Tag Archives: behavioural change

Repost: The definition of madness

So TfL have produced a short advert once again asking everybody to calm down, play nice, and share the road. I figured it might make a good excuse to post again this thing that I scribbled a couple of years ago.

On the Guardian Bike Blog, Tom Richards points out that “while we’d all love better cycling infrastructure, there is neither the money nor the political will…” Therefore we should focus on easier and more populist things — like conquering human nature and legislating to re-educate 30 million people.

Now, leaving aside the fact that the effects of changing driver education (if there are ever any effects at all, and it’s not a very robustly researched field) have long lag times — as long as street lifecycles. And leaving aside the fact that there is no evidence that this sort of intervention would ever actually have any significant effect on the sort of issues we’re concerned about, such as occurrence and severity of motor vehicle/cycle crashes (but if Richards were to propose a randomised controlled trial…). And leaving aside the fact that it could have, at best, only a small effect on the arguably more important issue of barriers to cycling, which are more about subjective assessment of the comfort of the environment than about raw injury statistics, and so can make no significant contribution to solving the wider issues which cycling is tied to. Basically, leaving aside the fact that this is, at best, a mediocre proposal. The interesting question is, why do people keep clinging to these kinds of ideas?

The idea that somehow physical engineering is difficult and expensive and unpopular, while changing human behaviour is quick, easy, cheap and effective, is one that the British are remarkably strongly attached to. It is manifested in a wide variety of rarely very effective campaigns and initiatives, from marketing the unmarketable to the bizarrely widespread belief that obscure details of insurance law are a significant influence on behaviour. One of my favourite examples of the attitude was caught by Freewheeler a couple of years ago, from “3 feet please” campaigner and now ex LCC trustee David Love:

This provoked a response from David Love in the Comments, who among things writes:

Sure, segregation would be great but in London at least there’s no room and no money so it’s not going to happen.
Campaigning for behaviour change is more realistic right now

And there you have the ‘realism’ of a man who is LCC Trustee and Vice Chair.

But the British tradition of soft measures goes far wider, deeper and further back than this. Motorists may moan about having been the victim of a “war” that restricts their freedom, polices their movements, or sends campaigns of severe punishment for accidental and unavoidable infringement of petty rules, but the reality is that right from the start, when the red flag acts were repealed, this country’s response (and that of much of the English-speaking world) to the problems that motorists create on the road has largely been light touch and libertarian, in which the children are simply asked again and again to play nice, even as they become ever greater bullies, and only if they’re really bad might they have their pocket money docked. We encourage and raise awareness, appeal to the legendary British sense of fair play, and still believe that the ideal road is within reach if only we can persuade everybody to get along through courtesy, good manners, and communicating our intentions clearly to one another.

Joe Moran has an entertaining history of this English approach to road safety in the chapter “please don’t be rude on the road” in On Roads. Amongst others he tells the story of Mervyn O’Gorman, who argued against introducing a driving test because all that a motorist should require is a natural “road sense”, and who acted on his belief that the cause of road accidents is poor communication by inventing the Highway Code, a list of mostly legally baseless customs and courtesies, explaining that “is is just as ungentlemanly to be discourteous or to play the fool on the king’s highway as it would be for a man to push his wife off her chair at the Sunday tea table and grab two pieces of cake.” Perhaps most entertaining is his coverage of the period in the 1930s when “courtesy cops” went around with megaphones politely asking errant drivers to behave themselves. He concludes:

Underneath this appeal lay an uncomfortable truth: many members of the respectable middle classes were incompetent drivers who were to blame for fatal road accidents. Rather than turning them into criminals through putative legislation, British traffic law relied on appeals to their sense of fair play. It was always better, went the mantra of the time, to cultivate good habits than propose bad bills. [Sound familiar?] So the courtesy cops did not prosecute motorists; they offered friendly advice to the careless. The Times blamed accidents on what it called ‘motorious carbarians’ — the few bad apples hidden among the vast majority of gentlemanly drivers, who could be relied upon to break the law sensibly. Motoring correspondents railed against excessive regulation in the 1930s in a way that eerily echoes today’s campaigns against speed cameras and road humps. ‘Regulation after regulation pours from the Ministry of Transport in a never-ending flood,’ complained the Daily Mirror in 1934 … but ‘courtesy and good manners may be cultivated easily enough by everyone.’

