The Five Levels of Employee Motivation

Employee motivation can be quite a challenge. The decision on how committed an employee will be towards the organization, division or team, depends entirely on the individual. Therefore, the first step to employee motivation is to engage with each individual. Find out what makes him/her tick. The purpose of this article is to know what to look for when you engage with the individual.

Many leaders make the mistake of applying a single motivational strategy to all their employees. The fact of the matter is that different things might motivate different employees. So how do you find the right formula for each employee?

The Loyalty Institute at Aon Consulting did extensive research on employee commitment. They came up with the five drivers of employee motivation, also known as the performance pyramid.

It works a lot like Marslow’s Hierarchy of Needs where the first level of motivational needs first need be satisfied, before a need arise in the next level. It wasn’t intended that way. It just happened to work out like that.

The performance pyramid can provide some wonderful guidance to know what to look for when you engage with your employees. Let’s have a look at the five levels and see how it can help you to find ways to motivate employees.

Level 1: Safety and Security

Along with a physical sense of well-being, there must be a psychological belief that the environment is free of fear, intimidation or harassment.

Level 2: Rewards

Yes, you knew it. Most people won’t come to work tomorrow if they win a big lottery today. This is the perception that the organization attempts to satisfy the employee’s compensation and benefits needs.

Level 3: Affiliation

This is a sense of belonging. It includes being “in the know” and being part of the team. This is also where a difference in personal and organizational values can have a big impact on motivation.

Level 4: Growth

Employees want to have the belief that achievement is taking place. I might feel safe, get all the money I want and feel part of the team. But if there are no growth opportunities, I might think about leaving the company.

Level 5: Work/Life Harmony

This term speaks for itself. Someone might have all the rewards that he/she wants, but he/she will burn out sooner or later if they don’t have the time to spend it on the other things they want.

What Should You Do With These Drivers Of Employee Motivation?

While all five levels are important, the key is to pinpoint where the individuals and the workforce are not having their needs met. Start by offering a safe, secure work environment and equitable compensation and benefits packages. This is the foundation. However, before you launch those new and trendy benefits, engage with each individual and take a good, hard look at the basics. The young smart upstart employee might not be as exited about that benefits program. His needs might be to use that money to buy a new sport scar. The opposite might be true for the 40 something baby boomer.

Some other pointers to keep in mind:

  • Be aware of the five levels of employee motivation when you engage with your employees.
  • Make your own assessment of what the needs of each individual are.
  • Engage with each individual. Explain the different levels and ask them where they find themselves on the pyramid. What are his/her biggest needs?
  • Engage with bigger teams and eventually with the whole organization about these levels of employee motivation.
  • Do something about it. If someone wants growth, give it to him or her. If they want work/life harmony, make a plan. And Ditto for the rest of the drivers.

Advertising As A Tool Of Communication

Advertising is a form of mass communication with the public. It is usually one sided i.e. from the company to the buyer/potential user of the product. It is a form of communication that typically attempts to persuade the potential customers to purchase or consume more of a particular brand of product/services. As rightly defined by Bovee, “Advertising is the non-personal communication of information usually paid for and usually persuasive in nature about products, services or ideas by identified sponsors through the various media.”

Advertising an important tool of communication is use to promote commercial goods and services, it can also be used to inform, educate and motivate the public about non-commercial issues such as AIDS, Don’t drink and drive, Polio, Save water, electricity, animals and trees etc. “Advertising justifies its existence when used in the public interest – it is much too powerful tool to use solely for commercial purposes.” – Attributed to Howard Gossage by David Ogilvy.

Advertising is most effective with products that can be differentiated from similar products based on consumer accepted quality difference. Tom Egelhoff has classified advertising in 6 types, i.e. for company image, name brands, advertising service instead of a product, business-to-business advertising, co-op advertising and public service advertising. Television, Radio, Cinema, Magazine, Journal, Newspaper, Video Game, Internet, Billboard, Transit Cards, Sandwich Board, Skywriting are the different mediums used to deliver the message. The companies choose the method according to the cost, budget, target audiences and their response. However, word of mouth advertising/ personal recommendations is an unpaid form of advertising which can provide good exposure at minimum cost.

