Pub Date : 2019-04-01DOI: 10.1177/237946151900500102
Joel Goh, J. Pfeffer, S. Zenios
Many studies have documented that workplace stress can harm health. But in an open, competitive economy, can these harmful effects realistically be prevented? To find out, we used publicly available data to compare U.S. and European estimates of health care costs and mortality from workplace stress. We found that if the United States had workplace policies that were comparable to those of a European country of similar wealth, it would spend approximately $40 billion less on health care costs related to potentially preventable workplace stress than it spends now. These results suggest that focusing policy interventions on the workplace could help address soaring U.S. health care costs.
{"title":"Reducing the Health Toll from U.S. Workplace Stress","authors":"Joel Goh, J. Pfeffer, S. Zenios","doi":"10.1177/237946151900500102","DOIUrl":"https://doi.org/10.1177/237946151900500102","url":null,"abstract":"Many studies have documented that workplace stress can harm health. But in an open, competitive economy, can these harmful effects realistically be prevented? To find out, we used publicly available data to compare U.S. and European estimates of health care costs and mortality from workplace stress. We found that if the United States had workplace policies that were comparable to those of a European country of similar wealth, it would spend approximately $40 billion less on health care costs related to potentially preventable workplace stress than it spends now. These results suggest that focusing policy interventions on the workplace could help address soaring U.S. health care costs.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"5 1","pages":"1 - 13"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44216297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.1177/237946151900500106
Mary Steffel, Elanor F. Williams, David Tannenbaum
In this review, we examine whether presumed consent organ donation policies save lives. We compare presumed consent defaults (where people are considered organ donors by default but can opt out of donation) with explicit consent defaults (where people are considered nondonors by default but can opt in to be considered donors). Experimental, cross-sectional, and longitudinal evidence indicates that rates of consent, donation, and transplantation are higher under presumed consent policies than under explicit consent policies. The evidence also suggests, however, that presumed consent is one factor among many that determine the number of organs donated and lives saved; policymakers must balance a number of other considerations to ensure that shifting to a presumed consent system will boost donation and transplantation rates. We underscore the importance of investing in health care infrastructure to support organ procurement and transplantation and offer empirically informed recommendations to enable consent policies to save the most lives.
{"title":"Does Changing Defaults save Lives? Effects of Presumed Consent Organ Donation Policies","authors":"Mary Steffel, Elanor F. Williams, David Tannenbaum","doi":"10.1177/237946151900500106","DOIUrl":"https://doi.org/10.1177/237946151900500106","url":null,"abstract":"In this review, we examine whether presumed consent organ donation policies save lives. We compare presumed consent defaults (where people are considered organ donors by default but can opt out of donation) with explicit consent defaults (where people are considered nondonors by default but can opt in to be considered donors). Experimental, cross-sectional, and longitudinal evidence indicates that rates of consent, donation, and transplantation are higher under presumed consent policies than under explicit consent policies. The evidence also suggests, however, that presumed consent is one factor among many that determine the number of organs donated and lives saved; policymakers must balance a number of other considerations to ensure that shifting to a presumed consent system will boost donation and transplantation rates. We underscore the importance of investing in health care infrastructure to support organ procurement and transplantation and offer empirically informed recommendations to enable consent policies to save the most lives.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"5 1","pages":"69 - 88"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43479347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.1177/237946151900500105
Peter Bergman
Parents powerfully influence their children's educational outcomes. Yet psychological and informational barriers impede parents’ ability to engage with their children in ways that improve outcomes: parents tend to have inflated perceptions of their children's performance, which can deter them from taking helpful steps to effectively support their learning, and parenting is complex. Limited cognitive bandwidth for coping with complexities can steer parents’ attention away from actions that have long-term benefits for their children and toward actions yielding immediate returns. Poor school-to-parent communication and poverty exacerbate all of these problems. In this article, the author demonstrates how providing timely, actionable information to parents can lower these barriers and help parents engage with their children more productively from kindergarten through high school. Moreover, providing this information can improve educational outcomes at low cost.