They say that the definition of madness is doing the same thing over and over and expecting a different result. For eighty years or more the answer to motorists playing nice has been just a little bit more education and awareness raising, and look where it has got us. It’s time to call off the search for the British sense of fair play and abandon the naive idea that meaningful and worthwhile change on the road can be achieved with a few gentle nudges.

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Don’t treat obesity as physiology or physics

I have a whole bunch of draft and outline blog posts from winter and spring that I was never able to find the time to finish off. To clear them out of the way, I’ve bashed out some half-hearted conclusions, and will post them this month.

Flicking through the pile of Natures that never got read properly, ready to be rid of them, I alighted on Gary Taubes’s opinion piece: Treat obesity as physiology, not physics. Bear with me while I appear to be completely off-topic talking science for a while.

Taubes argues that:

…obesity is a hormonal, regulatory defect… it is not excess calories that cause obesity, but the quantity and quality of carbohydrates consumed. The carbohydrate content of the diet must be rectified to restore health.

Taubes set out his case that it is not useful to think of obesity as a straightforward energy in/out imbalance that causes weight gain, but that it’s in understanding that specific forms of that energy — carbohydrates, and sugars doubly so — activate our body’s own fat accumulation systems (through the well understood insulin process) where solutions lie. You’ll be familiar with it from all that “Atkins diet” and “glycaemic index” stuff: energy in the form of carbs bad; energy from dietary fat not so much.

Taubes thinks this is important stuff because:

…the overeating hypothesis has failed. In the United States, and elsewhere, obesity and diabetes rates have climbed to crisis levels… despite the ubiquity of the advice that if we want to lose fat, we have to eat less and/or move more.

There is an obvious response to this, but Taubes pre-empts it:

Yet rather than blame the advice, we have taken to blaming the individuals for not following it ‘properly’.

Suggesting that Taubes thinks that if only we change the advice from “eat less and exercise more” to his “don’t eat high glycaemic index foods”, the advice will be followed and we will then succeed in defeating obesity.

I imagine any “advice” we give will be useless, whether it’s based on physics or physiology.

Because while obesity is about physics and physiology — and psychology and genetics and half a dozen other fields of science — none of those things explain what is important: why there is more obesity now than in the past, and how to make there be less of it in the future.

The laws of physics haven’t changed in fifty years. Physiology, and the genes that underlie it, can change — but only by evolution over the course of hundreds of generations, not a few decades. Sure, our bodies have a mechanism for turning carbohydrates into fat stores. But they always have.

The focus is on the quantity of energy in and the quantity out because that is what has changed during the rise of the obesity crisis. By all means refine that to a specific focus on an excess of high-glycaemic index foodstuffs and a deficit of burning off specific sugars, but the problem that really matters remains fundamentally not one of physics or physiology but of our environment.

Taubes is right to treat those who “blame individuals for not following the advice properly” with contempt. But not because the advice is wrong. Because any “advice” — right or wrong — is going to be useless. This is not a problem that individuals have created for themselves, and it’s not a problem that individuals can be “advised” to solve for themselves. This is a problem of the environment that we live in: the types of food that are available to us, and the opportunities for an active healthy lifestyle that have been taken away from us.

Taubes later uses an analogy with smoking and lung cancer, and the analogy perfectly describes what’s wrong with the idea that obesity should be treated as a physiology problem. We know a great deal about the physiology of smoking-related lung cancer. We know how all of the many different carcinogenic chemicals within cigarette smoke flow through the lungs and pass through membranes into the cells. We know the chemical reactions that they participate in and how those reactions cause damage to the cells’ DNA. We know exactly which pieces of DNA damage result in the harmful mutations that transform them into cancer cells, driven to grow and divide. We know exactly how those mutations — to genes with names like RAS and RAF, and EGFR and a dozen others — change the shape of the proteins that those genes encode, and why that change of shape causes those proteins to misbehave. We know how these things result in the tumour evading the body’s inbuilt defences, how they hijack the blood supply to allow their expansion, and how they go on to invade and destroy neighbouring tissue and eventually escape and metastasise.

And knowing these things about physiology makes not the slightest difference to solving the smoking problem. Smoking-related lung cancer, like obesity, is a process of physiology. But it’s a problem of environment. And the most important lesson from smoking for obesity is that you can’t solve a problem environment with advice alone. Bad lifestyle choices are not an individual failing. Good lifestyle choices need an infrastructure to support them.

