Smart financial incentives to promote cardiovascular health

The United States, like most countries around the world, is striving to improve its population’s cardiovascular health. Recent results, however, are mixed. On the favorable side, clinical medicine continues to improve. For example, a December 2019 review chronicled 39 improvements in the diagnosis and management of cardiovascular disease just in the preceding six months.1 On the worrying side, however, several risk factors due to lifestyle continue to worsen. The National Health and Examination Survey (NHANES) documented significant increases in the prevalence of obesity from 1999-2000 to 2015-16 (the most recent data) in both adults and youth.2 More recent self-reported data through 2018 showed the prevalence of both obesity3 and sedentary lifestyles has continued to worsen.4 Obesity increases risk not only for cardiovascular disease, but also for many types of cancer.5