1: The United States is one of the wealthiest countries on earth. Yet, in the 1960s and 1970s, the country had higher infant mortality rates than most of Europe and some parts of South America. In rural areas, a startling number of babies were dying before their first birthdays.
As it turns out, the key to solving this complex problem was understanding the concept called “Keystone Habits.”
Before leading a turnaround at Alcoa that increased the value of the company 5X, Paul O’Neill was a “whiz kid” working in the federal government in the Office of Management and Budget, one of Washington’s most powerful agencies. He was tasked with creating a framework for analyzing federal spending on health care. One of the foremost issues at the time was infant mortality.
2: “Some research suggested that the biggest cause of infant deaths was premature births,” writes Charles Duhigg writes in The Power of Habit. “And the reason babies were born too early was that mothers suffered from malnourishment during pregnancy.”
To lower infant mortality, mothers’ diets would need to improve. “Simple, right?” Charles asks.
Maybe not. To stop malnourishment, women would need to improve their diets before they became pregnant. Which means schools would have to start teaching about nutrition before women became sexually active. Which meant health officials had to create nutrition curriculums inside high schools.
“However, when [Paul] began asking about how to create those curriculums, he discovered that many high school teachers in rural areas didn’t know enough basic biology to teach nutrition,” writes Charles.
Which meant colleges would need to give future teachers a stronger understanding of biology. So in time, these teachers would be able to pass on this knowledge about nutrition to teenage girls. So these teenagers would start eating healthier. And years later would give birth to healthier babies.
“Poor teacher training, the officials working with [Paul] finally figured out, was a root cause of high infant mortality,” notes Charles. “If you asked doctors or public health officials for a plan to fight infant deaths, none of them would have suggested changing how teachers are trained. They wouldn’t have known there was a link.”
Today, Charles writes, the U.S. mortality rate is 68 percent lower than when Paul started his job.
3: Paul was learning the power of keystone habits. That “some habits have the power to start a chain reaction, changing other habits as they move through an organization,” or a country, notes Charles. “Some habits, in other words, matter more than others in remaking businesses and lives.”
Keystone habits offer what is known within academic literature as small wins. “Small wins are exactly what they sound like, and are part of how keystone habits create widespread changes,” Charles observes. “A huge body of research has shown that small wins have enormous power, an influence disproportionate to the accomplishments of the victories themselves.”
Keystone habits encourage change by creating structures that help other habits flourish. These small wins fuel transformation by the steady application of tiny advantages, all the while helping to convince people that bigger achievements are possible.
Reflection: Consider a significant challenge I am facing right now. Is there a keystone habit or small win I might capitalize on to help solve the problem?
Action: Journal about it.