Opportunities for Behavioral Economics to Transform Prevention

By Elle Alexander

Interest in behavioral economics is increasing, with even the World Bank recently releasing the report Mind, Society, and Behavior that discusses human decision-making and development policy. The University of Pennsylvania Center for Health Incentives and Behavioral Economics (CHIBE), founded in 2008, held its annual meeting on Behavioral Economics and Health last fall, bringing together an interdisciplinary group of scholars focused on developing solutions to promote health. Leaders in the field presented and actively discussed the research, highlighting key take-aways worth reflecting on in the new year. Derek Yach, Executive Director of the Vitality Institute, joined a panel of business leaders who discussed the implementation challenges of behavioral economics-based programs. Key takeaways from the meeting include:

Don’t settle on no

Kessler (UPenn) presented his research showing that repeatedly asking for organ donation increases yes responses, even of those who previously said no. Where else besides the Department of Motor Vehicles could we ask people to be an organ donor – at their annual doctor visit or when they sign up for their health insurance? Also, what other questions can be leveraged in this way? When the biggest challenge is obtaining a “yes”, consider testing if repeated requests increase your acceptance rate.

Too many options get in the way of the individual making the right decision

Saraubh Bhargava (Carnegie Mellon) shared research of 50,000 employee choices at a Fortune 500 firm that included 100 insurance plan options. Rather that improving employee choice, most employees chose a plan that was dominated, costing more for the individual than the optimal plan. Simplification and education reduce the amount of poor choices, so offering fewer smart choices is best. This also makes sense when considering food options: it can be difficult to purchase healthy bread when a whole aisle of mostly unhealthy options must be chosen from (see image associated with this blog).

The importance of habits

Matthew Rabin (Harvard) spoke about habits, which Daniel Kahneman (Nobel Prize winning behavioral economist) describes as Governing System #1 of the two-system decision making theory. Habits are essential to consider when focusing on interventions to prevent chronic disease – tobacco use and physical activity are habits. Brian Wansink discusses the unconscious decisions individuals make each day, many driven by habit, in Mindless Eating. For example, using smaller plates will reduce portion sizes and calories without much effort.

Behavioral economics offers huge potential to improve health behaviors, especially those related to prevention. Vitality has shifted food purchases to healthier items using cash-back rebates on healthy foods, highlighting the opportunity to improve diets using financial incentives. Further work is needed to translate behavioral economic learnings into programs and policies that improve health. For example, funding for prevention research is needed, which is in line with our Commission Recommendation to Invest in Prevention Science.

Have you used any behavioral economic principles to encourage healthy behaviors in your family, community, or workplace? Let us know in the comments below.

The Vitality Institute strongly believes in behavioral economics to improve health. Follow our blogs and tweets @VitalityInst to keep up to date with our work.


Image source: imgarcade.com


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