The definition of madness

On the Guardian Bike Blog, Tom Richards points out that “while we’d all love better cycling infrastructure, there is neither the money nor the political will…” Therefore we should focus on easier and more populist things — like conquering human nature and legislating to re-educate 30 million people.

Now, leaving aside the fact that the effects of changing driver education (if there are ever any effects at all, and it’s not a very robustly researched field) have long lag times — as long as street lifecycles. And leaving aside the fact that there is no evidence that this sort of intervention would ever actually have any significant effect on the sort of issues we’re concerned about, such as occurrence and severity of motor vehicle/cycle crashes (but if Richards were to propose a randomised controlled trial…). And leaving aside the fact that it could have, at best, only a small effect on the arguably more important issue of barriers to cycling, which are more about subjective assessment of the comfort of the environment than about raw injury statistics, and so can make no significant contribution to solving the wider issues which cycling is tied to. Basically, leaving aside the fact that this is, at best, a mediocre proposal. The interesting question is, why do people keep clinging to these kinds of ideas?

The idea that somehow physical engineering is difficult and expensive and unpopular, while changing human behaviour is quick, easy, cheap and effective, is one that the British are remarkably strongly attached to. It is manifested in a wide variety of rarely very effective campaigns and initiatives, from marketing the unmarketable to the bizarrely widespread belief that obscure details of insurance law are a significant influence on behaviour. One of my favourite examples of the attitude was caught by Freewheeler a couple of years ago, from “3 feet please” campaigner and now ex LCC trustee David Love:

This provoked a response from David Love in the Comments, who among things writes:

Sure, segregation would be great but in London at least there’s no room and no money so it’s not going to happen.
Campaigning for behaviour change is more realistic right now

And there you have the ‘realism’ of a man who is LCC Trustee and Vice Chair.

But the British tradition of soft measures goes far wider, deeper and further back than this. Motorists may moan about having been the victim of a “war” that restricts their freedom, polices their movements, or sends campaigns of severe punishment for accidental and unavoidable infringement of petty rules, but the reality is that right from the start, when the red flag acts were repealed, this country’s response (and that of much of the English-speaking world) to the problems that motorists create on the road has largely been light touch and libertarian, in which the children are simply asked again and again to play nice, even as they become ever greater bullies, and only if they’re really bad might they have their pocket money docked. We encourage and raise awareness, appeal to the legendary British sense of fair play, and still believe that the ideal road is within reach if only we can persuade everybody to get along through courtesy, good manners, and communicating our intentions clearly to one another.

Joe Moran has an entertaining history of this English approach to road safety in the chapter “please don’t be rude on the road” in On Roads. Amongst others he tells the story of Mervyn O’Gorman, who argued against introducing a driving test because all that a motorist should require is a natural “road sense”, and who acted on his belief that the cause of road accidents is poor communication by inventing the Highway Code, a list of mostly legally baseless customs and courtesies, explaining that “is is just as ungentlemanly to be discourteous or to play the fool on the king’s highway as it would be for a man to push his wife off her chair at the Sunday tea table and grab two pieces of cake.” Perhaps most entertaining is his coverage of the period in the 1930s when “courtesy cops” went around with megaphones politely asking errant drivers to behave themselves. He concludes:

Underneath this appeal lay an uncomfortable truth: many members of the respectable middle classes were incompetent drivers who were to blame for fatal road accidents. Rather than turning them into criminals through putative legislation, British traffic law relied on appeals to their sense of fair play. It was always better, went the mantra of the time, to cultivate good habits than propose bad bills. [Sound familiar?] So the courtesy cops did not prosecute motorists; they offered friendly advice to the careless. The Times blamed accidents on what it called ‘motorious carbarians’ — the few bad apples hidden among the vast majority of gentlemanly drivers, who could be relied upon to break the law sensibly. Motoring correspondents railed against excessive regulation in the 1930s in a way that eerily echoes today’s campaigns against speed cameras and road humps. ‘Regulation after regulation pours from the Ministry of Transport in a never-ending flood,’ complained the Daily Mirror in 1934 … but ‘courtesy and good manners may be cultivated easily enough by everyone.’

