Nudge Theory vs. Design Thinking for Health

My Oscar Health "welcome" box did a good job "nudging" me to want to make a doctors appointment. What a slick design! Actually, maybe it was just the design... ;)


In the previous two posts, I wrote about empathetic design + health. My own, admittedly biased opinion, is this: why wouldn't anyone want to feel healthier and more "well?" More energetic... more awake... more aware... Why wouldn't anyone want the world to be designed for more health? However, if this were truly the case, we probably would see far more people in spending time parks than in malls, taking the stairs than the elevator... (if able-bodied...), and creating firm boundaries for when to put down their work and spend time with their friends and families. Obviously the world isn't this simple and us humans are complex creatures with 832094823409203489 influences coming at us at all times in the form of advertisements, click-bait articles, the promise of overtime pay and/or impending bills, and alluring chocolate ganache cakes at every twist and turn...

...or maybe that's just me...

Anyway, onto the topic of this post - nudge theory, popularized by Richard H. Thaler, presents an interesting take on how to help humans make decisions for their best interests. The idea is that positive reinforcements and subtle or indirect suggestions can help influence behavior for the better. Already, typing that out, I feel a bit squeamish - it sounds a bit big brother-ish, no? I'm not alone in this opinion. Not to get too philosophical... but, who really can claim to know "our" best interests? Does there even exist a universal code of "goodness" and "wellness?" The question is complicated. And while I fully believe in "live and let live" I do think there are some baseline qualities to health and wellbeing that we all could adopt. Health consultant Dr. Nicola Davies writes about nudge theory + health in this post citing some simple changes like putting fruit versus chocolate at eye level in the grocery store, making the default "side" selection salad versus fries or something else, and having people automatically defaulted as organ donors (opting out as an option of course though, versus opting in). All of those thing sound good and relatively harmless to me, though for some organ donation is a hot-button topic.

However, while I do think that nudge theory and behavioral economics has a place in creating more health and well-being in the world, it employs a rather "top down" approach to creating change and the skeptic inside me wonders if change without agency is sustainable. 

Relatedly, though in slight contrast, "design thinking" has been co-opted by the self-help movement in places such as Stanford where a class called "Designing your life" now exists as one of the most popular courses for students. The course uses "design thinking" principles such as identifying problems and ideating on solutions to help students brainstorm ideas for their future vocation and lifestyle. Although the course seems to be primarily geared towards career decisions, it inevitably spills over into well-being and work/life balance by helping you get "unstuck" in all areas of your life. Tara Parker-Pope wrote in an article for the NYT on the course, "I still have a long way to go, but developing empathy for myself was truly a breakthrough made possible by design thinking." 

I'm not a purist or someone that follows one philosophy/approach to a problem religiously, (my major at Wesleyan was an interdisciplinary mix of Gender studies, Anthropology, religion, and movement studies, and my work as a user/design research draws on social science, design thinking, and business-savviness), BUT, I will say, the "design thinking" approach to bettering your life and well-being sounds a bit more self-empowering than the nudge theory approach. Still, I think they could be used in tandem for different purposes - and perhaps both are needed for positive, healthy change. Hopefully, by using both, behavioral economists and anthropologists and designers can help us all want to live healthier lives.

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