The traditional health behavioralists haven’t succeeded too well in changing our un-healthy behaviors. It may take an economist and a lawyer to sort this out.

In the new book,
Nudge, Richard Thaler (the economist) and Cass Sunstein (the lawyer) present a useful approach to motivating people toward better health behaviors.

One of the scenarios that particularly resonated with me was the empirical evidence that, if you put healthy food at the front of the school cafeteria, kids will eat it.

Thaler and Sunstein term this moving of the healthy stuff to the front of the line as “choice architecture.” Thaler’s tried this out in the milieu of 401(k) plans, where employers found that a large number of employees weren’t taking advantage of the opportunity to invest in them — even though the “free money” match by employers “should” have motivated the Rational Economic Man and Woman to invest.

That assumption — that people behave rationally — is the rub that Thaler and Sunstein turn on its head. They are marketing the idea of “libertarian paternalism.” The rationale is, according to Thaler quoted in an interview in the Wall Street Journal, to help people make decisions as if they had, “complete information, unlimited cognitive abilities, and no lack of willpower.”

This approach could be mighty useful for changing health behaviors.
Health Populi’s Hot Points: If we as a society value public health, Nudging is a useful strategy to improve health outcomes and optimize health spending. While some may view this approach as the slippery slope enroute to a Nanny State, the state of obesity (for which employers’ costs are estimated in a Conference Board report this week to equal $45 billion annually), smoking, drunk driving, and other health risks call for disruptive tactics.