Evidence to support health system prioritization of health behaviors in the COVID-19 era.

BACKGROUND: Since the COVID-19 pandemic health systems have shifted necessarily from chronic to infectious disease treatment, but chronic disease remains critical. One large health system uniquely tracks member health behaviors. This analysis compares data from select months of an ongoing monthly cross-sectional survey before and during the pandemic. METHODS: Responses in April 2019 (pre-pandemic), April 2020 (early pandemic) or April 2021 (later pandemic) were included in the primary analysis (N = 252). Differences in meeting health behavior guidelines were analyzed via logistic regression. RESULTS: A significant decline was seen for physical activity (19% not meeting guidelines pre-pandemic vs. 41% later pandemic) but not fruit/vegetable, alcohol, or sleep from early to later pandemic. Prevalence of women not meeting tobacco guidelines increased from early (5%) to later pandemic (10%) while prevalence in men decreased (10% vs 4% respectively). The percent of people not thinking about the good things that happen to them fluctuated closely with reports of new COVID-19 cases. CONCLUSIONS: Findings show the nuance of changing health behaviors throughout the pandemic. Results should be used by health systems to tailor support based on insights from the pandemic experience.

The Predicted Impact of Adopting Health-Promoting Behaviors on Disease Burden in a Commercially Insured Population.

OBJECTIVE: The aim of this study was to better understand, in a commercially insured population, the potential impact of adopting six health-promoting behaviors relative to treating diseases and conditions. METHODS: We combined survey and insurance claims data to compare the potential benefit from adopting behaviors relative with the burden from 27 groups of diseases and conditions. RESULTS: If every member adopted all six behaviors, an 11.6% reduction in disability-adjusted life years (DALYs) might be expected, and a 7.6% reduction in DALYs might be expected if they adopted the one most impactful behavior that they did not currently practice. These amounts are, respectively, greater than the DALYs attributed to all but the two and five most burdensome groups of diseases and conditions in this population. CONCLUSIONS: The potential impact of adopting health-promoting behaviors is large relative to the burden from most medical conditions.