Resolutions, experiments for a new year

This New Year I am experimenting, instead of resoluting. (I know, it’s not a real word. But it just sounded right.) I’m interested in how technology can play a role in behavior change, how to eat less, drink enough water, exercise more, and sleep better.

The tool I’m playing with is called a Fitbit. I’ll write more about that later, but it’s already interesting because it measures steps, your sleep pattern (although I am quite ready to argue about falling asleep in the chair while watching TV. The device (and my family) says “yes,” but I know better.

I see how this technology could be helpful to wellness programs. Sunday I walked 11,289 steps (not quite 3 miles), consumed more than 2,000 calories and slept 8 hours, waking up 7 times during the night.

We change what we measure – and that includes our own behavior. Just by watching my personal data, I am inclined to walk more and eat less.

But that’s only part of what could make Fitbit important to a wellness routine. Part two will come when others I know are on the system and add their stats through social networks. Think of a community of folks who are rooting for your success, for your better health, as you urge them forward.

This is more experiment, than a resolution. But this is the season for resolutions – and for many that means it’s time to quit smoking.

A story in Indian Country Today reported about the Tulalip Tribe’s tobacco cessation effort. “Here at Tulalip and throughout Indian country we face an uphill battle in addressing use of tobacco. Some tobacco companies use Native American images and cultural symbols in their advertising, such as warriors, feathers, and regalia. They also slip in words like ‘natural’ in the brand names to build image, credibility and sales within the Native American community,” Mel Sheldon, chairman of the Tulalip Tribes, told the newspaper.

I also like the innovative program run by the California Rural Indian Health Board– Keep Tobacco Sacred – because it reminds people about the traditional protocol for tobacco (instead of its recreational and commercial uses).

Smoking is a significant health concern for Indian Country. About a third of all American Indian and Alaskan Natives are smokers, according to the National Tribal Tobacco Prevention Network. It represents the highest use rate for commercial tobacco in every age, ethnic and gender category in the U.S. We die in greater numbers because of tobacco use.

And it’s not just the act of smoking itself. Smoking complicates the management of chronic diseases, including diabetes.

But this is a complex problem for tribal leaders because some tribal enterprises depend on the sales or use of tobacco. Smoke shops are a source of reservation capital and jobs and tribal casinos market to smokers in states where other casinos, bars and just about any facility open to the public is smoke-free.

Unfortunately it’s better for the casino business when there’s smoking. Even the casinos with separate non-smoking facilities find that people gamble significantly more per hour on the smoking side than in the non-smoking areas.

But what if the incentive framework was changed? What if the entire country – tribal casinos and their competitors alike – went non-smoking? That sounds far-fetched because the economics of a casino make this problem seem intractable.

But then again Indian Country has another history.

It turns out the Indian Health Service was one of the first hospital systems to go entirely non-smoking in 1985. “In late 1983, the PHS Indian Hospital on the Hopi Reservation at Kearns Canyon, Arizona, became the first to reach this goal,” the Centers for Disease Control said in a 1985 report. “Now, virtually all IHS facilities have become smoke-free. In addition, this initiative led to a smoke-free policy in the American Indian schools on the Navajo Reservation at Zuni, New Mexico.”

We don’t think of smoking at a clinic any longer. Could that be how we think of casinos one of these days? Some resoluting might be ahead.