Every day, people make health decisions that have long-term consequences on their wellbeing.

While some choices may be positive, such as choosing a healthy diet or exercise routine, others may be harmful, such as smoking, excessive alcohol consumption, or neglecting preventive care.

Understanding why people make these negative health choices is essential to developing effective individual interventions and general policies to improve public health.

Health behaviours are influenced by a variety of factors, including psychological, social, environmental, and biological ones.

Psychological factors

Psychology plays a significant role in shaping health choices. Behavioural economics research has shown that people tend to make decisions based on short-term benefits and ignore long-term consequences.

For example, someone might choose to eat a high-fat, high-calorie meal because it tastes good, despite being well aware of the long-term risks to their health. This is known as the "now or present bias", where individuals prioritise immediate rewards over delayed gratification.

Another psychological factor that influences health choices is willpower. People with a high self-control are better able to resist temptations and make adequate choices, while those with a low willpower are more likely to engage in unhealthy behaviours.

This is because willpower requires mental resources and repeated effort, and individuals who are unenthusiastic about or incapable of change, or who are depressed or burnt-out may have difficulty exerting self-will.

Studies have shown that willpower is a limited resource that can become depleted over time.

Emotions also play a role in health decision-making. People often turn to unhealthy behaviours like “comfort food”, as a way to cope with negative sentiments such as stress, anxiety, and depression. Others may engage in binge drinking or marijuana to numb emotional discomfort.

Social factors

Social factors such as cultural norms also play a role in shaping health behaviours. For example, in some cultures, being overweight is seen as a sign of wealth and prosperity, which can lead to overeating and obesity.

Peer pressure can also influence health choices, as individuals may be more likely to engage in unhealthy behaviours if they believe it is socially “needed” to make them feel more integrated in certain groups and communities: this is particularly seen in young adults who engage in early adverse health conducts, like smoking or drugs, so they become accepted among friends and/or colleagues.

Furthermore, socioeconomic factors like income and education can all play a significant role in shaping health-related choices.

Environmental factors

Environmental factors such as access to healthy food, physical activity options, good air and water quality, and healthcare services also influence health behaviours.

For example, individuals living in “food deserts” where healthy food options are limited or in high cost-of-living areas, are more likely to consume unhealthy diets.

Consumerism is the idea that increasing consumption of goods and services is always a desirable goal.

The business of consumerism may not only be nudging people to overbuy goods and foods, but also disproportionately promotes and glorifies items that are unfriendly to one’s health.

Simple examples are the endless and very well-designed ads for cigarettes, alcohol, and junk food chains.

Another example of consumerism is the purposeful design behind the line-up of unhealthy items on the market shelves, where low-quality foods occupy a central place, are quite colourful, and always at eye and hand’s level.

Healthy items on the other hand tend to be shelved away in high spots, behind other goods, or in the back of the store.

Biological factors

Biological factors such as genetics and personality traits also play a role in shaping health behaviours. For example, some individuals may be genetically predisposed to addiction and may be more likely to engage in behaviours such as smoking or excessive drinking.

Personality traits such as impulsivity and the likes may also lead individuals to engage in risky health behaviours.

At the end, and to improve our health choices, we need to be aware of the above factors and make conscious efforts to overcome them.

This may involve growing a sense of self-control, seeking support from our family and social networks, finding effective stress-management techniques, and advocating for better access to healthy choices and opportunities in our community.

• Joseph Yammine, MD is a consultant cardiologist at the Bermuda Hospitals Board. The information herein is not intended as medical advice nor as a substitute for professional medical opinion. Always seek the advice of your physician