Over the weekend, we read a notable study conducted by the United Health Foundation that offers surprising insight into the staggering numbers of Americans suffering from “Multiple Unhealthy Behaviors” (called MUBs). They sorted these MUBs into five distinct categories:

  1. Currently a smoker
  2. Less than 7 hours of sleep per night
  3. Body mass index > 30
  4. Low physical activity
  5. Consumption of alcohol (more than 2 drinks per night for men, 1 per night for women)

Seventy-two percent of Americans report having at least one unhealthy behavior, while more than 25 million, or twelve percent of Americans, report having three MUBs.

The odds of reporting fair or poor overall health increase with the addition of each unhealthy behavior. Adults with multiple unhealthy behaviors are more than 6 times as likely to report less than average health than those with zero unhealthy behaviors.

Generally, the poorer the person, the more unhealthy behaviors they report. Education also factors into the equation, with adults who haven’t graduated high school reporting more unhealthy behaviors than those with higher education. Interestingly, the disparity of income and education as it correlates to MUBs is different on a state by state basis. Some states such as Michigan show that while ~30% of non high-school graduates will suffer MUBs, only ~5% of college graduates will, a substantial difference of 25%. On the other side of the spectrum, the difference between California’s non high-school graduates suffering MUBs (~12%) is more moderately above its college graduates suffering MUBs (~4%). There were, unsurprisingly, no circumstances in which higher education or higher incomes lead to overall higher incidences of MUBs. In short, the more money you make, the more education you have, the healthier you will trend.

Adults with multiple unhealthy behaviors are more than 6 times as likely to report less than average health than those with zero unhealthy behaviors.

While the study breaks down the prevalences of unhealthy behavior by education, age, race, and income, it also looks at the larger picture geographically.

Of the estimated 58.5 million US adults (28.1%) with zero unhealthy behaviors, those citizens tend to be clustered in the Northeast (NH, VT, MA) and the West Coast (CA, OR, WA, ID, HI) while the highest concentrations of adults with multiple unhealthy behaviors tends to be clustered in the middle-south of the country (AR, LA, AL, MS) and mid-west (MI, IN, KY).

The authors of the study conclude that since the odds of reporting fair to poor health increase across the board with each additional reported unhealthy behavior, it is paramount for both doctors and patients to strive to eliminate MUBs in order to make America healthier on the whole.. They go on to recommend that we focus our efforts on particularly at-risk groups, such as those from low income and low education backgrounds, as these individuals are 6.1 times more likely to report fair to poor health than the population in the aggregate. By doing so, the study concludes, America will lower health-care costs across the entire spectrum of its population, as research shows that a small percentage of patients account for the majority of health care costs.