Good health isn’t just about daily exercise and a healthy diet. Access to safe housing, good schools and decent work are also important.

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Good health isn’t just about daily exercise and a healthy diet. Access to safe housing, good schools and decent work are also important.

Si-Gal/Getty Images

When COVID-19 hit, Americans watched the news in horror as the death count rose and rose again, with thousands dying a day during multiple surges. Deaths from the virus have been sudden and tragic, but today we are living in a slower-paced pandemic that also brings tragic loss of life every day, due to preventable chronic diseases.

These deaths are often hidden in plain sight. For example, nearly a thousand deaths a day are linked to diet-related diseases: heart disease, complications of type 2 diabetes and liver disease. And diet now surpasses smoking as the leading cause of death worldwide. Chronic stress fueled by poverty and racism also contributes to the toll of preventable deaths.

Chronic disease deaths aren’t that dramatic, but the tragedy is that despite having the most sophisticated healthcare system in the world—great doctors, world-class hospitals, many medical breakthroughs—the United States as a nation isn’t getting any healthier.

The pandemic has been a wake-up call in many ways. Life expectancy for Americans has declined during the pandemic, taking a historic turn for the worse. And while countries around the world have seen life expectancy rebound during the second year of the pandemic after vaccines arrive, the United States has not. This is especially true for Native Americans, whose life expectancy dropped to 65.2 in 2021.

Disparities can be seen within zip codes in the same state, like this one life expectancy monitoring Shows. If you take a fairly affluent zip code — 08542, say, in Princeton, NJ, — the people who live there can expect to live to be 90 years old. Meanwhile, not too far away in less affluent Camden, NJ, the average life expectancy is much lower — about 74 years, which is a stark reminder that where you live affects how long you live.

And while access to health insurance and good medical care is important, it doesn’t guarantee good health without access to some basics, like having a job or a safe place to live and go to school. Indeed, much research shows that poor health is driven by key social factors determinants such as stress, trauma, social isolation, racism, poverty, and lack of access to healthy food and other resources. For many Americans, the system is often against their efforts to stay healthy. So what would it take to make the healthy choice the easy choice?

This year, NPR is reporting an ongoing story series titled Living Better: How Americans Can Get Back to Their Health. We will tell stories of communities and individuals who have bucked the trends by improving people’s health outcomes and their lives. And we will share good new ideas that deserve to be disseminated and smart policies that deserve to be funded. The series begins with a series of stories about children, because childhood is where health and health disparities begin.

There is plenty of evidence that adopting a healthier diet and incorporating movement into your life can help reduce your risk of disease. For example, results from the diabetes prevention study 20 years ago showed that dietary and lifestyle changes were more effective than metformin, a leading drug, in reducing the risk of developing the disease, among people at high risk.

AND long-term follow-up shows that the benefits can persist. The challenge is that obesity and diabetes rates have continued to rise. So what’s the best way to motivate, educate and empower people to follow recommendations to eat better and adopt other healthy habits? One way is to increase programs in community settings, such as embed the DPP program in YMCA.

Additionally, many healthcare providers are pioneering ways to support healthy behaviors by providing medically tailored meals or prescription fruits and vegetables, aimed at integrating food into medical care to treat or prevent diet-related disease. This is part of a growing Food Is Medicine movement, and at a White House briefing last year, the Biden administration announced more than $8 billion in public and private sector commitments advance the agenda to end food insecurity and promote nutrition and health.

Another way is to capitalize on our understanding of human behavior. Our habits are contagious. There is a lot of evidence showing that the people closest to us influence our daily choices. If you are around happy people, positive emotions can spread. If you quit smoking, your spouse or roommate is more likely to quit as well. Improving your diet with a friend or family member can increase your odds of success. And social media habits can be contagious, too.

Our coverage explores all levers for influencing health, both personally and within communities. Despite the challenges and obstacles to good health, there are still reasons for optimism and things we can do to thrive.