Why we need a 'nudge' in the right direction
Whether or not we opt for "healthy" choices is largely down to our environment according to the LSE's Professor Paul Dolan. In this week's Scrubbing Up, he says government does have a role in "nudging" us in the right direction.
Did you have a couple of beers too many again at the weekend? Did you skip the gym again last night? Did you buy and then devour that giant size chocolate bar on special offer for a quid?
Such choices might make you happier, but they might not.
In fact, you might be behaving in all sorts of ways that are not consistent with your overall happiness. And, as an academic interested in human behaviour and happiness, I care about that.
I care that, as a result of lifestyle factors such as smoking, alcohol misuse and poor diet, many people get sick and die prematurely.
Behaviour 'not thought about'
Policy-makers care too, of course. For decades, they have provided us with more information about health risks and have used a range of financial and legal incentives that change the consequences of our behaviour.
But these interventions can only get us so far, and they nearly always widen the health gap between rich and poor.
In contrast to models of rational choice suggesting that we respond to information and incentives in very considered and thoughtful ways, recent behavioural insights suggest that human behaviour is actually led by our emotional and fallible brain, and influenced greatly by the context or environment in which many of our decisions are taken.
Behaviour is not so much thought about; it simply comes about.
At the same time as the limitations of traditional approaches have become apparent, policies that change the context or "nudge" people in particular directions have captured the imagination of policy-makers.
I have been involved in translating the lessons from the behavioural sciences into practical policy tools. There are some particularly robust effects that influence behaviour in largely automatic ways, which we have gathered up under 'MINDSPACE', and which is now being used by policy-makers when thinking about effective nudges.
These are the ways we are influenced:-
- Messenger - we are heavily influenced by who it is that communicates information to us. So HIV prevention interventions work best when information comes from people in a similar position.
- Incentiveshelp shape behaviour so, in addiction, vouchers which increase in value with each negative test work better than "flat" incentive schedules.
- Norms - people are more likely to be obese or smoke if others around them are or do.
- Defaults - most will "go with the flow". So the proportion of people willing to donate organs after death is much higher in 'opt-out' systems than 'opt-in' ones.
- Salience - novelty and relevance increase the chance we'll take in information. So, in tackling HIV amongst teenagers in Kenya, providing information about the relative risk of infection by partner's age group led to a significant decrease in teen pregnancy and pregnancies with older, riskier partners.
- Priming - how we act is often influenced by cues we are not consciously aware of. So people eat less when they have smaller plates.
- Affect - our emotional associations can powerfully shape our actions, so evoking moderate fear increases the likelihood of going for a health check.
- Commitments - we want to be consistent, so committing to stop smoking has an effect over and above other elements of the process.
- Ego - We also act in ways that make us feel better about ourselves and massage, so being exposed to favourable characteristics of people who exercise increases people's own exercise levels.
Recent behavioural insights shift the policy focus from the idea of an autonomous individual making rational decisions to a "situated" decision-maker, whose behaviour is largely automatic and influenced by context and "choice architecture".
This raises questions about who decides on this architecture and on what basis.
Many people dislike the thought of government intruding into areas of personal responsibility but they also realise that the state should have a role in behaviour change, especially when one person's behaviour has consequences for another person's well-being.
So we don't want the government to stop us enjoying a few beers with our mates, we do want them to do something about anti-social drinking on the streets.
There are some complex political and ethical issue here but one thing is certain - we are being influenced - and influencing others - all the time.
The choice environment is rarely neutral and "choice architects" will always be shaping decisions whether they like it or not.
Given the importance of context on our behaviour where possible, we should be doing what we can to construct an environment likely to improve wellbeing rather than worsen it.
It is hard to disagree with that.