Cigarette smoking, poor diet, physical inactivity are very commonly regarded as individual choices. But it is very hard for me to believe that these three factors are purely individual choices the free will, are they that is an important insight on your part that while the behaviors are practiced by individuals, they are socially patterned so that patients who live in particular neighborhoods have less access to certain kinds of food. People who have low incomes may only have access to hike, calories, calorie-dense foods. This are inexpensive. People who work at jobs. This are repetitive and physically demanding, don't want to get on a bike and ride 50 miles after work. All these things, including advertising patterns, all have an impact on the behaviors. The way to think of one way to think about it is that if you observe that these behaviors are higher in a particular area, suppose we moved everybody out of that area. George A. Kaplan, PhD. We substituted a new group of patients, they probably also would show the same levels of behavior. Medical second opinion is important. It is not about the individuals. It is not about some genetic propensity. It is not about something that is written in stone. It is about the conditions under. This patients live.