Various new forms of advertising are growing rapidly. One of them is Social Networking Advertising. It’s an online advertising with a focus on social networking sites and use of the internet/ World Wide Web in order to deliver marketing messages and attract customers. The other is E-Mail advertising; E-Mail Marketing is often known as “opt-in-email advertising” to distinguish it from spam. “I believe ‘credibility’ is one of the biggest issues yet to be addressed by Internet advertisers. Everyone has their eye on ‘privacy’ as a critical concern, but credibility will be far more enabling or disabling to website profitability. A company can have a web presence and, unless the brand name is familiar, consumers have no way of knowing whether it’s a big company, a small company, an honest company, or a single scoundrel. I may be worried about my personal data being disclosed in violation of my privacy, but I’m far more concerned about whether or not the person or company with whom I’m dealing is reputable. Can I believe their claims? Will I have a recourse if something is wrong with the merchandise? Credibility no longer is strictly a brick-and-morter issue. I can’t judge someone by their place of business, when I conduct that business on the Internet. I can’t grasp a hand and look into their eyes to judge their veracity. Credibility is a huge issue.” – Jef Richard.

For a message to be effective keep it short, simple, crisp and easy to absorb. It is essential to translate the products/services offer into meaningful customer benefit by advertising and to build awareness and generate response. REMEMBER: – THE AIDA MODEL -ATTENTION, INTEREST, DESIRE AND ACTION.

In the modern scenario, most of the companies outsource their advertising activities to an advertising/ad agency which is a service business dedicated to creating, planning and handling advertising and sometimes also performs other forms of promotion like public relations, publicity and sales promotion for its client. Departments of the advertising agency includes: – The Creative Department (who creates an actual advertisement), Account Service (who is responsible for co-ordinating the creative team, the client, media and the production staff), Creative Service Production (here the employees are the people who have contacts with the suppliers of various creative media), Other department and Personnel. (like public relations). As said by David Ogilvy once that the relationship between a manufacturer and his advertising agency is almost as intimate as the relationship between a patient and his doctor. Make sure that you can life happily with your prospective client before you accept his account.

Thus, I would conclude by the famous words of Bruce Barton (1955), “Advertising is of the very essence of democracy. An election goes on every minute of the business day across the counters of hundreds of thousands of stores and shops where the customers state their preferences and determine which manufacturer and which product shall be the leader today, and which shall lead tomorrow.”

Modern Health Care in the Age of the Internet and Social Medicine

Are we are all “medical citizens,” embedded as potential or actual patients, with our physicians, insurer’s, pharmaceutical companies, government bodies and others in a system of societal, moral and organizational stakeholders?

Today, with the advent of the Internet, High Speed Bandwidth, Social Media, Support Groups and Self Care Protocols, patients for the first time in the history of medicine have the ability to alter the outcome of disease and illness for themselves, family members, friends and significant others.

This essay attempts to address a most compelling issue of our time. Are medical self-help groups and self-care methods helpful or are they challenges to the delivery of traditional medical care? How do they differ and what consequences arise from this debate?

Also, how has the advent of the Internet and Social media transformed the landscape of medicine? What limitations may exist in this new era of information technology and social communication? And to what degree do they challenge traditional care models? Can a patient or their advocate become more of an expert on their own medical conditions than their own physicians? The answer to this question is a resounding yes, if the patient uses all the tools now available to them.

Various published estimates unanimously indicate that hundreds of thousands of patients die and millions more are injured by medical procedures gone wrong, medication errors or their side effects and by medications improperly prescribed or not taken as directed by patients. And it is not just the infirm that suffer, but their families, their loved one’s, friends and employer’s who must suffer with the grief and change of lifestyle that so often comes with these mistakes.

Furthermore, on May 8, 2013 National Center for Policy Analysis, in a release, stated that first diagnosis error rates are increasing at an alarming rate:

• An estimated 10 percent to 20 percent of cases are misdiagnosed, which exceeds drug errors, and surgery on the wrong patient or body part, both of which receive considerably more attention.

• One report found that 28 percent of 583 diagnostic mistakes were life threatening or had resulted in death or permanent disability.

• Another study estimated that fatal diagnostic errors in United States intensive care units equal the number of breast cancer deaths each year — 40,500.

Therefore, second opinions are often necessary precautions, as are third opinions when the first two differ. In fact, Medicare and insurers often pay for third opinions under these circumstances as it saves them billions in the long run.

