behavioral economics of health behavior linh bui
TRANSCRIPT
Behavioral economics of health behaviorLinh Bui
Role of Choice
“Choose a job. Choose a career. Choose a family…Choose good health, low cholesterol, and dental insurance. Choose fixed-interest mortgage repayments. Choose a starter home…Choose your friends. Choose your future. Choose life. But why would I want to do a thing like that? I chose not to choose life: I chose something else. And the reasons? There are no reasons. Who needs reasons when you’ve got heroin??
_TRAINSPOTTING (1996) [Screenplay adapted from the novel by IRVINE WELSH]
Contents
• Characteristics of behavioral economics
• Forms of behavioral economics
• Quantifying the Relative value of Addictive Drugs
and other commodities
• Demand curve
• Expenditure curve
• 2 strategies to assess demand for drugs/other commodities
Behavioral economics
• Understand decision making in population of unhealthy or at-risk individuals
• Overconsumption (substance abuse, obesity, etc.,)
• Health behavior linked to commodities (tangible consumable products)
Characteristics of behavioral economics• Emphasis on individual person
• With given the amount of time, money, effort, how we make choices and what factors affect our decisions
• Understand the nature of rationality and irrationality in human behaviorHomo economicusHomo irrationalis
Other resources
Game theory
“Prisoner’s dilemma”
1st criminal 2nd criminal
Both remain silent A 6-month-sentence
A 6-month-sentence
1st criminal betrays the other
Free A 10-year-sentence
Both betray each other
A 5-year-sentence A 5-year-sentence
Prospect theory
• Gambles (prospects) under conditions of risk are inconsistent in reference to whether there are gains or losses
• More conservative preferences for gains but more risky preferences for losses
Prospect theory
Choice 1 Choice 2
50% chance to win $150 Definitely lose $100
50% chance to lose $100 50% chance of winning $50 and 50% chance of losing $200
• Preferences are a function of :– Absolute resources– Relative changes in resources
Matching law• Matching between individual behavior and relative
reinforcement available• With a finite resources (time, money), how individuals access to
activities (eating, drinking, spending leisure time)
• Study substance abuse, tobacco and food overconsumption: Relative value of alcohol, tobacco, food remains high in spite of escalating health and psychological costs (physical illness, financial burden,etc.,)• Commodity overvaluation• Impulsive temporal discounting• Risky probability discounting: Willingness to accept greater
probabilities of negative outcomes to gain larger rewards
Matching law :Example
Overeating:
• Commodity overvaluation: Food (cheeseburgers ,etc.,) is overvalued (at a certain price, consumption is higher and willingness to pay is also higher)
• Impulsive temporal discounting: Overvaluation of immediate rewards (pleasure of eating, reduce stress, etc.)
• Risky probability discounting: Willingness to accept greater probabilities of obesity and other related health problems
Matching law: Example• Commodity
overvaluation
• Impulsive temporal discounting
• Risky probability discounting:
What might be the critical insight from matching law?
The relative value of an outcome is jointly determined by the outcome itself and alternative sources of reinforcement
Matching law: Example• Commodity
overvaluation
• Impulsive temporal discounting
• Risky probability discounting:
What might be the critical insight from matching law?
The relative value of an outcome is jointly determined by the outcome itself and alternative sources of reinforcement
Quantifying Relative value of Addictive Drugs and other commodities
• Law of demand
• Cocaine vs money (Higgins et al. 1994)
• Relative value of a substance: Benefit-cost ratio
applied to a substance at a given price
Demand curve
Demand curve
Intensity of demand
Demand curve
Inelastic
Elastic
Pmax
Demand curve
• Elasticity : How consumption change relative to
price changes
• Inelastic vs elastic
• Elasticity index: Overall cost-benefit ratio
• Pmax (Price maximum): how far demand goes
before it starts to be affected by costs
• Omax (Output maximum) = maximum amount of money (or other
resources) the individual was willing to spend on the commodity
How much a person value a commodity or behavior
Expenditure curve
Omax
Laboratory demand paradigms
• In vivo consumption under escalating conditions of response to cost
• Pharmacological studies of abuse liability and/or therapeutic viability
• Avoid reliance on self-report
• High experimental burden, ethical issues
Purchase tasks
• Estimate drug consumption at escalating levels of price
• Support for hypothesis: substance dependence and overconsumption are characterized by overvaluation of the commodities
• Self-report data but stable
Purchase tasks
• Dynamic changes in relative value of a drug: Subjective states (craving and stress) drive motivation for drugs
• Study substance abuse in a person’s natural environment: measure the relative reinforcing efficacy (socializing, watching television, exercising,etc.,)Anhedonia: heavy drinkers and drug users report less reinforcement from a variety of nonsocial activities
Conclusion• Characteristics of behavioral economics:
Unit of analysis: individual personUnderstand the nature of rationality and irrationality in human
behavior
• Matching law : Theoretical framework to understand overconsumption of addictive commodities
• Methods for demand assessment:Laboratory demand paradigmsPurchase tasks
• How does behavioral economics link to previous theories?
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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
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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