Introduction: We’re Not #1I believe Americans need a new way of thinking about health. Look where our current perspectives on the subject have gotten us – we are last among the world’s 17 most industrialized nations in all the key indicators of health. It’s hard to believe but true: we’re last in life expectancy; we have the highest rates of obesity, infant mortality, low birth weights, heart disease, diabetes, chronic lung disease, homicide rates, teen pregnancy and sexually transmitted diseases.The lead author of the Institute of Medicine, NIH sponsored study that revealed this situation remarked that “Americans get sicker, die sooner and sustain more injuries than people in all other high-income countries.” (That’s a quote from the report.) Then he added this coup de grace: “We were stunned by the propensity of findings all on the negative side – the scope of the disadvantage covers all ages, from babies to seniors, both sexes, all classes of society. If we fail to act, life spans will continue to shorten and children will face greater rates of illness than those in other nations.”Two Ways to Think of HealthI believe Americans are overly passive about their health. Good health can only be attained and maintained by conscious deeds. These deeds require planning and disciple. Examples include exercising regularly and vigorously, dining in ways that nourish the body without causing problems and otherwise behaving in positive, active ways.The level of health you will enjoy is clearly affected by your lifestyle choices. Your health status depends to a great extent on whether you invest in your well being or not. If you make little or no such investments, your health will depend on chance, genetics, the aging process and the timeliness of the quality of medical care you receive.If, on the other hand, you do invest, if you seek, protect and defend an advanced state of well being, the nature of the health status you will have will be dramatically different – and better.Therefore, we need to distinguish these two kinds of health situations – one passive, one active.The Institute of Health report that places America last reflects that segment of America that is passive. If the quite small segment of the American population that practices active health were separated, if their health data were compiled and compared, I’m sure we would be #1.For these and related reasons, I propose we view health in two different ways – by making a distinction between static health – which is how most view and approach their health, and earned health. The latter is what you get when you invest wisely in your own well being.It’s a way of life I call REAL wellness.Health As Currently PerceivedThe WHO definition of health is unrealistic (nobody, not even the most devout wellite, enjoys “complete physical, mental and social well-being,” at least not every day). Most think of health in far less exalted ways. Most think they are well if they are not sick. This is pathetic. It equates with not needing immediate medical attention. For the vast majority, this is a “good enough” view of health. Thinking that way is a self-fulfilling prophesy. It means that not healthy is the best you can hope for. This is the static definition of health and it must be reformed and at least accompanied by another, comparison perspective for those Americans willing to do their part. That would be earned health.I think we need ideas about health that remind people of a key fact, namely, that a passive situation is not as effective, desirable, protective or rewarding as a dynamic earned state of health. We should all be aware that static health, the default setting you get for just existing and doing nothing special to enhance health, can and must be reinforced and boosted.Employing a term like earned health might remind people that health can be much more than non-illness. The term earned health can signal the availability of a richer level of well being. It can remind everyone that health at its best is more than a static condition. Health is a dynamic state; it gets better with effort, worse if ignored.Earned health represents a higher health standard. Earned health is more ambitious and more consistent with a REAL wellness mindset and lifestyle than the current norm of health as non-sickness.The Static/Earned Health ContinuumThis continuum is another way of expressing Dr. John Travis’ original, simple line drawing model of health along a continuum, with “premature death” on the far left side of his continuum) and an ever-changing dynamic of “high level wellness” at the other, right side extreme. The “0″ in the middle represents a neutral point, which could be simple non-sickness.The Static/Earned Health Continuum-10 ______________ 0 ______________ +10Earned health is what happens from the neutral point to the +10 indicator. Everyone moves along an imaginary continuum of this kind every day, because health is dynamic, under constant change. By living wisely with the right behaviors, we fuel a state of health that is better than if we allow health status to be determined by the passage of time (i.e., the aging process, chance, medical interventions, circumstances and events.This continuum is a simple way of depicting the basic fact that earned health evolves largely due to our own efforts to improve and protect our well being; static health, on the other side is affected by what happens to you.By the way, Dr. Travis made regular expansions to his original model. You can view the latest edition and read more the continuum here. A related construct that will interest wellness enthusiasts is Dr. Travis Wellness Energy System.Earned health is not determined or advanced by medical interventions. Static health, that is, health along the continuum from the center to the left of the of the continuum, is so influenced.The Path to REAL WellnessTo become healthier in an earned sense, it’s up to us to act so as to move along the right side of the continuum.The failure to appreciate the different nature of health, earned from static, partly accounts for why America can have so much medical care and yet not enjoy the best quality of health status. After all, modern medicine is a wonderful thing but there are two problems: people expect too much of it and too little of themselves.Understanding the difference between static and earned health might encourage people to be less passive – to realize the need for and value of REAL wellness lifestyles.A Fable Here is a fable to express the limits of medicine to boost health status versus the power of our own behaviors.Imagine a country where everyone owns high powered luxury cars – they cost next to nothing and are easily replaced. In this mythical country, everyone gets unlimited free medical care of the highest quality, plus all the medications they need plus there are highly skilled trauma teams set up at every intersection. The thing is, the people in this mythical country can do whatever they like – there are no laws governing auto safety. Everyone drives way over the speed limits, nobody wears seat belts, there are no air bags and no stop signs, traffic signals or rules of the road. One more thing – brakes haven’t been invented yet.Interpretation of the FableThe greatest advances in the mythical society would not follow from introducing more doctors, hospitals, drugs or trauma teams. Changes in customs and driver behaviors would, on the other hand, go a long way to promote a healthier society.Changes in lifestyles are also the key to better health outcomes in the real world, our country in particular. We have a great health care system – now we need sensible people making wise lifestyle choices that make life not just healthier but more rewarding, more fulfilling and more attractive. We need to help people understand that health is not only a static phenomenon: Earned health offers so much more.The philosopher Epicurus (c. 341-270 BCE) offered this bit of wisdom long ago: “It is impossible to live pleasurably without living prudently, honorably, and justly; or to live prudently, honorably, and justly, without living pleasurably.”We all want to live pleasurably. Let’s recognize and act on the other qualities that enable us to earn active positive health. Let’s embrace REAL wellness lifestyles.