Prudence dictates that the “medical citizen” must beware of these pitfalls, as their lives may depend on it.

Also, with patient reviews and rating systems available right on our own smartphones, we must question whether or not physician decision making is being compromised as well. For instance, a surgeon knows that his or her treatment decisions can possibly either result in either saving a life or ending it resulting in damning social media judgements, whether legitimate or not, which can then hurt their medical practices? Does this introduce a bias that may alter or cloud a doctor’s judgement? There is no data to provide an answer as of yet.

So, are doctors becoming more risk adverse as a result of this new landscape? Physicians are now being compensated more and more based on better outcomes, lower costs, reduced re-admission rates and other variables – not staff friendliness or less waiting room times which many doctor review sites measure.

Often 5 star rating systems get few patient reviews despite the fact that the average doctor has some 2,000 patient charts (most healthy) and while it is human nature to complain when we don’t get the outcome we want, consumers are less likely to praise a positive experience because we naturally expect top service and thus neglect to post a positive patient review yet are rather far more likely to post a negative review to retaliate against the provider. So patient reviews are not a very good or objective source of fair and balanced overall rating of a doctor’s performance.

How can this dilemma be resolved especially when a surgeon does everything perfectly but the patient becomes a victim of medication errors, poor nursing compliance with medical orders or perhaps contracts a hospital born infection, or some other adverse event out of the doctor’s control even if the doctor’s work is excellent? Nevertheless these doctor review sites often blame the physician. So Patients need better tools to make judgements about their own healthcare whether it be which plan to select or which treatment option to go with given a choice.

If a patient does utilize a rating site, they should make sure it is a government site based on huge amounts of data or a private site wherein doctors nominate other doctors for their excellence and would use these “doctor’s doctors” to provide care for their very own friends and loved ones.

Doctor reviews by other sites using stupid criteria like waiting room times, friendliness of staff, waiting room decor and other questions that have nothing to do with best outcomes accomplish nothing but make money for their operators.

In modern day, it is not unusual for patients to challenge doctors when it comes to illness and disease. After all, according to Tejal Gandhi, MD, president of the National Patient Safety Foundation and associate professor of medicine, Harvard Medical School, “Preventable medical errors persist as the No. 3 killer in the U.S. – third only to heart disease and cancer – claiming the lives of some 400,000 people each year, at a cost of over a trillion dollars a year”".

Self-help groups and self-care probably date back to the dawn of civilization when people lived cooperatively in tribal settings. These groups dealt with all life issues related to the survival and political stability of the group. The dawn of medical ethics probably dates back some 2300 years with the publication of the Hippocratic Oath.

But now the game has dramatically changed due to major technological advances in medicine and with the great advances of the Internet now being the primary source of medical information for medical consumers. And with the explosion in social media, people have the ability to communicate and share information on a scale never before foreseen or imagined.

Add to this all the new stakeholders that have entered the fray such as insurance companies, employers, managed care organizations, Obamacare, biotech companies, governments and, of course, pharmaceutical companies and healthcare policy makers. The challenges faced by the medical citizen and social policy planners have never been so daunting.

Postmodern Medicine probably arose after the institution of Medicare in 1965 when Medicare was signed into law in 1965 by President Lyndon Johnson and third party payer insurance companies soon appeared thereafter. By the 1970′s the practice of medicine became the business of medicine and third party payment systems caused a surge in demand for services and the costs of healthcare delivery soared. Also, the debate over what is a disease and what is an illness now must be addressed in a sociological manner more than ever as it affects whether treatments are made available and what costs are covered by third party payers.

Self Help Groups are usually a group or set of people who all share or suffer from a similar malady which involves great personal cost and suffering for themselves and those who care for them.

Self-care is seemingly clear in meaning. We get a cut and we put a band aid on it. Have a headache, take an aspirin. But is it really so clear as pharmacy shelves that are now filled will medications that used to be available only by prescription and medical devices one can use for self-diagnosis and self-care which measure bodily functions and vital signs such as blood sugar levels, blood pressure, pulse oxygenation, etc. have resulted in patients self diagnosing and treating themselves, often without medical advice. Defibrillators are now a fixture in most large organizations where non-medical designated company personnel are trained and authorized to shock a worker’s heart in addition to CPR.

