For many years now, health educators and government departments have been trying to persuade us to adopt healthier lifestyles - eat more fruit and vegetables and less fat and sugar, stop smoking, drink less, take more exercise. What has happened? Middle class people with already healthy lifestyles have become even more healthy. Health among people lower down the social strata has also improved, but much less so. The result?  Ever-widening inequalities in health between rich and poor.

I have never seen this so starkly as on a trip to Los Angeles a few years ago.  My daughter and I stayed in two places - first in Hollywood Boulevard, and then on the beach in the wealthy and sophisticated area of Santa Monica. In the bustling tourist area of Hollywood, and on our trip to Universal Studios,  we saw more grossly obese people than I have ever seen in my life. At the theme park there was a fleet of special motorised vehicles for people who were too overweight to walk. The food outlets served huge platefuls of fries and battered food, and cakes that were big enough for four people. At Santa Monica, though, things were very different. Along the length of the beach they have laid a cycle track and people pedal furiously along it from six in the morning till late at night. There are parallel bars, rings and other gym apparatus set into concrete. At all times of day there are pin thin people exercising. There's not a fast food outlet in sight.

We don't precisely know the reason for the extraordinary disparity in response between different social groups, but the new government say, not unreasonably, that past approaches have not been working. They want to go for 'nudging' instead of 'telling' and legislating.

Why do we do things?
The anthropologist Gregory Bateson developed a model for understanding the structure of human activity and motivations that was later adopted by Robert Dilts, one of the originators of Neuro-linguistic Programming. He argued that for any project or activity we undertake we are operating, whether consciously or unconsciously, at several different levels:

Environment: where we are
Behaviours: what we are doing
Capabilities and skills: the skills we have or need to do what we're doing

Beliefs and values: what we believe about what we're doing
Identity: who we are when we're doing what we're doing
Greater purpose: who benefits from what we're doing

If our project is not going as well as we would like, we can simply examine what is going on at each of these levels, and make appropriate adjustments.

If you think about how governments try to persuade people to change their lifestyles it becomes immediately clear that they are operating mainly at the levels of behaviour and capabilities/skills. If we have the ability to discern healthy from unhealthy behaviours, the logic goes, then we will choose healthy behaviours. What it doesn't take account of is where people are (Environment) - if you live in a horrible flat on a violent estate and on very little money your priorities are going to be very different from someone who lives in a nice house in the country. If you're highly educated and therefore used to assimilating information (capabilities and skills), then leaflets and talks on eating five a day will be useful; if you left school at sixteen, unable to read, they will be less useful.  If you work in a position of authority, or at least have some hope of being there one day, then you are more likely to accept authority from others; if you are used to being at the bottom of every hierarchy, you may well resist and resent being told what to do (Behaviours). Remember the image of mothers passing chips through the railings of schools where Jamie Oliver was trying to introduce healthy meals?

If acting at one level doesn't work, then the obvious thing to do is try another.

Imagine Jake, a single, thirty-five year old man who wants to get fit but rarely makes it to the gym. His focus is on Behaviour, actually getting himself to the gym and using the equipment. It hasn't worked. Let's look at what is happening at the other levels.

Environment: Is the gym. It's near his workplace and is full of body beautiful people who make him feel even more flabby and sluggish than he already does.

Capabilities and skills. He knows how to use the equipment and he knows that if he uses it he will become fitter.

Beliefs and Values: He believes that taking exercise would be good for him. However, he values going straight home from work and sitting in front of the television with a glass of wine. 

Identity: He feels like an unfit, overweight slug, especially at the gym.

Greater purpose: He's never thought about it.

It doesn't take Einstein to see why Jake rarely makes it to the gym. Imagine instead that he decided to take up running in the park near his home (E). He chooses a time of day when few people are there and puts his favourite music on his ipod (B). He sees his runs as times when his mind can relax while he focuses on his body and senses (B/V).  He develops a self-image as a man who takes care of himself and is disciplined (I).  He realises that if he is fit and slim he will feel better about himself, will be more likely to find a girlfriend, will be happier, more productive, and generally nicer to be around. His colleagues, family and friends will all benefit (GP). 

Try this:
1. Think of something that you would like to do - a project, an activity, improve a relationship, influence someone.
2. Ask yourself the following questions, and notice how you feel when you answer:
Where will I do this thing?
What will I be doing exactly?
What capabilities and skills do I have, or do I need, to do this?
What is important to me about this, and what do I believe about it?
Who will I be as I'm doing this?
Who else will benefit when I'm successful?
3. Decide what, if anything, you need to change or do at each level. You may need to learn a skill, or get help from someone who has it. You may need to clarify why you're doing this thing, adjust your self image, or really understand who is going to benefit.

Have a great week!