{"title":"How Behavioral Science Can Empower Parents to Improve Children's Educational Outcomes","authors":"Peter Bergman","doi":"10.1177/237946151900500105","DOIUrl":"https://doi.org/10.1177/237946151900500105","url":null,"abstract":"Parents powerfully influence their children's educational outcomes. Yet psychological and informational barriers impede parents’ ability to engage with their children in ways that improve outcomes: parents tend to have inflated perceptions of their children's performance, which can deter them from taking helpful steps to effectively support their learning, and parenting is complex. Limited cognitive bandwidth for coping with complexities can steer parents’ attention away from actions that have long-term benefits for their children and toward actions yielding immediate returns. Poor school-to-parent communication and poverty exacerbate all of these problems. In this article, the author demonstrates how providing timely, actionable information to parents can lower these barriers and help parents engage with their children more productively from kindergarten through high school. Moreover, providing this information can improve educational outcomes at low cost.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"5 1","pages":"53 - 67"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46314125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-04-01DOI: 10.1177/237946151800400104
R. Califf
The fourth industrial revolution, in which most information is stored in digital form, is characterized by connectivity and communication among people and groups via, for instance, cell phones and smart watches. The amount of information now generated about people's health-related activities is multiple log orders more voluminous and complex than the data currently captured in the electronic health record from patient interactions with clinicians. Despite the data's complexity, it is now possible for health care administrators, policymakers, and clinical researchers to develop—and then test—data-informed interventions that could reduce health disparities. For example, programs initiated by a county government and a major medical system have, respectively, improved asthma management and reduced lead exposure in their localities. Use of big data can be a double-edged sword, however. The technology that allows for high-end use of data also opens the way to increasing disparities, as could happen, for instance, if geospatial information were used to locate clinics in places that optimize profit rather than meet health needs. Efforts are underway to limit this risk.
{"title":"The Ubiquity of Data & Communication: A Double-Edged Sword for Disparities","authors":"R. Califf","doi":"10.1177/237946151800400104","DOIUrl":"https://doi.org/10.1177/237946151800400104","url":null,"abstract":"The fourth industrial revolution, in which most information is stored in digital form, is characterized by connectivity and communication among people and groups via, for instance, cell phones and smart watches. The amount of information now generated about people's health-related activities is multiple log orders more voluminous and complex than the data currently captured in the electronic health record from patient interactions with clinicians. Despite the data's complexity, it is now possible for health care administrators, policymakers, and clinical researchers to develop—and then test—data-informed interventions that could reduce health disparities. For example, programs initiated by a county government and a major medical system have, respectively, improved asthma management and reduced lead exposure in their localities. Use of big data can be a double-edged sword, however. The technology that allows for high-end use of data also opens the way to increasing disparities, as could happen, for instance, if geospatial information were used to locate clinics in places that optimize profit rather than meet health needs. Efforts are underway to limit this risk.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"4 1","pages":"27 - 37"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49431584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-04-01DOI: 10.1177/237946151800400103
Catherine K. Ettman, S. Abdalla, S. Galea
Many behaviors, such as smoking and overeating, strongly affect a population's health. Further, social, physical, and economic contexts—for example, housing, transportation, education, and employment—shape health-related behaviors. To improve a population's health, policies must include actions that alter elements of these larger contexts. But the elements are vast and complex, and resources are limited. How can policymakers determine the right priorities to focus on? Building on the emerging field of population health science, we suggest four principles to guide priority setting: view population health as a continuum, focus on affecting ubiquitous influences on health, consider the trade-offs between efficiency and equity, and evaluate return on investment. This proposal offers a novel approach to setting policy for improving health behaviors.