They say that the definition of madness is doing the same thing over and over and expecting a different result. For eighty years or more the answer to motorists playing nice has been just a little bit more education and awareness raising, and look where it has got us. It’s time to call off the search for the British sense of fair play and abandon the naive idea that meaningful and worthwhile change on the road can be achieved with a few gentle nudges.

Behavioural interventions get more popular with time

If they work, that is. Same goes for any policy, investment, or change, really. Whether they work is in turn somewhat dependent on whether they are popular, of course, but what determines whether they are popular is different before and after implementation. Before implementation, various campaigners, interested parties, and media sources will be fighting to persuade us what a great / terrible thing the intervention will be, and before implementation an intervention might be unpopular because people have been given a false idea of how bad the problem is, what exactly the proposed solution is, and how likely it is to work. Once they see the intervention working and how much better the world is when that problem has been solved, the opposition fades.

The HoL Sci & Tech committee’s report on evidence-based behavioural change cites the example of the ban on smoking in public places, but a more relevant example might be the London Congestion Charge. Various powerful interest groups raised opposition to the charge in our Motorism-infected media, spreading scare stories of chaos and failure while playing down the problems that the charge was intended to solve. It was unpopular because people were told that it would make getting around more difficult. The reality was that the charge paid for or otherwise enabled a massive improvement in bus speed, frequency and reliability; Oyster; and better streets. For most people, getting around got easier and the streets got nicer. The Congestion Charge was unpopular when people trying to imagine it, based on the misinformation they had been given, but became popular when they could see the reality.

(Sadly this lesson has been missed by Edinburgh, Manchester, and New York, whose politicians rejected road charging because polls showed it to be unpopular. It’s alright for that London, say the newspapers of Edinburgh and Manchester, but they’ve got better alternatives to the car than us — failing to acknowledge the role of the Congestion Charge in providing those alternatives.)

The same applies to bicycle infrastructure. Councillors and politicians thinking about investing in bicycle infrastructure, perhaps even at the expense of a few parking places or a taxi rat-run, shouldn’t spend so much time worrying about per-implementation polls or how large a segment of the population are existing bicycle users. Opposition goes away once people see the reality — that there is no new parking or congestion apocalypse, only a new, better, option for making journeys.

It’s all good / Embrace life

Isn’t it weird how everyone’s getting so fat and dying of cardiovascular disease and cancers and diabetes? Why is that? I guess it’s genetics or something.

Meanwhile, I stumbled upon this in a folder of old unprocessed pictures. It was on New Cross Road back when I lived in that part of the world. There are a lot of billboards along the Old Kent and New Cross Roads, targeting the motorists who pass though, destroying and polluting other people’s neighbourhoods. Whether governments try to change our behaviour or not, you can bet that commercial interests will be doing their best, explicitly or subtly, and even by ensuring that our choices are restricted.

On the lower advert you can see a government nudge: the provision of information about the fuel efficiency of the car being advertised. The HoL Sci & Tech Committee report on behavioural change commented on this “information deficit” model of harmful behaviour, concluding that information provision on its own is generally insufficient to lead to behavioural change (though it can help to pave the way for more robust interventions). The real barriers to a low-carbon lifestyle are bigger than a lack of information about fuel use.

A more helpful move might be to prevent advertisers from making such absurd claims as that junk food is “all good” or that cars are anything other than life-sucking parasites. We don’t let tobacco and alcohol companies do it.

Norman Baker defends evidence-defying policy

Norman Baker, our ever embarrassing Lib Dem Minister for The Bits Of Transport That The Government Doesn’t Care About and part-time conspiracy theorist, pops up in the HoL Sci & Tech Committee report on evidence-based behavioural change policy, defending the coalition’s approach:

Even where ministers are aware of relevant evidence, other factors may lead them to disregard it. This appears to have been the case with current alcohol pricing policy (see Box 3, page 21). Norman Baker MP, a Minister at the DfT, explained: “evidence is best used to inform policy … but not to drive it in an unreconstituted way”; the Government “have to make choices based not just on the evidence-base … but also on the political objectives of the Government at a particular time, and to ensure fairness across the country”. Other considerations might include immediate reaction to events, judgements about ethical acceptability, cost and cost-effectiveness. These considerations might justifiably affect the extent to which a policy is based on the available evidence.

