CHANGING MINDS AND BEHAVIOR:Nudging People Through Policy

One of the paradoxes of life is that our big decisions are often less calculated than our small ones are. We agonize over what to stream on Neflix, then let TV shows persuade us to move to New York; buying a new laptop may involve weeks of Internet research, but the deliberations behnd a life-changing breakup could consist of a few bottles of wine.

Joshua Rothman, the New Yorker (1/21/19)

Planning must begin with a theory of change and an analysis of how an idea will spread, achieve impact, and influence others.

David Bornstein & Susan Davis, Social Entrepreneurship

We see things the way our minds have instructed our eyes to see.

Muhammad Yunus, Founder, Grameen microfinancing foundation


The goal of progressive advocacy is to create a more equitable, sustainable, democratic, and caring society with institutions and social systems that are efficient, transparent, and effective, and that facilitates respectful and mutually-supportive interpersonal and inter-community relationships while promoting individual opportunity and growth. Among other things, this includes making all hierarchies less exploitative, oppressive, and repressive – at least partly by making all social resources more accessible to everyone, with (as Liberation Theology puts it) a “preferential option for the poor.”


These goals imply a generally external advocacy orientation focusing on social structures rather than individuals. Personal growth is the goal, but social change is the facilitating context. The underlying assumption is, as Borstein and Davis wrote in Social Entrepreneurship, that “…a person deprived of education or opportunity is like a bonsai [dwarf plant]. The constraint isn’t the seed, it’s the pot.” The biggest things preventing personal – and community -- growth and wellbeing comes from the societal environment.


It’s true that we sometimes add to our own problems. Yes, people stumble when rocks are put in their path. But it doesn’t help if we don’t look where we’re going. Even if it makes sense within the current context, sometimes our choices hurt our own longer-term outcomes, perhaps damaging others and society as well. Smoking. Over-drinking. Dangerous driving. Domestic violence. The list goes painfully on.


Still, there is overwhelming evidence that, on a population level, vulnerabilities – to disease, economic trends, weather extremes, or local crime – are related to systemic deficiencies rather than personal failures or weakness. For all our inescapable personal responsibility for our own actions, it is actually the surrounding society that is often the source of the problems that grind people down, that undermine the local communities that might help them resist, that keep them from social systems that might help them deal with or even transcend their situation.


The current nation-wide opioid crisis exists as individual addictions. But people become vulnerable because of the felt helplessness and despair caused by the loss of jobs, status, and hope for improvement. People become vulnerable because of the collapse of their extended families and communities. Their addiction was facilitated by the greed of pharmaceutical companies, criminal doctors, and the political focus on punishment rather than treatment. It was no accident that African-American communities, bending under the stress of centuries-long racist violence and economic depression, experienced the first wave of traumatic heroin devastation. It was no accident that, as de-industrialization exposed the white working class to economic collapse, the opioid crisis spread through the Rust Belt.


RESHAPING BEHAVIOR

The first step towards change, as Alcoholics Anonymous forces attendees to enact, is to publicly admit that there’s a problem. But there is a huge distance between acknowledgement and behavior change. Few of us can do it without support. Peer-groups and counselling focus on providing support for the personal insights and inner growth needed to take responsibility, commit ourselves, and carry through. Religion and some social change movements also combine inner transformation with a larger context, perhaps including collective action to change the surrounding society’s “co-enablers” and larger problems.


Advocacy tends to be less deeply and personally transformative. However, advocacy does have an important role in pushing society’s policy-makers and institutions to provide support for individuals and communities needing to free themselves of self-destructive behaviors. The first job, of course, is to expose and transform the larger societal dynamics that have pushed people down or that would prevent their recovery and rise. There is also the need to care for the injured. And ways must be found to encourage people to change their behaviors and to support them along their new path.


SET THE TONE

One of the powers held by societies leaders, celebrities, and others in the public eye, is to set a tone. Staughton Lynd wrote about how the election of John Kennedy in 1960 changed the tone of racial interaction within the steel mill he worked in. Suddenly, racist jokes and taunting didn’t seem as acceptable or as funny. After the election of Donald Trump, educators documented a rise of school yard bullying; one Virginia study found an 18 percent increase in bullying incidents in areas where he received a majority vote compared to districts where he lost, including threats by attackers that “closely matched language used by President Trump.” As New Jersey Attorney General, Gurbir Grewal has said, “What we’re doing – and I think it’s very much a result of the tenor at the top – is a normalization of hate speech.” (New Yorker, 1/14/19) Neither Kennedy nor Trump explicitly told anyone to change their behavior. But the New Frontier was publicly associated with the civil rights movement -- Kennedy had phoned Coretta King after the arrest of her husband in Atlanta. And Trump had displayed an intimidating presence all through the campaign. Both had changed public behaviors in the larger population.