Supplies such as instant blood clotting powder, specialized bandages, diabetic compression socks that were not previously available in pharmacies, are now commonplace. But many of these products may do as much harm as good, if not used properly.

Self-care at least in many of its versions, usually includes some connection with the health care system, teaching people when they need a professional, how to do a self-examination and care for a condition without medical supervision. e.g. Changing wound dressings and bandages without the presence of a home care aid.

And with the advent of new and off-label use of FDA approved medications, televisions are awash with commercials advertising new drugs and therapies which espouse incredible benefits such as Viagra, which resulted in a stampede of male patients running to their doctors demanding buckets of the stuff, making Viagra one of the most profitable elective medications ever.

Television ads by pharmaceutical companies now target the consumer directly in order to create demand for their products, which can only be prescribed by a physician, are commonplace as well. Also, in fine print and muffled high speed speech, pharmaceutical companies attempt in these ads to disclaim liability for the fact that the medications advertised directly to consumers may have side effects that could seriously mess a person up or even cause death, while at the same time they are trying to get consumers to ask their doctors for these medications. This is a radical change in the supply chain and distribution of new pharmaceutical products and protocols.

So, what is a medical citizen to do? Turn to the Internet of course for information and Social Media discourse. The Internet is after all now the primary source of health and medical information as well as social communication.

Today, with over a hundred million American’s online with their computers, tablets, cellphones, and smart watches along with highly specialized apps, finding support is like reading a menu in a Greek diner. If can be hard to choose wisely.

The problem in discerning useful and credible information from garbage in, garbage out, or from commercial sites looking to sell goods and services targeting specific users based upon searches performed by the user and transmitted to advertisers via cookies and Flash Player LSOs.

Most people probably do OK and, undoubtedly, are using this resource responsibly. These resources can improve and maybe extend patient’s lives and allow them to find communities of other’s suffering from the same malady as them and can assist health care outcomes and help contain health care costs to society. We are now entering the world of virtualization, telemedicine, doctor and hospital rating websites and long distance robotic surgery as well as even fields like quantum medicine which seems like it comes right out of a sci-fi novel.

Where this will lead us in the future remains to be seen and cannot definitively be addressed in this essay.

This also leaves us with the issue of contested illness. As opposed to a disease, like a clogged artery that must be repaired with a stent in a catheterization laboratory by an interventional cardiologist, or an infection that must be treated with antibiotics by a physician, many illnesses are unexplained by traditional medicine, as opposed to diseases which are clearly recognized by healthcare providers. Illnesses are often easily dismissed by formal medicine resulting in denial of treatment or refusal of insurers to pay.

But the collective description of the same array of similar symptoms occurring among many thousands of individuals communicating with each other using self-help groups can lead to a change of heart in the medical establishment. Not to mention diseases that carry a social stigma with them where the patient is blamed for their own symptoms, like obesity, even though there are in fact diseases that cause obesity or depression, addiction and a host of illnesses that have not as yet been classified as diseases and for which there is no biomedical solution.

Online support groups can and have brought these conditions to the forefront, as in the case of fibromyalgia which is now recognized as a treatable disease, but for a long time was a contested illness dismissed by professionals as people too lazy to work or just seeking pain medication. What is certain is that online support groups provide people with opportunities to exchange information with each other and become experts on their medical problems.

Internet self-help groups are cost free and very effective. People helping people. It is a simple concept, especially in the age where the nuclear family is nearly extinct in western society, so people now seek out extended families. But self-help groups which are self contained and autonomous in theory are still predisposed to traditional group problems such as rivalry within the groups, inappropriate members, etc. They are also targets of commercial interests, for example when a user who does not know how to surf anonymously gets hundreds of cookies on the device they are using and then they start to receive unwanted ads by commercial interests or worse, spam and theft of private information.

Self-Help groups offer other benefits such as “Improved coping with Chronic Illness and Life Transitions, Friendship and Belonging, Spiritual Renewal, Increased Political Activism, Enhancing Civil Society and Reduced Healthcare Resource Use” (Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue 3 Pages 2-5)

That said, “social movements that consider themselves omnipotent and omniscient are often dangerous”. (Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue 3 Page 5)

You can bring a horse to water but you cannot make it drink. Many people are too set in their ways, too judgmental and have ulterior motives which can corrupt or disrupt the best intentions of the many.

