Understanding Health Behaviour

Content

People generally attach great importance to their health and would name it as one of the key aspects for a happy life. Nonetheless, many people do not adhere to a healthy lifestyle and therefore seem to behave in conflict with their own life goals. Smoking, physical inactivity, rejecting vaccination and screening or not adhering to physicians’ recommendations are popular examples. This raises the question as to how we can change behaviour and improve health and wellbeing. This is a question of concern to individuals, schools, companies and governments, and is the central question in this minor. The past decades have seen many different approaches as to how behaviour change can potentially be realised. Traditionally in many fields, but economics especially, individuals are seen as ‘rational decision-makers’, i.e. they know what they want, and make reasoned choices to achieve their goal of a better health and happiness. In this view, policies or interventions to promote behaviour change are only necessary when individuals are misinformed or choice is limited. 

In particular, two issues arise that are the focus of this minor:

1. The approach to behaviour and what incentivizes behaviour change employed in traditional economics often times does not apply successfully to health, as for most people health is very different from most other commodities. Questions of how to approach issues in health are the domain of health economics, which is one of the core components of this minor.
2. We all know that often people do not behave rationally when it concerns their own health and wellbeing. Understanding such non-rational behaviour requires insights from for example psychology and sociology, which are both central to behavioural economics – the second core component of this minor.

You will be introduced to the key concepts from behavioural and health economics, with examples related to health and healthcare. We will apply these concepts to i) understand health behaviour, both rational and non-rational, and ii) explore what this means for individuals, organisations and governments aiming to promote healthier behaviour (e.g., through nudging, boosting, incentives and regulation). Using these insights, you will select an actual health issue of your interest (e.g., excessive drinking, smartphone use in traffic), design an intervention, and reflect on it critically.

Learning objectives (required field):

After this minor students can:

1. Explain the traditional economic approach to rational choice, and discuss the merits and limitations of this approach for understanding and changing behaviour.
2. Explain why behavioural and health economics exist as separate disciplines, and discuss how they differ from traditional economics.
3. Give examples of heuristics and biases in intertemporal choice, risky choice, and social choice that violate traditional assumptions about rationality.
4. Apply these behavioural insights to understand and analyse health behaviour, in at least three settings: lifestyle choice, patient and physician decision-making, and preferences for health and wellbeing.
5. Differentiate between, provide arguments for and against, and give examples of appropriate applications in health for the following four common (policy) interventions: a) nudging, b) boosting, c) (financial) incentives, d) regulation.
6. Apply insights from behavioural and health economics to develop and evaluate an intervention aimed at promoting health and/or wellbeing.
7. Discuss challenges to promoting health and wellbeing for individuals, organisations and governments, such as cost-effectiveness and ethical considerations.

Special aspects

Given that all teaching materials, lectures, working groups, exercises and exams will be in English, sufficient skills in  understanding, reading, speaking and writing in English is a requirement for successful participation in this minor.

You will work together in small groups on developing your own health behaviour change intervention.

Teaching activities are scheduled on Mondays to Fridays.

Overview content per week (optional)

These topics will be covered per week:

Week 1: The ‘homo economicus’ – Learn about the traditional economic view on rational behaviour
Week 2: Beyond rationality I – Deciding between now or later, and when options and outcomes are uncertain
Week 3: Beyond rationality II – Deciding for and with others, and alternative motivations for behaviour
Week 4: Applications of behavioural health economics I: Lifestyle choices
Week 5: Applications of behavioural health economics II: Patient and physician decision-making
Week 6: Applications of behavioural health economics III: Preferences for health and wellbeing
Week 7: Behaviour change tools I: Regulation and (financial) incentives
Week 8: Behaviour change tools II: Nudging and boosting
Week 9: Challenges to promoting health and wellbeing: Cost-effectiveness and ethics
Week 10: Final exams and presenting interventions

Teaching methods

Each week will have several interactive lectures and working groups, in which students will work individually and in groups on cases specific to the learning goal of that week. For example, by analysing a specific health behaviour using the new knowledge covered in the lectures, or by debating positions on different policies for health behaviour change. Throughout the minor, students develop a portfolio that includes their weekly reflection on the covered material in various forms (e.g., short essay, slides, or vlog), a case analysis (of a health issue of their own choice) and the intervention they developed. The latter part of this portfolio is also presented to other students and teachers.

Teaching materials

The teaching materials will be a selection of journal articles and book chapters. Suggestions for additional reading (mainly popular science books) will be offered during the course. Several case studies are discussed during the working groups, and students can develop their own case and intervention during the final 5 weeks of the minor.

Method of examination

Students will be examined by means of a written exam (with a mix of multiple choice and essay questions), and through their portfolio. This portfolio is a document that is graded in three parts: 1) reflection exercises focused on the material that should be completed each week, 2) a case analysis for a specific unhealthy behaviour, and 3) a suggested intervention to promote behaviour change in the case selected for 2) including a presentation.

Composition final grade

The written exam and portfolio both comprise 50% of the grade (on a 1-10 scale). Each of the three parts of the portfolio comprises an equal part of that 50%. To pass this course, students need a weighted average grade of 5.5 or higher.

Participation in weekly working groups is not mandatory, but recommended to achieve the learning goals and successful completion of the weekly reflection in the portfolio.

Feedback

Students will receive regular feedback on their reflection questions, will be able to interact with the teachers during the interactive lectures and working groups, and will receive feedback on part 2 (case analysis) and 3 (intervention) of their portfolio during the minor.

Contact information

Arthur Attema & Stefan Lipman
Email: attema@eshpm.eur.nl / lipman@eshpm.eur.nl 
Telephone: 010-4089129 / 010-408 2507