When psychology meets economics to empower healthy citizens

Author: Sima A.Hamadeh, Ph.D., Associate Professor - Program Coordinator , Public Health Nutrition, Science Journalism, Haigazian University, Beirut, Lebanon

In this epoch of digital globalisation, connections between individuals, communities, industries, and nations are broader and deeper through flows of information, knowledge, products, and services that are digitally reinforced.^[1]

This creates challenges and opportunities such as adding flexibility to and accelerating the food chain supply, but also redefining the dynamic interplay between the health of citizens towards food and nutrition. Thus, a comprehensive and appropriate evaluation of food systems drivers and transformations and their impact on empowering citizens to make sustainable choices continues to be necessary.^[2]

The million-dollar question is how to better understand and deal wisely with these inevitable drivers and transformations of global food systems, and their transformational relationships with citizens' health?

Only the behavioural economics (BE) approach can answer this very important question.

What is BE? It is the field that combines insights from psychology and elements of economics to better understand the complex nature of human behaviour in several contexts and to examine all factors that influence economic decision-making processes by individuals and/or institutions with respect to different matters including nutrition, healthy lifestyles, and other issues relevant to sustainability.^[2-3]

Therefore, BE approach plays a significant role in shaping food and health systems by understanding and influencing people's behaviours and choices related to food consumption, production, and waste. Besides, BE can inform the development of public health policies mechanisms to influence socioenvironmental behaviours.

How behavioural economics concepts may be applied to different food settings and by several stakeholders?

Here are some ways in which BE approach influences and informs citizens' behaviours towards food in many contexts (supermarkets, restaurants, households, etc.) and thus, impacts health and sustainable food systems ^[4-7]:

• Nudging for Healthy and Sustainable Choices: BE uses nudges, which are subtle changes in the way choices are presented in different point of sales, to guide people towards healthier food choices. For instance, placing healthier and sustainable food options at eye level in grocery stores or cafeterias can indirectly encourage people to make better choices.
• Education and Information: BE insights can guide the design of educational interventions (e.g., cooking classes for youth and adults) that provide relevant information about the transformational relationships between food systems and healthy citizens. These informative interventions can increase consumers' literacy about sustainable health issues and empower them to make informed decisions.
• Default Options: By setting default options, BE can nudge people towards more healthy dietary habits and lifestyles. For example, making healthy meals the default choice in institutional settings such as academic institutions and worksites, or in meal kit subscriptions for food delivery services.
• Social Norms and Role Models Influence: People often make food choices based on what they perceive as the social norms or what their role models (parents, peers, influencers, etc.) are doing. BE can leverage this by promoting healthy eating habits through engaging journalism and social campaigns (mainly generated by Generation Z i.e., people born between 1965 and 1980) that highlight the positive behaviours of others in the community.
• Food Labeling: Clear and informative food labels can help consumers make more healthy and sustainable choices. BE research can inform the design of labels that highlight not only the health-nutrition related claims but also the environmental impact of different healthy food products, making it easier for consumers to select healthier items with more nutritious production methods and lower carbon footprints.
• Menu Engineering: In restaurants and food service settings, menu design and labeling can highly influence consumers' choices and positively empower their health and the health of their communities. By using BE principles while designing food and beverages menus, consumers can easily notice the health benefits of different food/dishes options and therefore, discourage unhealthy and resource-intensive dishes.
• Reducing Food Waste: BE can provide insights into how and why people waste food, and how to help them to change those behaviours. By that we mean, BE helps in choosing the relevant methods to educate citizens about the environmental and economic consequences of food waste on our planet and indirectly on their health. Strategies like providing smaller plate sizes in restaurants and offering practical tips on storing and using leftovers can contribute to reducing food waste at the food services settings and at the households respectively.
• Portion Control and Plate Design: BE studies have shown that the size and arrangement of portions on a plate can influence how much people eat. By optimising portion sizes and designing plates to prioritise fruits, vegetables, and whole grains, food systems can reduce overconsumption and promote healthier and more sustainable diets.
• Incentives and Rewards: BE techniques like rewards, discounts, or loyalty programs can encourage citizens to choose more healthy sustainable food options. For instance, offering discounts on locally sourced, unprocessed, or organic produce can encourage citizens to make healthier and eco-friendly choices.
• Long-Term Perspective: In the environmental sphere, BE encourages decision-makers to consider the long-term consequences of consumerism and food choices on the biodiversity and planet, which will also affect the global health of citizens. This can lead to the adoption of policies and practices that prioritise public health and sustainability over short-term economic gains.

Behavioural economics and healthy citizens: From knowledge to practice

In recent years and despite increased interest in adapting BE approaches in psychology, economics and public policy, the application of BE to health and food systems remains relatively sparse.

The above examples provide an overview of how incorporating BE approach into the whole food chain phases from production to consumption can lead to more cost-effective strategies that align people's choices with the broader goals of the UN-SDGs including improved agri-food and nutrition matters, climate and environmental preservation, resources efficiency, and healthy nations.^[8]

However, BE approach does have some limitations to consider when it's applied to the realm of sustainability including the "limited scope of its application" (e.g., BE is more effective for addressing individual behaviours/choices than economic systemic matters or structural factors that prioritise growth over health and sustainability), and the "complexity of human behaviour" (e.g., people are not always easily persuaded by behavioural interventions and might resists changes to their deep-rooted dietary habits and consumerism values (9). Besides, these limitations are more noticeable in communities highly exposed to unhealthy and non-sustainable food such as ultra-processed food or in communities living in food deserts. In these cases, the use of BE approach alone to empower healthy citizens and/or to achieve food security and sustainability is not enough but should be envisaged under a holistic approach that considers structural factors, cultural nuances, and ethical considerations.^[4,9]

Finally, adopting this holistic approach while incorporating principles of BE into public health initiatives, and into food and healthcare systems can enhance the effectiveness of interventions aimed at empowering citizens to make better choices and lead healthier lives. Although BE has much to offer to wisely deal with healthy lifestyles and sustainability matters, BE is well suited to be used in settings ready to make a transformation towards a healthy sustainable life.^[5]
 

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References

1. Yadong L. New OLI advantages in digital globalization. International Business Review, 2021; 30(2): doi.org/10.1016/j.ibusrev.2021.101797
2. Hamadeh S. Roadmap for future food systems and smart cities: Making the ecosystem connections and policies. Chapter IN: Sustainable Energy-Water-Environment Nexus in Deserts-Advances in Science, Technology & Innovation (Heggy et al., Eds), 2021:781-788.
3. Kretscmer S and Kahl J. Sustainable development goal drivers in food systems. Frontiers in Sustainable Food Systems, 2021; 5:536620.
4. Ledderer L, Kjaer M, Fage-Butler A et al., Nudging in public health lifestyle interventions: A systematic literature review and metasynthesis. Health Education and Behavior, 2020; 47(5):749-764.
5. Roberto C & Kawachi I (2016) Behavioral Economics and Public Health. New York: Oxford University Press.
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8. Abd Elkhalek A. An assessment of the applicability of behavioral economics' tools to policy making process considering sustainable development goals. International Journal of Economics, 2020; 12(10):57.
9.  United Nations: Department of Economic and Social Affairs Sustainable Development.