Many medical professionals feel that patients playing doctor carries potentially serious risks as patients are not doctors or trained medical professionals. On the other hand, many would argue the same about professionals and professional groups which previously enjoyed unquestioned stature and in many instances took offense to being questioned or challenged.

But for a patient with a complex disease possibly accompanied by other co-morbid conditions, The Internet affords them unlimited access to research the latest medical treatments, pharmaceuticals and lot of other research that their internist may not be aware of.

With heavy patient loads a physician does not have the time to spend researching all of the worlds medical literature on new FDA approved medications and procedures. After a doctor sees a patient, often they don’t give that person’s situation another thought as they have 30 more patients to see that day plus hospital rounds.

But for the sick, if they have reasonably good intelligence and most likely they have much more time on their hands to research their specific disease or diseases that have devastated their quality or life, ability to work or career advancement, relationships all of which suffer, it is a logical assumption that with enough time and perseverance, the patient can find better treatment modalities or better doctors that can relieve most of their symptoms or possibly cure them completely.

If a patient remains docile, asks no questions, fails to review complex bills which even medical auditors cannot understand the billing codes used, then the patient will likely not receive the best possible outcome.

This issue has been thoroughly researched by the Institute of Medicine and the data resoundingly shows that informed patients consistently have better medical outcomes than patients that suffer in silence. The data is irrefutable!

So common sense dictates that patients should be proactive and learn as much as they can about their diseases or illnesses and work collaboratively with their doctors as a team, the goal being better medical care. Often physicians resist this in which case, a change of doctor may be in the best interest of the patient.

For example, mortality related to cardiac catheterization and angiography are significant enough that patients should be informed of the risks of death or major complications from the procedure or that there is an alternative called computed tomography angiography which can replace conventional coronary angiography in appropriate patients and is half the cost of the traditional procedure which is very lucrative for interventional cardiologists whereas computed tomography angiography is not. It is also a non-invasive procedure which will benefit those eligible at much less risk and a lower cost as well.

I am now speaking from personal experience because my own father, who died on Jan 26, 2006, suffered from complications that arose after a cardiac catheterization and angiography procedure that was unnecessary. A year prior to my father’s passing he had a stent placed in his left descending coronary artery which went flawlessly. Because my father was retired and living in NY he would visit all of his doctors prior to making his annual trip to Florida where he spent the winters in the sun.

This procedure was elective because his cardiologist suggested that the stent be checked before the trip. I should have known better and stopped him, since I was a patient and medical consumer advocate and researched and published reports for consumers and researched diseases for medical professionals for a living. The name of my company at the time was “Health Reports” a service of Multimedia Solutions Inc. a NY company I founded but due to later disability had to stop.

I accompanied my father on all of his doctor visits and when he went to the hospital he for this ambulatory procedure he was fine and he drove his own car to the hospital anticipating go home the same day.

His Interventional Cardiologist that did the procedure afterward said the stent was in beautiful condition but something went wrong because after the procedure my fathers extremities started turning blue from cyanosis. The doctor of course denied any relationship between the two events that happened within hours of each other.

The only possible conclusion that I could draw was that the catheter wire chipped of a piece of calcified plaque and lodged most likely in his lung as an embolism as he developed severe respiratory distress immediately after the angiogram. Now that had to be the greatest coincidence ever or a terrible medical mistake.

So a routine preventive screening where I was going to drive my dad home the same day turned into a week in the hospital after which he was moved into a step down rehabilitation facility and was expected to recover and go home.

On the evening before he was supposed to go home to continue his recovery at home, I visited him with my daughter and immediately saw something was very wrong.

Since there was only one doctor on the floor for about 50 adult residents, I practically had to physically drag the doctor to his room where his only suggestion was that he go back to the hospital. It took the ambulance 30 minutes to arrive to take hime to a major trauma hospital that was literally only a couple of hundred yards from where he was. I could have wheeled him over to the ER faster.

He died around 2 a.m. the next morning. They said he died from mesothelioma. I knew that was impossible because I never even heard the man cough once in his life or present with any of the symptoms of mesothelioma and I was in business with him for many years as well as his son.