{"title":"Applying Population Health Science Principles to Guide Behavioral Health Policy Setting","authors":"Catherine K. Ettman, S. Abdalla, S. Galea","doi":"10.1177/237946151800400103","DOIUrl":"https://doi.org/10.1177/237946151800400103","url":null,"abstract":"Many behaviors, such as smoking and overeating, strongly affect a population's health. Further, social, physical, and economic contexts—for example, housing, transportation, education, and employment—shape health-related behaviors. To improve a population's health, policies must include actions that alter elements of these larger contexts. But the elements are vast and complex, and resources are limited. How can policymakers determine the right priorities to focus on? Building on the emerging field of population health science, we suggest four principles to guide priority setting: view population health as a continuum, focus on affecting ubiquitous influences on health, consider the trade-offs between efficiency and equity, and evaluate return on investment. This proposal offers a novel approach to setting policy for improving health behaviors.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"4 1","pages":"17 - 24"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45616035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-04-01DOI: 10.1177/237946151800400105
Paula M. Lantz, Samantha Iovan
Pay for success (PFS) is an emerging public—private partnership strategy for providing housing to chronically homeless individuals, people with mental or behavioral disorders, and adults recently released from prison. Socially minded private investors from both for-profit and nonprofit organizations provide the up-front funding for the projects. If an independent evaluation demonstrates that the intervention achieved predetermined metrics of success—such as decreasing the number of days children spend in foster care or increasing the number of people with stable housing—the public sector then “pays for success” by repaying the private investors, sometimes with interest. In this article, we describe seven ongoing PFS housing projects in the United States. Most are “housing first” interventions that provide permanent supportive housing to a chronically homeless population without setting any preconditions, such as sobriety. As projects are completed, analyses of the results should provide further insights into the complexities of designing behavioral-based PFS housing programs.
{"title":"Using Pay-for-Success Financing for Supportive Housing Interventions: Promise & Challenges","authors":"Paula M. Lantz, Samantha Iovan","doi":"10.1177/237946151800400105","DOIUrl":"https://doi.org/10.1177/237946151800400105","url":null,"abstract":"Pay for success (PFS) is an emerging public—private partnership strategy for providing housing to chronically homeless individuals, people with mental or behavioral disorders, and adults recently released from prison. Socially minded private investors from both for-profit and nonprofit organizations provide the up-front funding for the projects. If an independent evaluation demonstrates that the intervention achieved predetermined metrics of success—such as decreasing the number of days children spend in foster care or increasing the number of people with stable housing—the public sector then “pays for success” by repaying the private investors, sometimes with interest. In this article, we describe seven ongoing PFS housing projects in the United States. Most are “housing first” interventions that provide permanent supportive housing to a chronically homeless population without setting any preconditions, such as sobriety. As projects are completed, analyses of the results should provide further insights into the complexities of designing behavioral-based PFS housing programs.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"4 1","pages":"39 - 49"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48277182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-04-01DOI: 10.1177/237946151800400106
D. Taylor
One way to achieve health equity—ensuring everyone has fair and just opportunities to be as healthy as possible—in the United States would be to reallocate Medicare spending from low-value medical care (expensive treatments that do little good) toward high-value medical and social care (respectively medical interventions that have been shown to work well but are not covered by Medicare and nonmedical interventions, such as help with activities of daily living, that patients find more helpful than low-value care). In the current policy milieu, the most practical, direct step in that direction may be for Medicare—an already established, universal health care program for the elderly—to provide patients with more choices and autonomy.
{"title":"Improving the Match between Patients’ Needs & End-of-Life Care by Increasing Patient Choice in Medicare","authors":"D. Taylor","doi":"10.1177/237946151800400106","DOIUrl":"https://doi.org/10.1177/237946151800400106","url":null,"abstract":"One way to achieve health equity—ensuring everyone has fair and just opportunities to be as healthy as possible—in the United States would be to reallocate Medicare spending from low-value medical care (expensive treatments that do little good) toward high-value medical and social care (respectively medical interventions that have been shown to work well but are not covered by Medicare and nonmedical interventions, such as help with activities of daily living, that patients find more helpful than low-value care). In the current policy milieu, the most practical, direct step in that direction may be for Medicare—an already established, universal health care program for the elderly—to provide patients with more choices and autonomy.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"4 1","pages":"51 - 61"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42887995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-01DOI: 10.1177/237946151700300207
Y. Feldman
Even people who think of themselves as being ethical (“good people”) may engage in corrupt actions. In fact, the situations that seem least problematic can sometimes cause good people to behave immorally. Behavioral ethics research has demonstrated that various unconscious and self-deceptive mental processes promote such behavior in those individuals. To reduce the frequency of misbehavior by normally well-intentioned individuals, policymakers need to be aware that classic approaches to limiting corruption sometimes increase the likelihood that good people will engage in misconduct. Regulators also need to expand their toolbox beyond formal ethical codes and financial incentives by adding preventive interventions that are based on behavioral ethics research.
