Most people already know the health change they should make. The appointment they should schedule. The symptom they should check. The habit they should reconsider.
What’s striking is not that these concerns exist. It’s how long we live alongside them before doing anything about them.
The real question isn’t “why don’t people care about their health?”
It’s “why does action take so long?”
Part of the answer is simple and human: delay is easy. Even when a health concern feels serious, it doesn’t automatically translate into action. Life fills the space. Work gets busy. Family needs attention. There’s always a reason to wait.
Some health issues are easier to ignore than others. The ones that raise questions about identity, self-control, aging, or self-worth are often the ones we delay the longest.
Stigma is about shame. It distorts how people see themselves. It shapes the quality of care they receive. These are real harms, and many of them are deeply resistant to change.
But stigma also does something more quietly destructive: it stretches the time between knowing and acting. And unlike most social attitudes, delay is something we can actually design against.
In my work across multiple stigmatized areas of healthcare, from hearing loss to sexual health, from weight loss to alcohol use, I have seen the same pattern repeat. The journey to care is rarely linear, and avoidance unfolds in stages.
Take hearing loss. On average, people wait seven years before seeking treatment.
First, we deny the problem. Words are missed in conversation, we struggle in busy restaurants, but so what? The room was loud, that person mumbled. To stay in a place of denial, we develop workarounds. We adjust seating at dinner to sit near a favorite. We turn on subtitles. We turn up the volume. For years my own father boosted the treble on his TV, but refused to admit he needed hearing aids.
Second, we deny the solution. In my time at a direct to consumer hearing aid company, every day we heard people acknowledge out loud that something was wrong while still rejecting help. Always the same refrain: “I know I have a hearing problem, but I’m not ready for hearing aids.”
So why do we ignore something we know will help us? Because acting means accepting a label. And stigma makes that label feel like a verdict.
Take erectile dysfunction. For many men, seeking help can feel like an admission of weakness, a lack of discipline, or a loss of control.
Language matters enormously here. Erectile dysfunction was coined to replace “impotence,” an ugly term if ever there was one. Yet even so, few men will openly discuss it. During my time at a digital health company, we worked with more than 400 podcasts and social media creators. Ads for erectile dysfunction made many of them visibly uncomfortable. Yet those same men were happy to talk about low testosterone, even though the two are closely related.
Why? Because “low T” sounds clinical and neutral, while erectile dysfunction carries centuries of baggage.
As Ruth Goodman writes in her book “How To Behave Badly in Elizabethan England”, insults about such things go back all the way to the streets of Shakespearean London.
“A ‘cuckold’ was weak and sexually inadequate, a pale imitation of a real man. His wife strayed because he couldn’t sexually satisfy her and he had failed to exercise proper masculine authority over her.”
So if stigmatized health issues are easy to ignore, what actually moves people to act?
Permission.
At a virtual clinic treating alcohol use disorder, we see clear spikes in engagement during moments when people feel socially permitted to act. When the cultural narrative shifts, even briefly, the gap between “not yet” and “now” narrows.
Dry January is a month-long drinking pause that is widely understood, socially accepted, and growing. If anything should neutralize the stigma around examining your relationship with alcohol, it’s this.
But there are limits to permission. Data from the first Health State of Dry January report shows that many people who attempt it face active pressure from friends and family to cave.
“Just have one.”
“Don’t be dull.”
“What’s the big deal?”
That pressure matters. People who attempted Dry January but did not complete it were nearly twice as likely to report experiencing peer pressure compared to those who did.
If stigma can derail people even during Dry January, when abstaining is socially sanctioned, then stigma is not a background condition; it’s an active force. One we may never dismantle.
But we don’t have to solve stigma to save people time.
The longer someone waits to seek help, the more their condition progresses, the harder it becomes to intervene, and the easier it becomes to keep waiting. Delay compounds. That’s what makes it so dangerous, and so worth targeting directly.
That’s why I believe in telehealth models that reduce friction, lower privacy barriers, and shorten the path from awareness to action. They won’t eliminate stigma. But they might stop it from running the clock.
Photo: PeopleImages, Getty Images
Neil Walker is the award-winning VP of Growth at Oar Health, a telehealth company focused on treating alcohol use disorder. He has driven growth across stigmatized healthcare categories, including hearing loss at Audicus and men’s health at Ro. At Oar, he focuses on helping people drink less or quit by reducing friction, increasing privacy, and making it easier to take action.
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