Then, recently, when I was hospitalized in a Florida hospital for severe low potassium which was easily resolved over a few days of IV potassium infusion, a cardiologist walked into my room and said he wanted to do an angiogram just before my discharge, to check my stent that I had done a year earlier and I knew was fine and it literally became an argument because I questioned his authority. He finally admitted that the risk of death or complication during a cardiac cateterization were not insignificant. I finally agreed to a non-invasive Cardiac Ultrasound which showed absolutely nothing wrong.

And it had no relationship to why I was even in the hospital. I was released later that day and when I saw my regular cardiologist in New York, he called the other doctor a name I would rather not repeat and told me I may have saved my own life by contesting this man who I never saw before or since.

The odd thing is I only know this because I am an experienced Medical Literature Researcher but disabled.

Because too often patients are not informed of other treatment options for what ever ails them or for that matter the risks associated with many procedure options, because their doctors are simply unaware or don’t care or want to make the most money. Today, hiring an expert medical literature researcher is not a bad idea. And even a personal Patient Advocate which is a growing field for which no professional certification is required is a good idea if you can afford it because if your flat on your back and not in control and perhaps don’t even have family to help you, a personal Patient Advocate can be a good idea.

This is the new reality of healthcare. Its hard to be a practicing physician these days because of the rate of innovation, the problems of being a businessman, dealing with regulatory bodies, covering your hospitalized patients, litigation, etc. Many doctor’s can’t deal with it and quit medicine. And its getting harder.

Common sense also dictates that there is no longer a monopoly on medical information in this new era of instant information and mass communication and that transparency like revolution is a good thing once in a while.

In conclusion, as this essay attempts to address whether or not medical self help groups and self care alternatives are positive adjuncts or harmful challenges to medical care and how they contrast with one another as well as what consequences arise from such analysis, we can conclude with certainty that since the advent of the polio vaccine which brought about a tidal wave of medical advances available to help physicians cure disease, we are now in a new and ever evolving era of unprecedented advances in medicine, information and transparent social communication.

The costs of medical research and care have as a result of these advances skyrocketed to the point that medical resources have to be used in a more cost effective manner. Also, the issue of rationing medical care is one that social policy makers must give great weight to in their deliberations going forward since the implementation of the Affordable Care Act.

The issues are so complicated that consumers have a very difficult time making decisions as to how to best care for themselves and their families. Just picking a health plan can be a nightmare for families and professionals as different plans at different prices can work towards a families’ benefit or detriment depending on their socio-economic status, health history and lifestyles.

If these developments aren’t enough to contend with, the current power of the Internet as a source of both information and now also a powerful social medium in which people can connect with one another on a mass scale must be viewed as a benefit in a system that needs checks and balances due to the entry of so many stakeholders some of whom do not have the patient’s best interests at heart but instead are motivated by greed or are simply incompetent in their professions.

Self help groups, self care and the ability of a patient, or a loved one or an advocate to be involved in the management of illness and disease must work dynamically and cooperatively with their physicians, within this new medical landscape because the genie is now out of the bottle and we can’t look back but must look forward to a system of patients and caregivers working as a team towards the goal of healing and improving the quality of life of our citizens.

So what does the future hold. The last 30 years have seen an evolutionary leap more like one would likely see in a century or more. Now with new technologies such as 3-d copying and printing, and computer aided manufacturing and new medical fields like quantum medicine which uses the principles of quantum physics to better understand biology the future possibilities are mind boggling. The Civil war was only 152 years ago. Since then mankind has progressed from a way of life that sustained civilization for some 200,000 years at an astronomical rate. Can we absorb so much change so fast?

Gene Roddenberry foresaw a future beginning in 2236, 220 years from now with the release of Star Trek which has creating a self perpetuating movement. So what is our destiny, the view of Gene Roddenberry or perhaps, James Cameron’s “the Terminator” where mankind sparks an extinction level event by accident or by terrorism. Only time and man’s ingenuity will tell.

By Stuart J. Goltzman January 2, 2016 10:40 PM Eastern Time

All rights reserved, reproduction without alteration is authorized.

Cited Works:

(Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue3 Pages 2-5)

(Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue 3 Page 5)

What Has Changed in Health & Fitness Over the Last 30 Years?

There have been many changes in fitness over the past 30 years. It’s human nature to reminisce about times past. That’s great but lets not forget that things change as well. This is certainly true in the area of health and fitness. “If you do what you have always done, you will get the results you have always gotten” is true, but what if the situation changes? Then what used to work is no longer a viable and effect way to get the results that we want. In this article I will outline seven items that have changed over the past 30 or so years that affect the way we view health, fitness, exercise and what is considered “best”. Let’s look at some of these changes in Fitness.

