Promoting healthy habit formation is key to improving public health. Here's why

As a society, we are living in increasingly poor health. Today, 70% of deaths worldwide are attributable to four lifestyle behaviours: physical inactivity, poor diet, excess alcohol consumption and smoking. This is having a profound impact on societal health and increasing pressure on healthcare systems.

While it may feel like we are inundated with information about what we should eat, how much we should exercise, and the importance of mental health, there remains a chasm between what we know and what we do. How can we prevent the unhealthy behaviours that become entrenched as habits and cause a decline in our health?

To understand the science of how we can create healthy habits, Discovery Vitality partnered with the London School of Economics to examine the habits of more than one million members of the Vitality Programme in South Africa and the UK over a 10-year period.

The findings of the Vitality Habit Index are remarkable. They demonstrate that the effect of behaviour change on health and mortality is greater than we think, and forming healthy exercise habits has a profound impact on overall health.

Individuals who changed their behaviours to sustain a habit of moderate-intensity exercise reduced their common-cause mortality risk by 27%, according to the research.

As people age, these benefits are amplified further: for 45 to 64-year-olds, maintaining this moderate exercise habit over three years can reduce mortality risk by 38%. For over-65s, the reduction is closer to 52%. So the impact of healthier habits is also elastic: people who are older and sicker have the most to gain from a few lifestyle changes.

Perhaps most encouragingly for our health, good habits are protective: those who do 7,500 steps five times per week for two years can reduce their risk of type 2 diabetes by 41% and their risk of stage 4 cancer by 36%.

The data also demonstrates the power of something as simple as steps – a universal unit of currency to measure physical activity and transform health.

The data suggests that an average of 7,500 steps per day has a significant impact on mortality, and the impact increases with age.

But it lends a cautionary warning for us setting ambitious targets for those who are inactive or less physically active: the marginal mortality benefits plateau between 7,500 and 8,000 steps.

In short, the holy grail of 10,000 steps is a myth and risks us overlooking the power of small changes.

Knowing the benefit of healthy habits only gets us so far. How do we change behaviour to form health habits at a population level? Let’s start with the science of habit formation.

It takes seven to 15 weeks to form a strong habit, with more than 80% of participating members forming a strong habit within this timeframe. Further analysis shows that of those 80%, approximately 75% developed a strong habit within 10 weeks.

The research further shows that the key to forming good habits is gradual and consistent behaviour change – with incentives often providing a helpful kickstart. A gradual step progression yields higher achievement levels and lower drop-off rates.

Attempting to increase daily step count by more than 800 steps at a time notably increased the likelihood of the individual dropping out from establishing a consistent, positive habit. Those who start slowly and increase intensity gradually are likely to create and maintain their habit for 1.5 times longer than those who start with high-intensity workouts – going too fast too soon.

Our data also shows that good habits are durable and tend to last longer than bad habits. Additionally, habits – good or bad – are remarkably resilient: consider that almost 50% of members reverted to their pre-pandemic behaviours after the extreme disruption of the pandemic.

These findings provide powerful and tangible evidence for governments and health policy-makers to promote healthy habit formation to improve public health.

Firstly, it provides a core approach for anyone wanting to step up their physical activity habits. Habit laddering is the most effective pattern to form and sustain strong habits that leads to positive health outcomes. Key points are:

Governments and policy-makers should also consider targeted, short-term incentivization programmes to encourage gradual formation of habits with demonstrate health impacts and invest in initiatives across urban environments and wellness schemes to foster active lifestyles.

Businesses also have a role to play in improving societal health. They can develop a health and wellbeing strategy, with relevant and targeted interventions for their employee to protect and improve their health.

This includes integrating physical activity initiatives into workplace wellness programmes and daily routines, to improve mental health and productivity. The strategy should be supported by data and reporting mechanisms to monitor progress and understand the impact.

We need to shift our perspectives on our personal health and reframe heuristics – simple mental shortcuts to make judgements quickly and efficiently – where necessary.

Achieving good health need not be intimidating or costly. We can start small and change our behaviour gradually over time. Additionally, we need not anchor on the belief that the older or sicker we are, the less benefit we stand to accrue from good choices. It’s never too late to start.