A recent article in the New England Journal of Medicine argues that the infrastructure to harness healthy habits already exists within our social interactions. The support from friends and families can help us make healthy decisions on a daily basis. The article outlines five rungs of social incentives used to improve patients’ health and to test their effectiveness. Here is a short description of each of the rungs illustrated in the article:
Rung One: “Patients have no explicit social engagement.”
Since health is at once a public and a private matter, some of our most important daily health maintenance routines are invisible to the world. The authors point out that our health can be invisible even to us - without a pedometer, we don’t have a grasp of our daily activity. Realizing the correlation between self-awareness and developing healthy habits, CHIL has partnered with New York City schools to bring pedometers to students. Read more about our pedometer program.
Rung Two: “Patients’ activities, outcomes, or goals are visible to others.”
In order to encourage healthy behavior, you and your family can physically partake in habits, such as taking daily medications and vitamins, in a visible place. Restaurants have started to use this model to promote handwashing by moving the sink out of the bathroom and into a more public space.
Rung Three: “External support is explicitly established.”
Signing up for external support, such as text alerts, to remind you and your kids to exercise can increase healthy outcomes. For everyday challenges, such as lowering blood sugar levels, simple interventions like weekly phone calls with a mentor can be more effective than expensive drugs.
Rung Four: “Interventions leverage reciprocity.”
It’s all about being committed to a friend’s goals as well as your own regardless of your age. Even physicians are known to work in teams to competitively improve outcomes. This element of competition can certainly energize patients combatting chronic diseases such as diabetes.
Rung Five: “Reputational or economic incentives are layered on top of social commitments.”
This is the ultimate goal in the five-rung model. Individuals and teams can work together to create leaderboards and competitions. By doing so, there can be an increased sense of accountability as people work together toward a reward. Patients have greater potential to succeed if teammates know each other beforehand and are introduced to incentives together.