1. Activity level

This change in fitness is pretty obvious. We just don’t move around as much as we used to 30 years ago.

Currently, the average sedentary person living in an urban setting takes 900-3000 steps a day. Uh… that’s a puny number! In the journal of sports medicine existing literature was pulled together to set a general guideline of what a good number of steps per day would be

The author Dr. Catrine Tudor-Locke translated different physical activity into steps-per-day equivalents. A rate of fewer than 5,000 is classified as sedentary, 5,000 to 7,499 is low active, 7,500 to 9,999 is somewhat active 10,000 or more is active and 12,500 or more is very active. So what does 900 make us? Close to dead! But its not hard to imagine. Get up from, take elevator to car park, drive car, take elevator to office, sit down, order fast food, reverse the process to go home and go back to bed. Just to note, 1km is about 1300 steps.

Its gotten to the point where we have to purposely inconvenience ourselves to get our activity level up. Here are some suggestions (that actually show us how pathetic our average activity levels have become).

Park at the far end of the car park and walk to your building Instead of dropping the kids off in front of the school, park a couple of streets before it and walk them the rest of the way… 10,000 is actually considered a LOW estimate for children.

Go round the shopping centre or supermarket in a random. With today’s super malls, this is a big thing!

Take the stairs instead of the lift or escalator (well if you work on the 50th floor, maybe climb halfway to start)

Give the dog an extra 5 minutes on his walk (we need it even more than him)

Stop emailing colleagues in the same office, instead go over and talk to them (shockingly effective considering how much email we send each day!… great for team building as well)

Go for a walk during your lunch break, walk to get your lunch or to find somewhere to eat your lunch

Get up and do something, run up and down the stairs for example during TV ads (no excuses here!)

Walk to the corner shop instead of driving or popping in on your way home

Walk to friends houses instead of driving

Take public transport and walk from the train station

Dr. David Bassett studied an Amish community to see what things were like in the past. These guys have no cars, no electricity and do hard manual labor to put food on the table. Its like time travel to the past. They eat 3 large meals a day with lots of meat, vegetables and natural starches like potatoes.

The 98 Amish adults Bassett surveyed wore pedometers for a week. The men averaged 18,000 steps a day. The women took an average of 14,000 steps.

The men spent about 10 hours a week doing heavy work like plowing, shoeing horses, tossing hay bales, and digging. The women spent about 3.5 hours a week at heavy chores. Men spent 55 hours a week in moderate activity; women reported 45 hours a week of moderate chores like gardening and doing laundry. Wow that’s a lot of manual labor. Get a pedometer (its only like 20 bucks) and see how you fare.

2. Fat Percentages and Obesity

Activity level leads us right on to this point about obesity. The scary obesity rate is one of the most obvious changes in fitness.

The obesity rate among the participants in the study of the Amish population was 4 percent, as determined by body mass index, or BMI. The current obesity rate among the urban populations is 30% or more. OK the obesity percentages are a scary thing because obesity is already in the “VERY high risk of a lot of bad ways to die” category. There is still the overweight category (obviously fat but not hitting the medically obese range) to consider. These people are at a high risk already!

The total percentages of overweight + obese are really wild… hitting close to 70% in some cities. Compare this to the average in the 1980s. 10-15% obesity in most cities. It rose to the mid 20% in 1995 and its now at an all time high.

3. Diet

OK linked to point no.2 is of course diet. This is another obvious change in fitness. Its very simple actually. We now eat more refined foods (white bread, sugar, rice, flour, noodles). In the body these give pretty much the same response – FAT storage. The only time we should eat these items is immediately after hard training. As we can tell from point no.1, not much of any training is going on. But lots of eating is!

We also eat less fresh fruits, vegetables and meats. We eat more snacks like chips and cookies (which are also refined despite what advertisers claim).

