A thought suddenly occurred to me. Unless one is living in a war zone or a famine-stricken nation, how many people in modern society find it "physically impossible" to practice the health guidelines listed in textbooks?
Rarely does anyone fail to exercise because they lack the money—all it takes is a pair of sneakers and a neighborhood park. No one fails to quit smoking because they lack the time—choosing not to smoke requires no time at all. The same goes for maintaining cleanliness, eating less salt, and avoiding high-fructose corn syrup. Barring extreme disasters, a health textbook is a 100% physically achievable reality for modern humans.
If so, we must change the question: why do we still fail when there are no physical barriers?
At this point, we confront a crucial truth: the discipline of public health is actually much closer to psychology, which deals with the human mind, than to biology, which deals with cells and hormones.
The Vast Distance Between ‘Physical Possibility’ and ‘Feasibility’
In the past, public health was strictly a matter of biology and sanitation. That was back when preventing infectious diseases like the plague or cholera simply meant upgrading water and sewage systems and catching rats.
However, in a modern society where vaccines and antibiotics have been invented and the struggle for basic survival has been resolved, the threats to humanity are chronic illnesses like diabetes, high blood pressure, and cardiovascular disease. The true name for these ailments is "lifestyle diseases." This means they are the cumulative result of years of "behaviors"—what I ate today, when I slept, and how much I moved.
This is where the clash between biology and psychology occurs. The muscles to move the body (physics) are perfectly intact, but the motivation to move the mind (psychology) fails to activate.
Evolutionarily, the human brain is wired to have a "Present Bias." It places a far higher value on the immediate, guaranteed reward of a sweet donut melting in the mouth than on the distant future reward of clean blood vessels ten years from now. During our hunter-gatherer days, consuming every calorie in sight was advantageous for survival. When textbooks speak of the biological imperative to "endure for the sake of the future," our instincts issue a psychological command to "eat it now."
Handing Sneakers to a Drained Battery
In psychology, there is a concept called "Ego Depletion." It is the theory that human rationality and willpower are not an infinite spring, but a battery that drains the more it is used.
Imagine an office worker who woke up early, crammed into a packed bus, performed emotional labor while walking on eggshells around the boss, and managed a deluge of tasks, draining their willpower battery completely over the course of the day. On the way home, when their smartphone battery is at 3%, we would never call them to assign more work.
Yet, health textbooks make the unreasonable demand that this depleted human eat a salad and head to the gym. What they lack is not the time to go to the gym (physics), but the mental energy to step out the door (psychology). Just because something is physically possible does not mean it is psychologically feasible.
From Admonition to Seduction: A Paradigm Shift in Healthcare
This is why modern public health has begun to abandon the practice of sitting patients down and lecturing them, "You have a fatty liver, so stop drinking." It is because we realized that it carries zero psychological effect. Instead, behavioral economics and psychology have filled that space.
Indicating calorie burn on subway stairs or turning them into piano keys that make sounds when stepped on to make people want to walk; designing cafeteria layouts (Nudges) so that people pick up healthy salads first; and using consultation techniques where doctors, instead of giving one-sided orders, ask, "What positive changes do you think cutting back on alcohol would bring to your life?" to help patients find their own motivation—these are all evidence of this shift.
What Ultimately Moves a Human Being
Unraveling the mechanisms of disease and the principles of medicine is indeed the realm of biology. However, making sure the patient takes that medicine on time, and getting them to lace up their sneakers at the front door, is entirely the realm of psychology.
The true battlefield of public health is not the cells under a microscope, but the human mind agonized every night over whether or not to open a food delivery app.
No one is physically incapable. They are merely stopped short before a psychological barrier. Therefore, good healthcare should not mean shoving a rigid, text-heavy textbook in a patient’s face. Rather, it must be a tender psychology—one that quietly looks into the patient’s drained heart and opens a tiny fracture of space so that the mind can begin to move on its own.
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