Immersion Health Behavior
Health behaviors are actions that affect an individual’s health. They can improve it, like good nutrition and exercise, or increase the risk of disease, like smoking, risky sexual activity and overuse of alcohol. Health behaviors are responsible for about a third of the difference in longevity and quality of life in US communities.
You may think of health behaviors as an individual’s choice but remember that not everyone has equal access to the resources and supports needed to optimize health. Adverse childhood experiences are strongly linked to substance use and chronic illness later in life. Policies and programs at the local, state and federal level can help to address these inequities – many of you will advocate for the systemic changes that make healthy behavior easier for everyone.
As you care for individual patients, asking about these sensitive topics in an empathetic and nonjudgmental way can lead to counseling, change, and ultimately, better health. But asking about health behaviors can feel more challenging than taking a patient’s HPI – for a variety of reasons.
| Why discussing health behaviors may be hard | for patients | for providers |
|---|---|---|
| Not understanding the relevance to care |  |
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| Topics not usually discussed with people we just met | |
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| Not knowing how to ask (what words to use) | |
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| Not wanting to make someone feel stigmatized or blamed | |
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| Concerns about confidentiality – who will find out? | |
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| Fear of being stigmatized or judged | |
Transition
For now, we’ll have you ask a short list of screening questions – you’ll delve into this in more detail later this fall. The transition to the health behavior history should:
- Normalize this section of the history
- Establish the relevance to your patient’s health
- Ask permission to proceed
Transition with a phrase like, “May I practice asking you some questions about personal habits that could affect your health?”
- How would you describe your diet?
- Is exercise part of your routine?
- Do you smoke or use tobacco products?
- Do you drink alcohol?
- Do you use any recreational drugs?
- Any concerns about your sexual health?
Examples: Brief substance use & sexual history