{"title":"Using Behavioral Ethics to Curb Corruption","authors":"Y. Feldman","doi":"10.1177/237946151700300207","DOIUrl":"https://doi.org/10.1177/237946151700300207","url":null,"abstract":"Even people who think of themselves as being ethical (“good people”) may engage in corrupt actions. In fact, the situations that seem least problematic can sometimes cause good people to behave immorally. Behavioral ethics research has demonstrated that various unconscious and self-deceptive mental processes promote such behavior in those individuals. To reduce the frequency of misbehavior by normally well-intentioned individuals, policymakers need to be aware that classic approaches to limiting corruption sometimes increase the likelihood that good people will engage in misconduct. Regulators also need to expand their toolbox beyond formal ethical codes and financial incentives by adding preventive interventions that are based on behavioral ethics research.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"3 1","pages":"87 - 99"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41892160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-01DOI: 10.1177/237946151700300205
L. Treviño, J. Haidt, Azish Filabi
Recent cases of corporate fraud have heightened regulatory interest in leveraging organizational culture to encourage ethical behavior. Policymakers in government and industry wish to use culture to enhance the enforcement-based approaches that they have historically relied on, but they want guidance on how to proceed. In this article, we review the organizational behavior literature on ethical culture. We define the components of ethical culture in organizations and summarize research into how to assess and strengthen it. We demonstrate that assessment must be an integral part of regulatory efforts to strengthen ethical culture, and we recommend that policymakers encourage industries to use standardized, validated measures to further policy goals.
{"title":"Regulating for Ethical Culture","authors":"L. Treviño, J. Haidt, Azish Filabi","doi":"10.1177/237946151700300205","DOIUrl":"https://doi.org/10.1177/237946151700300205","url":null,"abstract":"Recent cases of corporate fraud have heightened regulatory interest in leveraging organizational culture to encourage ethical behavior. Policymakers in government and industry wish to use culture to enhance the enforcement-based approaches that they have historically relied on, but they want guidance on how to proceed. In this article, we review the organizational behavior literature on ethical culture. We define the components of ethical culture in organizations and summarize research into how to assess and strengthen it. We demonstrate that assessment must be an integral part of regulatory efforts to strengthen ethical culture, and we recommend that policymakers encourage industries to use standardized, validated measures to further policy goals.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"3 1","pages":"57 - 70"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44233916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-01DOI: 10.1177/237946151700300206
Nicholas Epley, David Tannenbaum
Creating policies that encourage ethical behavior requires an accurate understanding of what drives such behavior. We first describe three common myths about the psychological causes of ethical behavior that can lead policymakers to overlook constructive interventions. These myths suggest that ethical behavior stems from a person's beliefs; changing behavior therefore requires changing beliefs. Behavioral science, however, indicates that the immediate context (such as an organization's norms and accepted procedures) exerts a surprisingly powerful influence on behavior. To be effective, policies must treat ethics as a design problem; that is, policymakers should create contexts that promote ethical actions. We then discuss three psychological processes that affect ethical activity–attention, construal, and motivation—and describe how understanding them can help policymakers in the public and private sectors design environments that promote ethical behavior.
{"title":"Treating Ethics as a Design Problem","authors":"Nicholas Epley, David Tannenbaum","doi":"10.1177/237946151700300206","DOIUrl":"https://doi.org/10.1177/237946151700300206","url":null,"abstract":"Creating policies that encourage ethical behavior requires an accurate understanding of what drives such behavior. We first describe three common myths about the psychological causes of ethical behavior that can lead policymakers to overlook constructive interventions. These myths suggest that ethical behavior stems from a person's beliefs; changing behavior therefore requires changing beliefs. Behavioral science, however, indicates that the immediate context (such as an organization's norms and accepted procedures) exerts a surprisingly powerful influence on behavior. To be effective, policies must treat ethics as a design problem; that is, policymakers should create contexts that promote ethical actions. We then discuss three psychological processes that affect ethical activity–attention, construal, and motivation—and describe how understanding them can help policymakers in the public and private sectors design environments that promote ethical behavior.","PeriodicalId":36971,"journal":{"name":"Behavioral Science and Policy","volume":"3 1","pages":"73 - 84"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44135160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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