It would be a powerful first step for national leaders to admit there is a problem that needs fixing, take societal responsibility for at least some of its existence, and announce support for victims’ efforts to heal and move on.


LEGAL LEVERAGE

Endorsements and general media approval of a new behavior are positive inducements helping motivate people to change. However, many people’s first idea about correcting behavior is negative: “there ought to be a law.” Laws are a good way to establish norms. And the passage of a new law does, in itself, create some amount of public awareness. No-smoking laws, for example, changed our expectation of what people do in bars, restaurants, and many public places.


But the law itself is seldom enough. Behavior is a decentralized phenomenon – each person separately either waits to dispose of their fast-food soda cup in the trash or litters, brings used motor oil to a garage for disposal or dumps it in the street, separates out recyclables or puts it all in the land-fill-bound trash. Enforcement of such dispersed actions is nearly impossible –there simply aren’t, and shouldn’t be, enough police.


In addition, legally requiring behavior change can seem – and is – incredibly intrusive and can trigger enormous pushback if there isn’t already widespread public support. Mayor Bloomberg was simply too far ahead of public opinion when he tried to impose healthier behavior by outlawing supersize sugar-added drinks in New York City; the policy had to be withdrawn.


Enforcement on individual behaviors does have a place. High profile cases shape public perception, as the #metoo campaign against sexual predators in the workplace has shown. Enforcement is easier when there are leverage points which affect large numbers of people – making restaurants and bars responsible for telling patrons not to smoke, requiring local stores to charge a deposit on disposable containers and to collect returns, telling garbage trucks to not pick up trash barrels that lack city permit stickers, making bar-tenders responsible for not serving drunks and home-owners responsible for teenage drinking parties.


On the other hand, sometimes raising penalties leads to less enforcement if general attitudes don’t feel that the punishment fits the crime. Making small-scale littering a crime requiring imprisonment, for example, would make it even less likely that anyone would ever be cited. As one advocated pointed out, “[Out of proportion penalties are] counterproductive…and may exacerbate police officers’ reluctance to hand out enormous fines for relatively minor offenses. As a result, enforcement may come to seem arbitrary or even discriminatory.”


The law is a tool, a powerful one. But the presence of a powerful tool sometimes distorts our understanding of the tasks needed to do the job – the cliché is that “when you’re holding a hammer, you think that every problem looks like a nail.” It’s possible that the issue most important to you is not a nail, that other tools are better suited for the task. And the coercive feeling people feel about behavior-changing legal requirements is unlikely to induce those affected to join you in a push for more.


LEARNING FROM PUBLIC HEALTH

Public Health has made a science of what is annoyingly called the “socio-ecological model” of the “social determinants of health” – essentially meaning that our overall wellbeing is shaped by our social and material environment even more than our genetic code or conscious personal choices. It’s not the simplistic either/or of “nature versus nurture” or even a matter of personal responsibility. We are born with a set of personality tendencies or “tempers,” but it is how the context of our lives shapes our individual experiences that determines which of them gets expressed and which stay dormant.


When public health advocates began their campaign against smoking it seemed like an impossible dream. Tobacco companies were incredibly wealthy with powerful ties to politicians. Cigarette advertisements permeated TV and radio and the hero of nearly every movie smoked. Most daunting of all -- a huge percentage of the adult (and teenage) population was addicted. Smoke filled nearly every business meeting, restaurant, cinema, stadium, and home. In order to change policy, anti-smoking advocates had to change behavior and consciousness.


The first step was getting out the facts – smoking was harmful to your health. The tobacco companies spent millions trying to bury this information, but the reality of coughing and lung cancer was so obvious that by the mid-1960s there was pretty general awareness that smoking was bad. But as any of us who grew up in that era can attest, knowing this made people feel stupid or even guilty about lighting up, but it didn’t do much to stop smoking.


Changing the frame of public understanding was the next step: smoking wasn’t just personally bad, it also endangered everyone around you. The concept of second-hand smoke changed the public debate by giving non-smokers and trying-to-quit-smokers social authority to complain, expanding the public health constituency to the point that voter pressure began to be strong enough to counter business lobbying and campaign contributions.


Similarly, the deliberate introduction – through extensive media outreach – of the “designated driver” idea changed the dynamics of the Mothers Against Drunk Driving campaign. Ever since the repeal of Prohibition, having a good time with friends over a few drinks and heading home with a happy buzz was a celebrated and looked-forward-to rite of passage and a normal part of adult social life. Yes, horrible accidents happened but no one thought of themselves as the type who would be that irresponsible. The designated driver idea, combined with MADD’s expanding efforts to publicize the frequency of alcohol-related deaths of young people, provided a reasonable way for groups to enjoy themselves without hurting others or themselves. Today, getting caught driving drunk elicits shame rather than bragging rights.