What does “political objectives of the Government” even mean? It sounds awfully like “ideology”. What does “immediate reaction to events” mean? Sounds to me a bit like outlawing a recreational drug because a couple of people who coincidentally used it recently died, or locking a lot of people up for petty crimes because they happened in the context of a recent big news story.

Of course, cost, cost-effectiveness, ethical acceptability, and indeed general public acceptability must be taken into account. But those things are pieces of evidence like anything else. This stuff is all part of the evidence that evidence-based behavioural change policy needs to be based on.

As the report itself goes on to discuss, behavioural change policies will fail if the public does not understand the problem — or the magnitude of the problem — that the policy is trying to solve. The solution must be seen to be proportionate to the problem. Sometimes you need to prepare the public and make your case: a few years of “clunk-click” paved the way for seatbelt legislation. If an intervention is a really good one, it only needs to be on the border-line of public acceptability to work and to very quickly become accepted: opposition to the ban on smoking in public places quickly disappeared, and it takes effort to find people opposed to the congestion charge these days.

Equally relevant is the fact that the public acceptability of interventions depends on their success. Design an intervention that doesn’t actually work — perhaps by ignoring the evidence — and you invite a backlash. The report cites the example of high alcohol prices in Scandinavia. This could perhaps help to explain the media’s obsession with The War On The Motorist: policies to tackle the problems of mass motoring might be unpopular if the number of vehicles on the road carries on growing regardless (even if the situation would have been even worse without those policies).

I don’t know. The formula might be complicated, but I can’t think of any part of it that should not be based on real world values. Can anybody see a favourable interpretation of Baker’s words?

Nudge nudge, do you follow me?

Call me a stereotype of the scientist buried in his own irrelevant little world, but it occurred to me that I know far more about how to manipulate the behaviour of transformed cell lines than that of people. The War On The Motorist™ was, of course, part of the great evil Labour project to change some of our more anti-social and self-destructive behaviours. So I thought I should probably find out about how these government-led behavioural change projects work.

There are, of course, all sorts of different ways that governments can try to reduce destructive behaviour, from outlawing it to asking nicely, via making the bad options harder and making the good options easier:

(This table, incidentally, neatly describes where the chaps at Cycle Chat slipped up when claiming that the rise in domestic recycling rates demonstrates that we can achieve mass cycling without cycling facilities: mass domestic recycling required a change in the physical environment — kerbside recycling boxes — exactly equivalent to the changes to the physical environment that are required before we can expect most people to cycle.)

The current government has an ideological bias against some of these varieties of behavioural change, and in favour of others.* Regulation and taxation is, of course, off the agenda. Rather, the government says it wants to influence behaviour by making it easier for us to make the right choices. It will do this, it claims, without making the bad choices impossible or even more expensive, and without even requiring our conscious deliberation. In the fashionable pop-economics terminology, it’s going to “nudge” us in the right direction.

The pop-economics writers have some favourite examples of “nudges”. Changing the environment by putting the fruit bowl in plain view and easy reach, without banning the junk food option. Or reducing laundry loads by changing the hotel bathroom signs from “hang your towel on the rack if you are going to reuse it” to “most guests hang their towels up and reuse them”. The environment or the information nudges people into making the right choice, without actually taking choice from them.

It all sounds very nice, but I wonder what the evidence says about the government’s approach? Does it really work? Are they doing it right? And what does it mean for transport and The War On The Motorist?

Luckily, the House of Lords Sci & Tech select committee are ahead of me. I like select committees. So far as I can tell, their job is to closely and carefully scrutinise what the government is doing (or failing to do), point out when the evidence indicates that they’re messing things up, and then to be completely ignored by government, media, and the unfortunate oblivious electorate. The HoL Sci & Tech committee produced a report a couple of weeks ago looking at the present government’s approach to behaviour change programmes, and in particular, the extent to which they were informed by the evidence of what works and what is worthwhile. I’ve been scrolling through it and will probably dump a load of thoughts on the blog this week.

My initial concern was that, though it speaks of nudges and wanting to avoid limiting choice through regulation, it is not regulation that the government is really trying to avoid: it is spending money on doing a job properly. We’ll see if I’m at all reassured by the time I’ve finished digesting it and posting about it…

* Of course, the far end of the libertorian wing will object to any and all government-led behavioural change, but I will assume for now that we all understand why we need it, and why we need it done properly