe a rebel is opposed to garlic but they will donate to vampire deterrence research.?

Maybe rebels are interested in reducing the fatality of a vampire bite instead of preventing it.

Maybe it’s just a matter of money. I’ll eat garlic for $100.

Either way, again, collaboration seems to be required for success.?

• How do you increase the tolerability of an intervention??
• What is the plan for non-adopters?
• What happens if interventions fail

Concluding thoughts:

Many of the things we need to do for healthier and longer lives are simple ideas that can be hard to implement.? But time and time again, humans are able to take on difficult tasks. The road ahead will require collaboration, creativity, and compassion.

In the often-quoted words of Margaret Mead?

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.”

Finally, if any vampires are reading this, please don’t take offense. Truly, I am a big fan. I’d appreciate any insight into immortality that you can share.