"I want to stay healthy, but I hate having to endure." What motivational design drives people toward "prevention"?

Amid challenges like rising healthcare costs and a super-aged society, the importance of the "healthcare" domain is increasingly recognized. However, unlike treating illness, "medically healthy people taking further action for their future health" (i.e., prevention) is surprisingly difficult. Now, after experiencing the spread of the novel coronavirus, we want to reconsider: "What motivates people to act for their health?"

The theme of this first installment in our series of interviews with healthcare experts is "Preventive Medicine." We welcomed Dr. Tadashi Mami, a pioneer in preventive medicine at Mami Clinic, as our guest. Naho Takizawa from the Dentsu Inc. Healthcare Team conducted the interview. The discussion references findings from the "Wellness 10,000 Survey 2020," an annual survey conducted by Dentsu Inc. since 2007.

*About the Wellness 10,000 Survey: A large-scale quantitative survey aimed at understanding healthcare insights from consumers' health awareness and behaviors, revealing market needs and trends from the consumer perspective. Launched in 2007, it is conducted annually with 10,000 men and women aged 20 to 60.

The truth about health: "Even if something is good for my health, I don't want to force myself to do it."

Takizawa: The spread of COVID-19 has reaffirmed the importance of "prevention" for us. I believe this experience has fostered a mindset of preventing illness and taking personal responsibility for managing one's own health.

Dr. Mami, who specializes in preventive medicine—a field gaining significant attention now—previously worked in emergency and critical care medicine. Could you tell us why you shifted to preventive medicine?

Mami: At the emergency center, we see patients brought in with burns covering 90% of their body surface area, cerebral infarctions, myocardial infarctions, and accident victims. It was a place where less than 10% of people walked out healthy.

Witnessing the reality that many patients transported by ambulance never fully recover to their previous state of health made us keenly aware that we should be more conscious about "choosing not to get sick."

In my early 40s, I spent three and a half years teaching at an institution retraining emergency medical technicians. After that, I studied nutrition at Harvard University in the US and entered the field of preventive medicine.

Takizawa: So you truly felt firsthand in the emergency room that "it's too late once you get sick."

Mami: Yes, exactly. People who get sick often feel like "I suddenly felt unwell" or "I suddenly got bad test results." But human health doesn't change dramatically overnight. When heading toward illness, it follows a gradual decline.

When someone falls ill, their subjective feeling is like the left diagram, but the actual deterioration is gradual, as shown in the right diagram.

That's why it's hard to notice when your body is heading toward illness. The anti-aging comprehensive health check available at my clinic aims to "objectively observe the subtle differences between yesterday and today." It includes examination items not found in standard checkups.

Preventive medicine involves making lifestyle changes before health issues appear through testing, as well as early detection and treatment of disease. Preventing disease progression and recurrence also falls within the scope of preventive medicine.

Takizawa: While awareness of the importance of "prevention" is indeed growing, the Wellness 10,000 Survey actually found that 60.6% of respondents answered, "Even if something is good for health, I won't force myself to do it or endure it."

Furthermore, regarding "immunity," the hottest topic at the time of the survey, among the 7.9% who reported concerns, 45.6% stated they "currently take no measures." A significant 19.7% also said they "will not engage in prevention or improvement efforts going forward." These results suggest that while people intellectually want to stay healthy, a certain number are unwilling to push themselves excessively or simply don't know what specific actions to take.

Mami: That might just be how it is. Humans tend to get swept up by immediate pleasures or fun things, right? We often only realize things once we lose our health. When you're young and feeling great, few people start doing radio calisthenics just because it's good for you (laughs). The reason people don't want to push themselves is that they lack a compelling reason to do so. There's an honest feeling that doing something without a reason is pointless... The healthier you are, the harder it is to find motivation.

Motivation design is key to changing health behaviors

Takizawa: What kind of goals do patients who come to Dr. Mami's clinic voluntarily have?

Mami: Many come saying, "I had a comprehensive health checkup, but I still don't feel quite right," or "I want to understand my condition in more detail."

Most are in their 30s or older, with roughly equal numbers of men and women. Younger individuals in their 30s often come because they've achieved business success and recognize that staying healthy is essential to maintaining their top position. We also see older patients who've experienced serious illness in the past and simply don't want to go through that again.

Overall, many are business owners. They likely approach managing their health with the same objective mindset they use for managing their companies. I believe they are intelligent individuals who deeply understand the value of health and know that "health doesn't come to you if you just wait."

Takizawa: So some patients are motivated by their work when they come here.

Mami: Yes, there are two main motivations among these individuals. Some feel their memory and decision-making abilities have declined compared to the past, leaving them feeling less energetic. They want to improve their performance to compensate for this decline. Others aim to enhance their performance beyond their current level. What both groups share is the motivation to "improve their performance."

Takizawa: I believe the people who come to your clinic possess a high level of awareness, knowledge, and initiative regarding preventive healthcare. On the other hand, in advancing projects in the healthcare field, I've also come to feel that even if you accurately communicate, "Taking this action will lead to these specific health benefits," there are limits to how much that alone can motivate people.

The inconvenient truth is that even if people say they're interested in healthcare and want to practice it, deep down, some may not be genuinely committed to prioritizing their health. So, the hypothesis I want to test now is: "Instead of focusing solely on becoming healthy, can we motivate people by highlighting the value that lies beyond health?"