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Population Health & Behavioral Science

My mother was diagnosed with Type II Diabetes in her late 40s, but it wasn’t until she lost all her teeth at age 52 that she started monitoring her blood sugar level fastidiously. She would call and tell me insights about what affected her blood sugar level—insights that her doctor couldn’t figure out through office visits alone. What motivates people to become custodians of their own health? Major life events or medical emergencies do, but life would be so much better if the illnesses could be prevented in the first place.

My mother’s story is indicative of larger health trends. The number of people in the world with Type II Diabetes is expected to rise from 366 million today to 552 million in 2030; and while about 17 million people died from cardiovascular disease in 2008, some 23 million are expected to do so in 2030.

Research makes clear that the key to disease prevention is lifestyle change. Because we now recognize the complex environmental, economic, and cultural effects at play in behavior change, the government and public health sectors tend to propose big solutions such as the famous Food Pyramid. Yet over the years, most efforts at preventing obesity and promoting physical activity have had only limited success. Why? One reason is that some of these interventions  assume people make sensible and logical decisions that will maximize gains and minimize losses for their future. However, people don’t always make choices that are best for them.

Social psychologists and behavioral economists have coined the term “cognitive bias” to describe these decision-making fallacies. Here are a few common ones:

Cognitive biases are levers we can pull to create more effective designs. For example, the “Nudge Unit,” a consultancy in the UK, uses small policy changes to help people make better choices about everything from saving money to paying their taxes on time. Its Tax Arrears Experiment helped the government collect more than £200 million in unpaid taxes in 12 months. It did so by changing the wording on a standard letter from “Please pay your taxes on time” to “Nine out of ten people in the UK pay their taxes on time.” This experiment leveraged the bandwagon effect to change a behavior. I believe good design means making small moves with big impacts, and work like the Tax Arrears Experiment serves as a model for my practice.

The study of cognitive biases provides insights into how we make decisions and how our minds work. They are the keys to more effective design interventions for wellness. Biases are part of the human experience and good design is about working with human nature, not against it. There are many opportunities for designers to think about design for prevention rather than intervention to reduce the $3.207 trillion, or $10,000 per person per year we spend on healthcare today.

Biases are part of the human experience and good design is about working with human nature, not against it.