Health

Scholars take a look at decision making

4 min read

Decisions, decisions. We all make them, starting with which side of the bed to get up on in the morning.

But on a personal and public scale, many decisions have grave consequences for health, financial well-being, and — true enough — the fate of the planet.

As important as it is, decision making has been the subject of very little intellectual inquiry. Experts from many disciplines are just starting to untangle the intellectual, social, emotional, and anatomical factors that relate to making choices.

A lot of this untangling took place during “Improving Decision Making: Interdisciplinary Lessons from the Natural and Social Sciences,” a symposium last week (April 17) at the Radcliffe Institute for Advanced Study.

The daylong series of lectures — relieved by intense interchanges at poster sessions — brought together hundreds of national experts in neurobiology, economy, public policy, psychology, artificial intelligence, and negotiation techniques.

The symposium “spans multiple disciplines,” said Rosalind A. Segal, director of the science program at the Radcliffe Institute. Scholars from Harvard alone, she said, represented business, government, medicine, and the sciences. (Segal, one of the event organizers, is a professor of neurobiology at Harvard Medical School.)

The same interdisciplinary approach is employed at the new Harvard Decision Science Laboratory, which opened last December at the Harvard Kennedy School.

Decision science is in its infancy, but at its scholarly core are two older disciplines, economics and psychology. The resulting hybrid of “behavioral economists” are starting to make their voices heard, especially in public policy.

Take health care, for instance. Lots of evidence of bad decision making there, said Carnegie Mellon University Professor George Loewenstein, a pioneer among behavioral economists.

From 1960 to 2000, rates of U.S. obesity more than doubled, he said — and 71 percent of Americans are either obese or overweight. The social consequences: One-third of all deaths are now linked to lifestyle factors controlled by personal decisions.

And what about personal finance? A similar mess, said Loewenstein. Americans have low savings rates and high debt rates. The typical U.S. household staggers under $9,000 in credit card debt and pays $1,000 a year just to service it.

Meanwhile, public policy attempts to reverse these sad trends are failing because they rely too much on simply imparting better information, a tactic that evidence shows doesn’t work. “Knowledge increases,” he said, “but without similar changes in behavior.”

Nearly two decades of nutrition labeling is a flop — people are getting fatter. And recent municipal efforts to limit fat in New York City restaurants have — perversely — led to more supersizing at mealtime.

Loewenstein urged new pathways to public policy on debt, diet, and other social problems. He suggested using typical human “decision errors” — laziness, short-sightedness, an aversion to losing money — to improve behavior.

For one, reset default options — like 401(k) savings plans that people have to back out of rather than sign up for.

For another, “incentivize” behavior change. Loewenstein likes weight-loss programs that require monetary “deposit contracts,” for instance. Fail to lose the number of pounds you contracted for and you lose your money. This triggers “loss aversion,” he said. “People really hate losing money.”

Information, packaged nontraditionally, can also play a role in changing behavior, said Yale University’s Dean S. Karlan. He’s a behavioral economist who studies economic and health behaviors in the developing world.

In Peru, Bolivia, and the Philippines, Karlan tested a low-tech way to increase savings rates: frequent reminders via cell phone text messages or letters. Within a year, he said, savings rates increased by 6 percent.

Complex neural systems affect decision making, a fact that has prompted a new world of inquiry — “decision neuroscience” — that sometimes gets down to the level of single cells.

Antoine Bechara, who teaches neurology and psychology at the University of Southern California, outlined his recent work on the areas of the brain that affect decision making. He proposed a “somatic marker framework” for understanding the neural networks controlling emotions, impulse control, and craving.

Decision science investigates the personal, the public, and the medical — and it also has a role in the realm of work.

Carnegie Mellon economist Linda C. Babcock considered the rapid decisions women have to make when negotiating for higher pay, benefits, or promotions in a working world still dominated by men.

Her studies investigate the efficacy of various “scripts” women can follow during negotiations. But in every scenario, she said, women face social backlash for being too aggressive or too timid. Babcock called this decision dilemma “a tightrope.”

In brief concluding remarks, Harvard College Professor Daniel Gilbert — a social psychologist — swung back to decision making’s wider frame.

“We are the only species that actually has a chance of dying by its own hand,” he said — and bad decisions “are the only enemy we have.”