Take action against the Big Four. There's no getting around it: Our own behaviors are the chief causes of disease, disabling conditions and premature death. Four health risk behaviors -- smoking tobacco, risky alcohol use, unhealthy diet, and physical inactivity -- lead all other dangers.

These behaviors account for approximately 40 percent of all total deaths in the U.S. per year," says Maribel Cifuentes, R.N., deputy director of Prescription for Health, a Robert Wood Johnson Foundation national program based at the University of Colorado, Department of Family Medicine. Behavior has a larger impact on health than genetics, environment, or social circumstance, Cifuentes adds, yet "the choices we make…are powerful and changeable."

Change isn't easy. Maybe you've tried before. It may take several attempts until you succeed. Ask for help from your primary health care provider. "Setting reasonable, attainable goals and having a feasible plan on how to achieve them is very important," says Cifuentes. Small successes lead to larger ones.

Looking for a shortcut? Try changing two behaviors at once. A study conducted by The Johns Hopkins Medical Institutions found that overweight adults with high blood pressure who tackled two of these risk behaviors at the same time -- physical inactivity and unhealthy diet -- had good results making changes for the better in both.

Build a two-way partnership with the professional in charge of your health. When you improve communication with your primary care provider -- doctor, nurse practitioner, or nurse -- you create shared decision-making that benefits your overall health. Sometimes, though, developing a rapport may seem difficult to do because of limited time or personality differences.

At your next check-up or appointment, promote a dialogue by bringing a list of questions or concerns to discuss. You might also take along a chart of your family's health history, to talk about possible genetic health risks. Your health care professional should listen and offer help. If you feel ignored or dismissed, speak up. You may need to look elsewhere to find a more responsive professional.

Put on a pedometer. This popular little device is more than just a fad. It can have a big impact on your health by encouraging you to increase your physical activity. Pedometers count the number of steps you take in a day -- the more, the better. Many of us take only 2,000 or 3,000 steps a day -- or fewer. "Often, people are shocked when they first start wearing a pedometer, as most people think they are more active than they actually are," says Linda S. Rellergert, M.S., nutrition and health education specialist with the University of Missouri Extension.

How many steps should you try for? Rellergert advises wearing the pedometer for a week, recording your daily step count on a logsheet. That becomes your baseline amount. "Try to get 10 percent more steps the next week or two," she says. "Continue to increase by 10 percent until you can sustain 8,000 to 10,000 steps per day." Walking faster or on hilly terrain will help build aerobic fitness even more. Keep a log of your step count for motivation to reach your goal.

To work accurately, the pedometer must be placed firmly against your body (as on a waistband), over the knee or hip, upright and vertical. A good, simple pedometer costs about $20. Pedometers designed on a piezo-electric system have been shown to be more accurate for use by overweight and obese adults than spring-levered models. A pedometer designed on a piezo-electric system has no moving parts, making it less subject to errors caused by tilt, a common problem with standard spring-levered pedometers.

Find alternates for the sugar and salty tastes you might crave. Sugar tastes good to most of us, so it's easy to consume too much. That can add pounds and limit the intake of healthier foods. Salt not only tastes good, but also enhances other food flavors. Lowering salt in your diet can reduce high blood pressure and lessen overeating.

Choose healthier substitutes and you'll gradually crave sugar or salt less. Cook with cinnamon or vanilla to add sweetness. Savory spices, like oregano, can replace salt. Grab fresh fruit for snacks instead of cookies or chips. In baking, reduce the amount of sugar in the recipe or replace it with artificial sweeteners. Quench your thirst with water or sugar-free drinks.

Find resources for health insurance coverage. Having no health insurance, or being underinsured, may keep you from staying well or worsen chronic conditions, such as high blood pressure, asthma, or diabetes.

The Health Assistance Partnership can guide you about Medicaid and Medicare, private insurance including health savings accounts, your state's no-cost or low-cost insurance, and coverage for high-risk individuals. If your income is low, you may be eligible for free hospital or nursing home care under the Hill-Burton Program. Partnership for Prescription Assistance helps you find sources for free or nearly free medications if you have no prescription coverage.

In addition, talk honestly with your health care professional about your lack of health insurance. Many will reduce fees to uninsured individuals, provide you with free samples of medications, or connect you to prescription aid programs.

For full details on these and other ways to find low-cost or free help, visit the healthywomen.org "Toolkit for the Uninsured and Underinsured".