Behavioral

Mindfulness - Something for Everyone

The timing couldn’t be better - not long after our recent post on ways to be in the present, the New York Times published a piece on “Mindfuless for Children.” The author defines mindfulness as “the simple practice of bringing a gentle, accepting attitude to the present moment,” and argues that even the youngest children can benefit from this approach.

 

The graphics in this article are beautiful and worth checking out, but we’ve condensed some of the main points here:

 

Mindfulness starts young. Even infants can notice the difference between a stressed, distracted parent and a smiling, “present” parent. Mindfulness experts say that eye contact is important to establish a connection between an infant and a parent; unfortunately, smartphones have become a huge distraction in establishing that connection. Experts recommend putting down the phone, however briefly, to interact with infants. The same goes for raising toddlers - as they start to learn to express themselves, helping them identify and describe their feelings is very important.

 

Mindfulness is important throughout childhood, from infancy to early childhood to teenage years. The appearance of mindfulness can evolve. For example, a focus on gratitude and recognizing happy moments for young children evolves to a focus on healthy interpersonal relationships in teenage years. A surprising number of diverse factors are involved in mindfulness. For example, increase in movement and activity relieves stress and improves physical health for guardians and children alike.


Mindfulness can’t be “outsourced.” People who work with children and teens to bring mindfulness into their lives emphasize the key role parents and guardians can have in contributing to children’s health. Mindfulness “isn’t like piano lessons,” where parents can simply drop off their kids to get their weekly lesson. The author of the article concedes that parenting is hard work, and often very stressful, but they are the main figures in their children’s young lives. Caregivers don’t have to be expert meditators; instead, they can focus on things like forgiveness and appreciation of the present along with their children. Having this approach will have positive mental health impacts for everyone involved.

Prize-Winning Behavioral Economics

Earlier this month, Professor Richard Thaler at the University of Chicago Booth School of Business won the 2017 Nobel Prize in Economics. Professor Thaler’s work in behavioral economics has impacted our understanding of human behavior, and has also influenced government's’ approach to behavior as well.

 

A recent article in the New York Times explains some of Thaler’s work and contributions. Standard economic theory assumes that human beings behave “rationally.” Economists knew this was not precisely true, but operated on this assumption for a long time. Professor Thaler pushed the field to try to truly model human behavior by observing the fact that humans consistently behave in ways that deviate from what is expected - in other words, even if people behave “irrationally,” we can still model and predict their behavior.

 

Professor Thaler has found, for example, that people who own a good will value it much more than other people who do not own that good. This is called the endowment effect. This could suggest, for example, that people who own fitness technology or pedometers might value them more than other people do. If they value them more, Thaler’s work suggests that people may be more likely to use them.

 

Thaler also found that people will punish what they perceive to be unfair behavior, “even if they do not benefit from doing so.” It would be interesting to see the link between this sort of behavioral finding and application to health care and children’s health. Since there are so many actors involved in children’s health - the children themselves, providers, teachers, public officials, parents and guardians, and more - unfair practices or policies could be a real complaint that affects relationships between these actors.

 

Thaler hopes that behavioral economics, now part of mainstream economics, will move beyond the discipline alone to become an integral part of how we think about human behavior. More research in its intersection with health and children’s healthcare will be very exciting to see!

 

Economics, Doctors, and Us: A New Kind of Medicine?

A physician wrote a piece in the New York Times recently that is very relevant to our mission and work here at CHIL. Dr. Khullar writes that years of medical and scientific education often do not influence his decisions as much as his patients’ habits and environmental cues. If anything, a decade of diverse and intense training has made him more attuned to noticing subtle “nudges” and cues that incentivizes him to provide the best care he can, or incentivize his patients to be proactive about their health care.

 

According to Dr. Khullar, the field of behavioral economics holds that “human decision-making [often] departs” from what might be expected if agents behaved “rationally.” This description seems to characterize medical care as well, where all sorts of factors (emotions and uncertainties, for example) can complicate medical decisions. Despite this connection, Dr. Khullar says that members of the medical community have “only recently” begun exploring how behavioral economics can improve health. This is a crucial change, since medical experts bear an enormous responsibility in how they present care options to patients and how they encourage patients to pursue treatment options. For example, the framing of default options as opt-in or opt-out can have a huge impact on how healthcare is delivered to patients.

 

Pioneers in linking behavioral economics, decision-making, and medical care are focusing on designing randomized trials or applications to tackle some of the basic, and difficult, challenges in healthcare. Dr. Khullar names some of these challenges as encouraging doctors to provide evidence-based care, incentivizing patients to take their medications (a form of preventative care), and aiding consumers in choosing better health plans that were more comprehensive for their needs. Innovators are also using these challenges as opportunities to create applications to, for example, reward patients for submitting pictures of themselves taking medications each day. These designers create program infrastructures that reward patients for weight loss goals they establish by entering them into lotteries or deposit contracts. Health insurers are jumping onto this wagon as well, and researching goals for patients and doctors to meet when it comes to diseases like diabetes management.

 

The title of the New York Times piece is “How Behavioral Economics Can Produce Better Health Care.” This title leaves out some crucial actors in the study and delivery of a marriage between behavioral economics and health research. Doctors, patients, and economists each play a distinct role in identifying and acting on potential improvements in healthcare delivery. Projects like the ones we have at CHIL are designed with students as patients in mind - behavioral economics isn’t only for economists! We can all use a project-oriented approach to improve our health.