Abstract

The past two centuries have shown radical improvements in health and longevity, with hygiene as the key contributor to this trend in the 19th century and antibiotics and vaccinations in the 20th century. With most infectious diseases largely at bay in the developed world, the greatest contributors to suboptimal health today are largely behavioral. For example, there are three behavioral risk factors-tobacco use, poor diet, and inactivity-that contribute to four chronic diseases: heart disease, type 2 diabetes, lung disease, and some cancers. Together, these behaviors account for more than 50% of preventable deaths (see the Web site 3four50.com). While medical advances will surely continue, it is likely that the next great advancements in health in the 21st century will occur via more effective behavior management.

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