Q: Your research is about behavioral insights, so could you first please explain what behavioral insights are?
Dr. David Halpern: Behavioral insights are really about introducing a more realistic model of human behavior, what actually drives our behavior, as opposed to what economists might have presumed drives our behavior.
Q: And how does that relate to healthcare?
Dr. David Halpern: Because an estimated 50%, or even 75%, of years of healthy life lost are as result of behavioral factors; smoking, drinking, our diet, our exercise, our lifestyle, if it was any area of policy where it’s obvious we should be interested in human behavior, its health.
Q: How can behavioral insights potentially lower the cost of healthcare?
Dr. David Halpern: One of the reasons why governments are interested in this area of research is because it can lower costs. In Britain for example, older people fall over in the ice, but if you give people better shoes, they are much less likely to fall over. So it might be a non-traditional health intervention, a behaviorally-based one, but it can be extremely cost effective.
Q: What do you hope to achieve with the report?
Dr. David Halpern: What we hope to achieve is to get a lot of healthcare professionals, as well as policymakers, much more attuned to just how powerful behavioral insights can be as a paradigm of intervention.
Q: What is a nudge unit?
Dr. David Halpern: A nudge unit is essentially a group of experts from different disciplines – originally we set up a very small team; eight people including a psychologist; an economist; but also people who understand the policy area – brought together to come up with creative and new solutions to policy problems.
Q: Your report points out that nudge units are being set up in countries around the world, to leverage behavioral insights into policy. Why do you think there is a recent surge of interest in this approach to healthcare?
Dr. David Halpern: I think I can at least tell the story of what happened in the UK. First, the government was short on money so they were looking for more cost effective ways of doing things. Second, there was a reluctance to pile on evermore regulation. There is also definitely a sense that the literature has reached a certain point where it has broken out from a small community of psychologists, and now these insights are being translated into other areas and disciplines. The final thing, which I think is really pushing it forward now, is that we have a body of evidence which has come through in the last five years, showing just how extraordinarily powerful behaviorally-based interventions can be, from increasing tax payments to getting people to save more, as well as improving population health.
Q: Let’s talk about your acronym “EAST” what does it stand for and how does it work?
Dr. David Halpern: EAST is a pneumonic for remembering things. If you want to affect human behavior you might at least think about these four very basic principles which we see repeatedly, make it as Easy as possible, make it Attractive in terms of its psychological profiling, make it Social, so it’s what’s everybody else doing, and Timely, when is the right moment to intervene or provide this nudge. If you at least think about those four things, you are much more likely to have an effective impact.iety.
Q: In terms of the impact of WISH and the impact of your research, what type of impact do you hope it will have?
Dr. David Halpern: We believe behavioral insights are already producing lots of very interesting ideas, some of which are slightly unexpected and so we are very keen to see that wider uptake. In fact the behavioral insight literature gives us good clues about not only about how can we be healthier, but how can we be happier too.
Q: How is the research you’re doing relevant here in Qatar?
Dr. David Halpern: Qatar obviously is very interesting. It’s a very wealthy country, building in many ways a top notch healthcare system, but you can also see it subject to some of these very powerful behavioral factors that are in fact driving ill health. An obvious example would be the rise of diabetes. There is a high prevalence of a very expensive, and not very effective, way of dealing with this, through secondary care, so how can you use this knowledge in a case like Qatar’s to redesign those wider forces in order to help people live healthier lives? It’s likely to be much more effective, and certainly much more cost effective, to go with the behavioral and in general the preventive route, than use the secondary route.
Q: What is the significance for you, being part of WISH?
David Halpern: I personally work in many different policy areas. Health has always been of great interest. I think there are two things in particular that I’m struck by, working with WISH. One is that it brings together some great experts in relation to health, and even across the health community. Second is that there is a lot to be learned across countries, especially where you can see that other countries have come up with solutions, sometimes particularly imaginative and innovative ones, and they are very slow to diffuse. I think WISH enables that to happen and ultimately enables practitioners and policy makers to stand back a little bit from their day-to-day issues and say ‘wait a minute, when we look around, what is the most effective thing that we can do to help our populations and use the precious resources that we’ve got?’.