For fairly obvious reasons medicine and health has received its fair share of scientific study. Our hunger for anything vaguely related to health is underlined by the media’s constant coverage of advances in the study of cancer and obesity. Something would seem amiss if we were to flick through a newspaper and not read about new obesity rate projections, cancer population statistics or the scourge of passive smoking. We know more than we ever have about what types of behaviours are bad for us and exactly how bad they are (normally presented in a convenient percentage to maximise both ease of understanding and anxiety for readers). Yet, the scientific community has also started to uncover reasons why these risky behaviours persist and one of them is sensationalist and headline making, to say the least.
Your choice of friends can put you at serious risk of obesity, cancer and an early grave. Although a shocking and dramatic concept, much research has amassed in support of this. Evolving in groups and reliant on each other for protection we find ourselves as naturally social creatures. We care about our position in the group and because of this we can be swayed by the group. Classic psychology experiments by the likes of Stanley Milgram and Solomon Asch confirmed this notion over 40 years ago. Based on ingenious experimental studies Asch showed that in the laboratory we would follow the group and change our opinions and beliefs to fall into line with the crowd. But 40 years on we now know that these findings were not to be confined to the laboratory as recent research highlights the impact those around us have on personal health and well being in the real world.
A 2007 study led by Nicholas Christakis and James Fowler published in The New England Journal of Medicine was one of the first hallmark papers in this area. The authors reported findings indicating that your likelihood of gaining weight and becoming obese drastically increased if a friend, family member or spouse has recently gained weight. In the case of a close friend, their recent weight gain increased a person’s chance of becoming obese by over 50% in this study. Similar findings have been reported for cancer screening and self examination – keeping company that aren’t of a health conscious nature significantly reduces ones likelihood of making adequate and regular checks.
So what explains these findings? There is thought that it is due to the operation of social norms. Generally speaking we look to what the norm is amongst those around us and then behave accordingly. One problem here of course is that large parts of society are overweight or unhealthy, which makes for norms we really could do without. A second problem is that research indicates people aren’t aware that social norms have such a strong influence on their behaviour. An interesting study headed by Lenny Vartanian showed that if participants believed their peers were eating a lot they followed suit and ended up overeating, but even more importantly they were adamant that social norms were not influencing their behaviour.
One obvious answer would appear to be to raise awareness about the influence unhealthy norms can have on our behaviour. But a more cunning and controversial approach would be to harness the power of social norms to help solve some of societies major health problems. Work from our laboratory this year has shown that informing people that a lot of people are actually trying to eat more healthily than might be expected has impressive effects on choice of healthier foods. In line with this idea a recent study in notable journal Psychological Science indicates that a similar approach could be adopted to nudge society in the right direction with regards to cancer screening. This kind of nudge approach has also been tested in the US to try and reduce high and irresponsible alcohol consumption and in doing so try and prevent burden on health, the economy and society.
Although possessing scientific backing, this strategy raises ethical dilemmas. Should we be using what is effectively propaganda to make society a healthier place to live? Is it justifiable to coerce, providing we have science on our side and are fairly sure it will work out for the best? Or should we forget fighting fire with fire and look elsewhere for the answer to society’s health problems? The alarming effect those around us can have makes for a great news story, but working out how we can tackle worrying levels of unhealthy behaviours that are now becoming the norm yields an even greater challenge.