NUDGING TOWARDS PERSUASION

The facts about smoking and over-drinking were vital but insufficient. Even the reframing as a poisoning of others and a form of murder wasn’t enough. It required an actionable solution, massive public education, and effectively focused points of enforcement. Both ideas – protecting public places from second hand smoke and the designated driver – did not come out of nowhere. Both were carefully developed by public health researchers and advocates (people at one of my former workplaces, the Harvard School of Public Health, played key roles).


The passage of ideas from inside the brain to real-world embodiment requires a complex and often missing set of conditions. While changing ideas can lead to changing behaviors, it often doesn’t. Sure, we are all able to make a personal decision and stick to its lifestyle implications to some degree some of the time. But it takes an incredibly self-disciplined person to do it – almost no one keeps to a diet. And it is even more unlikely for an entire population to spontaneously and simultaneously become convinced of a radically transformative idea and be able to carry it out.


For most of us, what allows us to stick to our guns is not will power but the support of our surrounding environment – our family and friends, our homes and workplaces, our streets and stores. Even small cues, nudges, in our surroundings make a difference. We are much more likely to eat appropriate amounts if our plates are smaller, if the vegetables are put on the table and the meat left on the counter, if our glasses are filled with water and the soda is not stacked up in our fridge, and – most importantly – if our friends are also doing the same. The book, Thinfluence, by Dr. W. Willett and Melissa Wood, points out that a person’s chances of becoming obese is largely shaped by their social environment – family, friends, advertising, and workplace culture: “A person's chance of becoming obese increases by 57 percent if a close friend is obese, 40 percent if a sibling is obese, and 37 percent if a spouse is obese.” People are much more likely to stop smoking if they can’t light up at home or in public places, if it’s harder to find places to buy cigarettes, if the cost goes up, and – most importantly – if smoking loses its social status because other people and the media treat it as obnoxious or even stupid to do.


There are dangers to the strategy of shaping a particular context for a particular effect. Confronted with the economic decline of central cities and the resulting rise of crime, the “Broken Windows” idea dominated Community Policing efforts in the 1990s, starting in New York City. The idea was that by reducing the level of “visible disorder” on the streets, people would feel safer and be more willing to be outside where their presence would rebuild local communities, discourage more serious criminals, and reclaim the city for the law-biding. But instead of focusing on the slumlords who didn’t fix the broken windows, the strategy turned into mass arrests of low-income non-white people for petty misbehaviors, or just on suspicion, or just because they were there. “Walking while Black” became dangerous. While the number of panhandlers and street vendors declined, there is “very little evidence suggest[ing] that it…had anything to do with the drop in New York’s violent crime rate, which was part of a nationwide trend that began in 1991.” (“Down the Chain”, by Clio Change, The Nation, 11/19/18)


GETTING TO GO

A high percentage of us feel strongly about “individualizing” the color of our smartphone covers, “personalizing” the photo displayed on our computer, and developing a “personal style” for our hair and clothes. And that commitment to personal expression extends into our personal behaviors, which we tend to think of as our own choice.


However, of the endless daily choices about behavior, opinion, and decisions we face, most of us, most of the time, follow the crowd. The more public the behavior, the more embedded in our cultural norms, the less often we give ourselves permission to be “abnormal”, to stand out, to be conspicuously different. And even among these deviations, the vast majority are about things that feel important – like our appearance -- but have little impact on the world. In fact, most of us, most of the time, do our best to fit in to our social and cultural surroundings. We go with the flow. Advertisers know that the most effective marketing strategy is to convince someone that “everyone else” is buying or doing something as well.


It’s not about shirking our responsibilities or even laziness: it is theoretically possible to choose to walk straight through a mile-long field of giant boulders, climbing over each rock, and some people might occasionally and heroically take that route. But it is much easier, quicker, and usually done without much thought to follow the established path and walk in a meandering manner around the boulders, perhaps only climbing one to get a better view.


This process operates in politics as well. In addition to having insufficient time and energy to know about, much less personally investigate, every issue facing our city and nation or mentioned in the newspapers, most of us, most of the time, rely on other people to guide us towards opinions about public policy issues. And the “opinion leaders” we tend to follow are usually people that our cultural has already given some prominence – elected officials, celebrities, recognized experts, clergy, corporate executives, established civic leaders, and others. Unless we believe that the established path is going to bring us into a hungry lion’s den, why not go along with the current?


But we do change, even our most addicted behaviors. And it is one of the jobs of advocacy to make it easier to succeed by changing the context within which we make our behavioral choices.

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