Unhealthy behavior is a way of life in Huntington W. Virginia.

A recent CDC study of U.S. health claims that this out of the way college town has the dubious distinction of having the poorest health ranking in the country. Nearly half the adults in the five county metro area of Huntington are obese, far higher than the national average. Huntington also leads in 6 other illness measures including heart disease and diabetes. It even tops the percentage of adults who have lost all their teeth (half of them have). This is in sharp contrast to another out of the way college town—Burlington VT—ranked by the CDC as the healthiest city in America in 2008.

Huntington and Burlington share similar attributes of both being college towns and both having overwhelming white populations of English, Irish or German ancestry. But there the similarities end. Burlington is younger, better off financially (8% living at federal poverty level vs. 19% in Huntington) and better educated (40% have at least a college degree vs. 15% in Huntington). These differences, coupled with regional cultural differences help to explain why Huntington’s adult population is not only unhealthy but has little motivation to improve.

In Huntington, high unemployment and the high poverty level combine to make even basic health care services unaffordable. In Burlington, IBM, the area’s largest employer, influences good health through its insurance plans and well funded wellness initiatives. In Huntington, many people think of exercise and healthy eating as luxuries. In Burlington they are considered the norm.

While the poor health rating for the Huntington area is a terrible distinction, the locals rarely talk about it. In fact, follow up surveys showed that most people weren’t aware of it. And when made aware, most saw little reason to change their behavior.

Huntington is a perfect candidate for applying behavioral economics to change the health status of a population. By identifying biases that lead to bad health decisions, health providers and community agencies can exploit these biases by making the healthiest choices the ones that follow the path of least resistance. For example, fast food is a major food supply for residents who believe they can’t afford to buy healthier food. Fast food restaurants could apply behavioral economics by substituting bottled water for soda as the default beverage with a combo meal. The soda would be available only on request.

Gabe d'Annunzio