These changes in fitness are made more troubling because even natural foods today are not as good for us as they used to be. Current farming methods make vitamin and mineral content in fruits and vegetables drop about 10-40% depending on the mineral. Corn fed meats don’t give us as good an omega 6 to omega 3 ratio as we used to get from grass fed and free range animals. (that means not so many healthy fatty acids for us)

And of course, we are also simply consuming more calories. The Amish people in the study in point no.1 ate about 3600 calories/day for men and 2100 calories/day for women. Many sedentary people consume this much and more! How? Well a fully “featured” gourmet coffee from coffee bean or Starbucks can add up to 500 calories in an instant of caffeine folly.

That’s 2 hours of walking for an average sized lady.

Just remember, calorie quality counts as well. 2000 calories of vegetables, meat and healthy fats is infinitely better than 2000 calories from french fries. Its close to impossible to get fat on the first, and nearly impossible not to get fat with the second.

I like this car analogy. If you had a 2million dollar dream car, would you put low grade or high grade petrol into it? High grade of course! Then why do some people put low grade filth into their bodies which are so much more important than the car we drive?

4. Games children play

The average child who grows up in an urban environment is a motor-skill weakling. As a hobby, I coach youth basketball. In our talent scouting, I have kids do a very simple drill of dribbling in and out and around cones. There are so many kids who can’t do it and some who I think might fall down if asked to RUN around the cones without the ball! This is in contrast to the past where kids ran around, chased each other, played physical games and sports of all kinds, where the playground was the center of fun for young kids. This lack of activity not only causes a change in fitness for the child in his/her youth, but has a profound long term effect as well.

Of course this change in fitness is a result of a combination of possible factors.

Parents who only consider academic success to be worth striving for, who only give a child recognition and praise when they do well in academic subjects.

An education system who also values book knowledge above other things and takes away physical education classes to put more academic lessons in.

Poorly taught PE lessons that don’t help a child develop motor skills in the key early years Busy double-income families where fathers are not free to play with their children (or don’t care enough to… money isn’t everything dads)

The maddening computer game addiction situation where virtual life is more important than real life. I believe this is the reason for all the empty basketball courts in my neighbourhood. It used to be that teams lined up to play there. Now only people my age (late 20s to 30s) play. No young kids are there any more.

But actually, so what? The issue is that if kids stink at sport and physical activity, the well known psychological factor of “competence” comes is. Simply put, in general, we do what we are good at. If our next generation is poor at sport and physical activity, they are even less likely to do any of it! Which combined with items 1 to 3, make for a deadly health crisis for many countries. Obesity costs the UK 7.4 billion in national health care per year! If we don’t help our kids, that’s only going to grow to be a bigger and bigger burden for everybody.

5. Social Support

This is a more subtle change in fitness. People are communal animals. We stick with things because there is a supportive community behind us. Even drug and alcoholism rehab centers recognise this. We all need social support. But social links are getting weaker. And no, Friendster and MySpace links don’t make up for it.

In a more connected but less close world (I know so many people who are only comfortable behind a computer screen and not in front of a real person) there is less social support than in the past (extended families, communal living, strong friendships within a neighbourhood etc) and its hard to stick with something which requires dedication and sacrifice like an exercise program. I’m not a sociologist but I do believe there is a reason that exercise classes do better in terms of membership than individualized training. Most of them certainly are not as effective as great individual coaching. But the social factor does come in when sustaining a lifestyle change is involved.

6. Free Time

This subtle change in fitness is pretty clear. We just have less time that we “own”. Bosses, social, family and other commitments make free time a very precious commodity and it adds difficulty to the fact that time is our only non renewable resource. When we choose to exercise or spend time cooking to keep a healthy lifestyle, we are competing with movies, games, TV and other things for free time. We know that exercise is good for us, but it not only has to be good for us, it has to be BETTER in our minds than the latest episode of desperate housewives, or the latest computer game. That’s the issue. We need to prioritize long term health over temporary fun.

7. Training methods

OK here is where we are doing well. 30 years ago the aerobics craze took the western world by storm. Its not a very good training method both in terms of results, and in terms of results per unit of time. Add that to the fact that we have such minimal time to train, we can’t afford to train in a sub-optimal way. We know a lot more now. Fortunately for us, there are good methods that smart coaches use to improve training efficiency and get RESULTS even with less training time. Some of these include smartly designed resistance training programs, interval training and good assessment techniques to determine individual needs. If you have a coach like that in your corner, you can turn back the clock and avoid becoming one of the ever growing statistic of people who’s health is headed in the wrong direction. Stay fit and strong and good luck!