HEALTH ECONOMICS (PART 2) Schrader White – H 571 Week 6.
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Transcript of HEALTH ECONOMICS (PART 2) Schrader White – H 571 Week 6.
HEALTH ECONOMICS(PART 2)
Schrader White – H 571 Week 6
Overview
Behavioral Economic Decision-Making
Delay Discounting
Probability Discounting
I will go over these theories in a monetary sense, and then apply them to health behavior
Delay Discounting 101
Behavioral economic measure of impulsivity
“… how deeply a reward is discounted based on its delay in time”
The balancing of small pleasures in the present vs. large benefits in the future.
Generally driven by disproportioned priorities
Example of Delay Discounting The Ant and the Grasshopper (Aesop -
600 BCE)
The grasshopper has fun over the summer, but starves in the winter. While the ant gives up idle pleasures over the summer to gather food, then has plenty of food when winter comes.
Are you the ant?Or the grasshopper?
Economics of Delay Discounting
A person’s indifference point: When the combination of amount and delay make the smaller immediate award equal to the larger delayed reward.
The smaller the delay to provoke a switch, the more impulsive the individual is considered.
Delay Discounting
Immediate Reward
Delayed Reward
$90 Today $100 Today
$90 Today $100 in 1 Day
$80 Today $100 in 7 Days
$70 Today $100 in 28 Days
$60 Today $100 in 180 Days
$50 Today $100 in 365 Days
$40 Today $100 in 1825 Days
Impulsive Self-Controlled
Application to Health Behavior People seek immediate gratification at
the expense of long-term gains Drinking, Smoking, Illicit Drug Use, or Eating
(overconsumption)
These behaviors are “enjoyable” in the short-term, but have lasting effects on physical and psychosocial health
Application to Health Behavior People with overconsumption disorders
know that larger delayed outcomes – physical health and vocational success – are very important to them, but nonetheless tend to persist and either maintain the problem or make it worse.
“Inability to delay gratification”
Overvaluation of immediate rewards
Examples
You want to be a healthy body weight more than you want a piece of cake (in the long run) – but if cake is immediately available, it can be eaten without much effort, while maintaining a healthy body weight will take more effort. An impulsive person would eat the cake, a self-controlled one would resist temptation.
You swore off cigarettes 2 months ago, but would rather smoke right now, than continue to maintain your non-smoking lifestyle - which takes more effort and isn’t as immediately rewarding to you as smoking. An impulsive person would smoke, a self-controlled person would not.
Findings from Research
Various Research found that substance abuse and overconsumption aren’t alone in regards to delay discounting. Other health behaviors fit too!
Can anyone think of any other health behaviors?Also, how does delay discounting apply?
Furthermore,
Various Research found that substance abuse and overconsumption aren’t alone in regards to delay discounting. Other health behaviors fit too!
Can anyone think of any other health behaviors?Also, how does delay discounting apply?
Pap smears, mammograms, prostate exam, cancer screening, dentist appointments, cholesterol testing, flu vaccines
Thus,
“Overvaluation of immediate outcomes at the expense of future outcomes appears to play a role across a wide range of health behaviors.”
Probability Discounting 102
Similar to discount disability, but decline in reward’s value is based off of its uncertainty
Refers to how sensitive a person is to risk associated with rewards
A measure of risk taking
Identifies people as Risk-Averse or Risk-Prone
Economics of Probability Discounting
Probability Discounting
Certain Reward
Probabilistic Reward
100% Chance for $90
100% Chance for $100
100% Chance for $90
99% Chance for $100
100% Chance for $80
75% Chance for $100
100% Chance for $70
50% Chance for $100
100% Chance for $60
25% Chance for $100
100% Chance for $50
10% Chance for $100
100% Chance for $40
1% Chance for $100
RiskAvers
e
RiskProne
Application to Health Behavior Many unhealthy behaviors do not result in
negative outcomes in every instance
Each cigarette, drink, and bag of drugs is probabilistically related to negative outcomes, not certain negative outcomes.
Unprotected sex, poor medicine compliance, delayed cancer screenings
If a person is willing to accept the risk of negative outcomes for greater reward, their “cost-benefit” ratio is acceptable.
Relation to Other Theories
Value-Expectancy Theory People will change behavior if they anticipate
value to that change Does not account for delay in reward or
probability of reward occurring
Delay Discounting focuses on the reward’s delay
Probability Discounting focuses on the likelihood of the reward occurring
16
DECISIONS/INTENTIONS
SOCIAL SITUATION
BIOLOGY/PERSONALITY
THE THEORY OF TRIADIC INFLUENCE
ATTITUDESTOWARD THE
BEHAVIOR
SOCIALNORMATIVE
BELIEFS
Trial Behavior
EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological
SELF-EFFICACYBEHAVIORAL
CONTROL
Nurture/CulturalBiological/NatureIntrapersonal Stream Social/Normative Stream Cultural/Attitudinal Stream
Values/Evaluations
Knowledge/Expectancies
PerceivedNorms
Information/Opportunities
InterpersonalBonding
SocialCompetence
Interactions w/Social Instit’s
Others’Beh & Atts
Motivationto Comply
Skills:Social+General
Sense ofSelf/Control
SelfDetermination
1 2 3
7 8 9 10 11 12
13 14 15 16 17 18
l
4 5 6
19 20 21
22
23
DistalInfluences
ProximalPredictors
Levels ofCausation
UltimateCauses
Social/Personal Nexus
Expectancies & Evaluations
Affect andCognitions
Decisions
Experiences
a
b c d e
f
g h i
jk m n
o
p q r
s
t u v w
x
Related BehaviorsJ
K
CF
IB E HA D G
CULTURALENVIRONMENT
Well, now the fun is over…
Questions?