Public reaction to government policies is often an afterthought as it can be difficult to predict and control. Investigations from behavioral economists regarding public health concerns during the pandemic show that these reactions could be anticipated and even incorporated into how policies are written and communicated.
Many facets of the pandemic have been intangible for lawmakers and public health officials, particularly regarding public reaction to new policies and mitigation efforts. Dr. Mario Macis of the Carey Business School is an economist, previously working at the intersection of economics and psychology. With the onset of the COVID-19 pandemic, he added a public health focus to his research, studying the forces that drive behavior in the midst of this unprecedented public health crisis. As someone working at the crossroads of multiple fields, Dr. Macis believes that the best path forward to prevent or address future health crises is one of collaborative data collection and analysis that incorporates predictors of individual behavior.
Throughout this pandemic, I have performed three main COVID-related studies: (1) a survey-based study on people's willingness to comply with stay-at-home measures in Italy, as a function of their expectations about the duration of the measures; (2) an investigation of people's willingness to share information about preventive behaviors in Zambia to understand if we could leverage people's contacts and peer networks to spread information about recommended preventive behaviors; and (3) an assessment of people's reaction to price surges following sudden increases in demand in the United States and Canada, particularly for health-related goods during emergency situations.
The common theme is that it's important to understand people's psychology and reactions to what happens during a pandemic — how they respond to both policy interventions and market forces, to inform current policy and be better prepared for future pandemics. We need to incorporate insights from multiple disciplines to make sense of people's reactions, but also to inform public intervention.
We cannot ignore data about individual behavior when dealing with policy. Taking the example of my work on people's intentions to comply with stay-at-home measures, we found that people's expectations matter and that handling expectations is as critical as deciding what the actual policy will entail. If leaders tell people that a lockdown will last for three weeks, then extend it without having initially acknowledged that the lockdown duration is subject to change according to the current public health data, that negative surprise extension can reduce people's willingness to comply with the measures, possibly jeopardizing the efficacy of the policy.
I've seen other areas where a gap between expectations and reality created a conflicting message that affected people's propensity to do what they were asked to do by public authorities. In fall 2021, the recommendation from health authorities was that healthy adults did not need a vaccine booster. Then, months later, the message became that boosters are essential to prevent severe symptoms, hospitalization, and death. Some people perceived this change as contradictory. We continue to learn from studies, improve our understanding, revise our recommendations accordingly, but the public doesn't necessarily understand that. Public health authorities need to do a better job communicating uncertainty and the self-correcting nature of data-based advice.
We work with professional survey firms to obtain representative samples of the relevant population to get a reasonably unbiased picture of a certain group. We design the surveys to collect information in ways that minimize biases like social desirability bias, which is when participants feel that there is a right or wrong way to answer a survey question, and then give us what they think is the right answer.
Another technique is to introduce incentivized choices into a survey. Incentivized choices typically come with a monetary reward that creates real stakes for the respondent. Then, you look at the results from the incentivized choice and see if people's behavior is consistent with their responses to the hypothetical questions from before. We found that people actually put their money where their mouth is and reject financial rewards when they go against their personal beliefs. In the U.S. and Canada study on price gouging and price controls, we offered participants an extra dollar on the condition that the study would then also donate a dollar to an organization promoting unfettered markets. People who wanted price controls to avoid price gouging consistently rejected the extra dollar to support this organization that has beliefs contrary to their own. I believe our survey results, in part, because of this additional evidence from an incentive-compatible device.
The former director of the National Institutes of Health, Dr. Francis Collins, in his farewell speech, made a direct reference to the need for public health authorities to understand behavior better. He's right. It's not just about the science. Obviously, science is critical, but we've seen in the U.S. that good science does not always translate to behavioral changes. For example, widespread vaccine availability did not correspond with high uptake in many states. Our governments have finally realized that large-scale pandemics can happen, despite several previous wake-up calls that were not sufficient to induce our governments to take bold action. This pandemic, which is not over, could happen again. We were surprised this time, but if we are again surprised in the next pandemic, that's inexcusable.
There are non-pandemic challenges where economics — and behavioral economics in particular — can play a big role, such as climate change. The market alone is not going to address it, and the government alone is not going to address it. Governments and the private sector will have to work together, similar to what some countries have done to promote the development of COVID-19 vaccines. We need large-scale behavioral changes driven by policy and markets for the type of impact that we need. We have to collect data to understand what motivates people to adopt certain behaviors, but we also need to assess the incentives of people in corporations and be prepared to use standard economic tools like taxes in addition to behavioral nudges. We need to understand where the market fails, and therefore where government intervention is needed to address these issues with a mixture of price and behavioral interventions. I hope that these conversations and contributions will not fade into the background because we could face similar challenges and the government and the private sector will need to work together.