Every day at 5pm it’s our national Unhappy Hour. The brave and vigilant watch the Coronavirus Daily Update in fascination, shock, sadness and, for some, scepticism. Next to a government Minister who will be “following the science” we may now find a senior Public Health behavioural scientist. Behavioural science is in the news.
For a variety of reasons, many people want to understand, predict and change human behaviour: military strategists, advertising agencies, and political Parties to name a few. Whether or not the knowledge accumulated from a century of experiments on human behaviour is enough to qualify as a science is a moot point. Were it a science, you might expect behavioural scientists to have become millionaires from buying and selling shares, playing poker, or even being successful at profiling serial killers. They aren’t rich and they don’t identify killers as portrayed in the movies. In reality the human sciences find it difficult to produce hard metrics that might point to controlling or predicting people’s behaviour. They have not achieved, for example, anything equivalent to measuring the length of a Coronavirus’ RNA – it’s much longer than that of most viruses - or plotting a space-craft’s trajectory to Saturn. Instead many of us are left with the impression that generalities about human behaviour can be generally unhelpful.
Individual human beings are different. We all recognise that. And we also know that individuals behave differently to groups. People share different cultures which may weight different characteristics and values differently influencing how individuals act. And groups of human beings present different characteristics from each other, some of which can be important, not least susceptibility to different maladies, sickle-cell anaemia or diabetes for example, or living in different sized family groups. The differences are shockingly illustrated by the high death rates from Coronavirus amongst British BAME. Disentangling the causes will be complex.
The biggest established group difference in mortality from Coronavirus is that between rich and poor which means that ‘morbidity’, the rate of disease in a particular community or population, has as much to do with political choices as individual behaviour. This fact, well known and acknowledged in Public Health, has become disturbingly clear to more people thanks to quantitative reporting and analysis of deaths and infections during the pandemic.
Predictions about the reaction of the British public when asked to stay at home and socially distance were incorrect: this misreading seems to have resulted initially in an assumption that the period of lock-down had to be minimal or people would revolt - consequently lock-down was disastrously delayed and infection built up. This is not the wisdom of hindsight. In early March when Northern Italy was getting into serious trouble, how could the Prime Minister have stayed unaware of the gravity of the situation and the potential exponential spread of the virus? Was the government fearful of the implications of people not “following the science” or were they simply choosing from amongst a range of policy responses provided by behavioural scientists? Was the Cabinet too pre-occupied with the economic consequences? The subsequent rules, to stay at home, for weeks, legally enforceable by the police, were hardly an example of “nudging”, using material or social rewards or mild forfeits, to get people to do the right thing. All very mysterious, which is the way government, unchallenged, likes it.
Government’s preventative health policies are not decided in a vacuum. Reducing smoking took years of persuasion, public education, support for quitters, restrictions on marketing and then legislation. All in the face of opposition from the tobacco industry and smokers. Similarly tackling the obesity epidemic, reducing alcohol and sugar consumption, was and is resisted by corporate interests. Up against such odds - and business is already lobbying for an immediate end to lockdown - the smartest of the behavioural scientists faces a daunting task. Meanwhile government can, and does, finesse the problem of the pressure on the NHS by blaming all those who inconveniently live into their 80s and acquire ‘co-morbidities’. And more recently on the scandalous death toll in Care Homes on ‘comings and goings’ – such as the staff.
Now the benighted behavioural scientists are called on to advise about messaging in preparation for the unlock-down. This means finding a way to get the people who are not designated key workers and not in fear of destitution, and who have been encouraged to return to work, to choose to do so. But how to calm public fears and how to differentiate messaging to different groups while at the same time avoiding confusion? How to change behaviour without compulsion? On this occasion we can expect some nugatory nudging; fear of death has concentrated the mind and the British public will decide for itself.
Understanding, predicting and changing public behaviour in response to the threat of coronavirus infection is now at the centre of the political stage. But behaviour is not hard science; it’s often a matter of well or ill-informed opinion. And opinions conflict.
How the public is now going to respond is a matter of contested opinion. The public’s response to the forthcoming government messages will not be determined solely by their content and repetition but by trust, or distrust, of the government, the assessment of its competence or incompetence. Knowing how crucial trust is, Sir Keir Starmer’s approach as Leader of the Opposition has been cautious, or as he terms it, “responsible”. Governments’ relative past failure to heed health messages, their neglect of strong regulation of the food and alcohol industry by appropriate legislation, as well as neglect of creating capacity for the mass manufacture of vaccines, is history. And the Leader of the Opposition is unlikely ever to get a straight answer from the Prime Minister to his question “how on earth did it come to this”.
See also TheArticle 06/05/2020