While the illness-care system de-emphasizes the role played by lifestyle in determining the state of health, the truth is that our health is much more in our own hands than in those of our doctor. Most illness in this country results from the everyday choices we make about how we live our lives, rather than from lack of access to health services. No training is needed to put on a seat belt in the car or to buckle up young children in a car seat, but these simple gestures can save lives and dramatically decrease the chances of severe injury. It takes only a minute to ask your doctor or pharmacist to check your prescription and over-the-counter medications for possible adverse drug interactions, or to double-check that what has been prescribed is exactly what was placed in the bottle.

From 1992 to 2003, the FDA received about 26,000 reports of medication errors - that's about 200 errors a month. But most experts believe that thousands more go unreported. The reasons for these errors are many, but improper labeling and confusion over product names are the most common. Among the elderly, hospital admissions for incorrectly used prescription drugs is extremely high, and drug errors within hospitals also pose a problem. Many patients are taking multiple drugs when they enter the hospital, and when new drugs are administered, some can adversely affect others. The Institute of Medicine, of the National Academy of Sciences, has estimated that drug errors alone may account for about 7,000 deaths each year in the United States.

You already know many ways to prevent accidents, since most of this is basic good sense; for example, making sure the smoke detector is working in your home or using a designated driver. Yet the complications and pressures of modern life may cause you to put these safety precautions low on your list of priorities. Many of us also know that some foods are de-energizing us, increasing our stress levels, and ruining our teeth, yet we like them, we are addicted to them, or they are convenient, and so we keep eating them instead of transitioning to a more wholesome diet. The world around us can be dangerous, but there are many practices and devices that can make it safer. Commonsense safety is easily overlooked as an integral part of a personal wellness program.

Self-responsibility in this domain may start with a slow walk" through and around your home, your workplace, and your car, looking for safety hazards. Look over the list below and ask yourself what you already know about safety and wellness in each area.

• Home fire extinguishers
• Icy sidewalks and steps
• Use and maintenance of stairs and handrails
• Slippery floors and movable area rugs
• Wet, slippery surfaces, especially bathtubs
• Children's access to prescription or over-the-counter drugs
• Out-of-date prescriptions or over-the-counter drugs
• Seat belts and air bags
• Automobile tires, wiper blades, and antilock brakes
• Car seats for children
• The speed limit
• Operation of machinery under the influence of alcohol or drugs
• Escape plans in case of fire both at home and away
• Overloaded, improperly fused electrical outlets
• Poorly protected electrical wires
• Use of electrical equipment near water
• Space heaters
• Storage of cleaning products, medicines, and poisons in homes where children live or visit
• Use of household cleaning products and pesticides that contain toxic substances
• Emergency phone numbers
• Accessibility of first-aid supplies
• First-aid skills for choking, burns, shock, and the like
• Protection from high sound or noise levels
• Safe disposal of paints, paint thinners, gasoline, oil, and so on
• Children's toys

Depending upon where you live, you will have many other items to add to this list. In Arizona, where Regina lives, the creation of "defensible space" around homes is critical during the long dry seasons when the risk of forest fires is extreme.

The next major advances in health of the American people will come from the assumption of individual responsibility for one's own health and a necessary change in lifestyle for the majority of Americans. —John H. Knowles, MD, former president, Rockefeller Foundation

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