the domino effect


the domino effect 02.19.13

Several weeks ago I wrote about how I summited a mountain in Arizona. It happened because my company gave all its employees the opportunity to participate in a wellness initiative, and this venture therefore seemed like a good idea.

These kinds of programs have become increasingly popular as health insurance companies search for health-based ways – as opposed to claims denial-based ways – to reduce how much they spend on medical care. And if you’re an Aetna insured participating in such an initiative, your wellness gets measured by the number of steps you take and the amount of time you exercise. (It can also be quantified by weight loss, but my team opted out of that metric. Our internal rationalization for that decision? We’re all in such great shape that there’s no weight to lose.)

You monitor the number of steps you take using a pedometer that Aetna gives you. With nearly half the people at my company participating in the wellness initiative, company events have a The Sneetches feel, some people having stars (pedometers attached to their belts or waistbands) and others lacking them. Those of us wearing our white, circular pedometers look like modern drug dealers or doctors, periodically checking the readout to see where we are versus our goals.

Aetna gives you the opportunity to set targets however you want. As I wrote last March, the average American amputee walks a hair over 3,000 steps a day. In contrast, healthy, active bipeds walk 13,000-14,000 steps a day. (The Amish, sans automobiles, walk 17,000+ steps daily.) Taking all of this into account, I set my target for an average of 5,000 steps a day, reasoning that when I worked out I could easily reach 5,000 steps, while on days that I didn’t I’d be largely desk-bound and sessile.

I find the data, and my response to it, fascinating.

*   *   *

We’re now nearly at the halfway point of this little social experiment. As of today, I’m a bit short of the 5,000 step daily average, logging in at 4,687 steps/day. In the magical Aetna scoring system, this places me on the low end of the “Moderate” category. However, ten days ago I was in danger of acquiring the dreaded “Sedentary” label, meaning that I expend roughly as much energy as a 19 year-old cat the day before it dies.

I considered my options. I could don shorts and quick-wicking shirts to formally work out more often and for longer. Alternatively, I could figure out how to log more steps within the context of my average workday. As I looked at my daily calendar, I realized that the latter approach had higher upside. Specifically, I came to the conclusion that a fair percentage of the meetings I attend by phone don’t require me to sit, at least not for the entire call. In addition, I realized that I tend to take quick breaks from my work every 60-90 minutes. What would happen, I wondered, if instead of checking out sports websites or technology blogs, I just … walked?

And so the experiment began.

I have learned that the distance from one end of my house to the other is 25 steps, give or take a step. I’ve learned this from the little 10-minute jaunts I started taking during my work breaks. As I pace back and forth across the house like a ghost condemned to walk the same path for eternity, I can log about 1,000 steps during each work stoppage. Do this five times a day and I make my number while having engaged in close to an hour of activity separate and apart from my actual workouts.

In addition, if I walk while talking on the phone during the frequent meetings I attend, the steps magically pile up without my even being aware of it. When the weather’s warm enough, I tend to do this across our front porch, as it allows others in my house to watch TV without me stomping past them 100 times while also preventing people on the other end of the line from hearing Sponge Bob in the background.

I suspect the sight of me walking peripatetically to and fro while talking to no one and waving my hands makes the neighbors nervous, but the results speak for themselves: last week, I averaged more than 5800 steps a day, despite the fact that I consciously devoted myself to doing nothing over the weekend, logging a mere 2800 steps for the two days combined. (That, my friends, is the definition of “Sedentary.”) And there’s still room for improvement – I haven’t run regularly since the end of the year, something that will change starting next week now that my prosthetist has made some needed adjustments to my running leg.

But viewing your life through a pedometer leads you to consider quantifying everything. For example, today I tracked how many times I got up out of a chair. The final tally: 38. Today wasn’t unusual, so assuming that I average 35 “chair exits” a day, that means I perform that activity 245 times a week, 980 times a month, and close to 12,000 times a year. (This suggests to me that prosthetic technology capable of helping me offload my sound side when standing up might have real value as the years roll by.)

When I look back at my weekly totals, the Monday-Friday step counts dwarf their weekend counterparts. I shut down on Saturday and Sunday. Doing anything on either of those days would significantly increase my totals.

On the other hand, certain kinds of activities – for example, the 3 hours I spent shoveling out of my house after the big blizzard a few weeks ago – don’t trigger the step counter, much to my chagrin. So despite the most active day I had since Scottsdale, the pedometer logged less than 800 steps. (I considered throwing the white device into the 30 inches of fresh snow but thought better of it, largely because my back was so sore that throwing anything might have led to temporary paralysis.)

I share this with all of you because this is teaching me that very small changes can yield significantly different results. For all the criticisms that insurance companies deservedly receive, initiatives like this one present real opportunities to improve your health. The power of the pedometer has surprised me.

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