Behavioural Economics: Influencing behaviour in health

Toni Ardolino and Tom Fowler

Coalition agreement

“There has been the assumption that central government can only change people’s behaviour through rules and regulations. Our government will be a much smarter one, shunning the bureaucratic levers of the past and finding intelligent ways to encourage support and enable people to make better choices for themselves.”

2

Behavioural economics has been studied for 40 years

• Condenses the relevant evidence into a manageable “checklist”, to ensure we can take account of the most robust effects on our behaviour

• Demonstrates how behavioural theory can help meet current societal challenges

• Shows how we can all build behavioural theory into the way we work

What does MINDSPACE do?

Most interventions to date have focussed on  ‘changing minds’

But we also behave in more  ‘automatic’

ways

‘It turns out that the environmental effects on behavior are a lot stronger than most people expect’

Daniel Kahneman, Nobel Laureate

Key insight: you can change behaviour  without changing minds...

Information is generally not the problem

Fisher & Fisher, 1992; Psychological Bulletin

77%70%

61%59%59%58%

49%44%

35%

Eating more fruit and vegetablesWhat do you think ‘eating a healthy diet’ involves?

Germany

UK

Italy

Neth

EU 25Spain

Sweden

France

Ireland

Eurobarometer 64.3 2005. Base c1,000 interviews in each country

-80 -60 -40 -20 0 20 40 60 80 100

Italy France **DenmarkSweden

NetherlandsBelgiumAustria

Lithuania**Estonia **

LuxembourSlovenia*

GreeceSpain

IrelandHungary

LatviaSlovakiaMalta **FinlandCzech

CyprusEngland

Germany

Women Men

% Overweight % Obese% Obese

UK

AffectNorms

Commitment

Priming

Ego

Incentives

SalienceMessenger

Defaults

MINDSPACE

A checklist for policymakers

Messenger

We are heavily influenced by who communicates information

• Perceived authority (formal or informal)

• Expertise

• Peer effects

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Teens and Toddlers – reducing teen pregnancy

Incentives

Our responses to incentives are shaped by predictable mental shortcuts such as strongly avoiding losses

• Losses loom larger than gains

• We overweight small probabilities

• We mentally allocate money to discrete bundles

• We live today at the expense of tomorrow

Incentives may ‘crowd out’ intrinsic motivations

Norms

We are strongly influenced by what others do

• If the norm is desirable, let people know about it

• Relate the norm to your target audience

• Consider social networks

• Norms may need reinforcing

• Be careful when dealing with undesirable norms

Standard Environmental Appeal

Many Others

Hotel towel study

50

20

25

30

35

40

45

Environmental Appeal

% Towel Reuse Rates

35.1%35.1%

46.0%46.0%

Many Others

Negative social norms

Defaults

We ‘go with the flow’ of pre-set options

• Individuals regularly accept whatever the default setting is, even if it has significant consequences

• Many public policy choices have a no-action default imposed when an individual fails to make a decision.

Organ donation

Salience

Our attention is drawn to what is novel and seems relevant to us

• Bombarded with stimuli – unconsciously filter out information

• Novel, accessible, simple information is salient

One Year MembershipSemi‐annual 

Membership

Monthly

Drawing attention to the stairs – the ‘fun theory’

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Making food labelling relevant and effect

Priming

Our acts are often influenced by sub-conscious cues

• Subsequent behaviour may be altered if people are first exposed to certain sights, words or sensations

• Not remembering - acts outside conscious awareness

Affect

Our emotional associations can powerfully shape our actions

• Emotional responses to words, images and events can be rapid and automatic, so that people can experience a behavioural reaction before they realise why.

• Moods rather than deliberation can therefore affect decisions

“Give up before you clog up”

Commitment

We seek to be consistent with our public promises, and reciprocate acts

• People use commitments to counter will-power weakness

• Strong instinct for reciprocity

Japan’s ‘care credits’ Reciprocity in action

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Ego

We act in ways that make us feel better about ourselves

• When things go well in our lives, we attribute it to ourselves; when they go badly, it’s the fault of other people, or the situation we were put in

• When our behaviour and goals are in conflict, it is often our goals that get changed

Conclusion

• Overlap inevitable

• Most policy will be a combination of these factors

• Toolkit of theory behind behavioural economics to aid policy making

behaviouralinsights@cabinet-office.x.gsi.gov.uk