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Health Decisions, Mental Shortcuts

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How small changes can impact our affect heuristic health choices.

harvard, melbourne, health

On any given day the average person makes hundreds, if not thousands, of tiny rapid decisions that will impact their health.  The decision to eat fruit or sweets for breakfast, to drive faster or slower on the highway, to take the elevator instead of the stairs; choices so routine, it is almost an automatic behavior.  Through his studies of social behavior and advertising, Dr. Ichiro Kawachi, Professor of Social Epidemiology, and Chair of the Department of Social and Behavioral Sciences at the Harvard School of Public Health, has been shedding light on how even little changes to an otherwise daily routine, can have a big and beneficial impact.

Some of the insightful examples Kawachi shows us come from cafeterias and fast food restaurants.  In the case of an institutional cafeteria, you typically get a tray and move along past several stations of food until finally you arrive at the cash register.  According to behavioral research, the food that is on display towards the beginning of the journey is what people typically fill their plate with first.  By the time they arrive at the end of the line, there is no room and they will typically choose to not take those items. In cases where a less healthy food like french fries appear at the beginning of the line and vegetables at the end, people will more likely fill their plates with fries and other items and not take vegetables.  When this order was inverted, people actually took more vegetables and left the fries behind.  In other words, one small change impacts that quick decision to choose a healthy food over an unhealthy food.

In the world of fast food, when a customer makes their order they are always asked if they want to “super size” it.   As Dr. Kawachi explains, when this is presented as the default option, people are much more likely to choose it.  The decision is not even necessarily based on how hungry a person is or how much happier they will be with more food, it is more often the way the choice is presented. In experiments where this routine was altered, the cashier replaced the traditional question with “would you like to downsize that order” (instead of large fries- a medium, instead of a double cheese burger- a regular cheese burger). As many as 1/3 of all the customers presented with this choice opted to downsize their order. Again, an example of how the way a choice is presented that can make a big difference.

There are also examples of behavioral health choices that have proven harder to predict and influence. Smoking, for example, in the past few decades, has been the target of wave after wave of public health warnings and even labels that basically say “this will kill you”, yet many people still smoke.  Unlike healthy eating or exercising where the benefits and costs are felt more immediately, smoking is a case where the immediate gratification can often outweigh the concerns of longterm health problems.  In such cases public health advocates and behavioral psychologists are now looking into other ways of helping people not smoke, especially in the phase where an individual is not  yet craving cigarettes when they are better able to sway decisions and build up will power.

What Dr. Ichiro Kawachi is advocating is a better approach than the lecturing and banning tactics incorporated by governments and health agencies in places like New York City. Instead of preaching to someone about what is wrong with their automatic behavior, which has been shown to have very mixed results, we would be wise to “level the playing field” with advertisers and start changing some of those default options for some that stimulate good health and a better quality of life.

Source: Up Close

Photo: Dave77459 / flickr

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