The following is the opinion and analysis of the writers:
Nearly 50% of health disorders derive from behavior, although it may seem closer to 100% at present, given the current pandemic.
Clinicians, scientists and teachers of medicine are well aware of the challenges for people to make decisions to behave in ways that improve health and decrease illness.
Why are we so challenged with decision-making?
According to Nobel Prize winners Daniel Kahneman and Richard Thaler, challenges include our tendencies to place higher value on near–term rewards (food, pleasure, toilet paper) at the expense of later obesity, addiction and empty store shelves.
We come by this honestly from our ancestors; not only do we learn that “a bird in the hand is worth two in the bush;” we become avid bird collectors in times of stress. It seems we are also more sensitive to loss than to gain; we are often loath to change the status quo, and we hold on tenaciously to what we have.
We are challenged to assess risk accurately; we have issues with understanding probability. Uncertainty raises the specter of danger, again fueled by ancient emotions.
For better or for worse, in sickness and in health, we are social creatures. Given limitations on time, energy and cognition, we look to others for information and resources that we do not readily have ourselves. While we benefit from being part of a larger group, we pay prices as well, as our global and local intersections reveal.
We are sensitive to the ways in which situations are framed: “Keep your distance so that you and others are safe” rather than “exclude others from the group.”
What is to be done?
We can spend some time zooming out, taking a larger perspective, taking care. There is ample evidence that we make better decisions when we are fed, rested, safe, healthy and undistracted. Given our tendencies to avoid losses and to misunderstand risk, we can be alert to the effects of a sense of the “negative unknown” on both our decisions and the decisions of others.
To paraphrase the historian Jon Meacham, there are three priorities in human life:
Curiosity is what draws many of us into science. We can use our collective and individual skills to make discoveries and innovations to address new challenges so that we are all better off, and have time and opportunity to play and create.
Humility. There is much we do not know: our instruments can sample less than 5% of the universe. There is noise and luck and randomness, which can affect any of us.
Empathy. We care about each other. We are all affected by the uncertainty, and the potential and real harms we are experiencing. Notice how much emotion affects our, and others’, decisions, and make appropriately generous allowances.
Thank you to all who are doing what you do well: people in health care for assessing, triaging, advising, treating and teaching; all of us for caring, and for modeling our care for each other.
Let’s keep ourselves and others away from cliff edges, and guide each other to the safety that allows us to live and work together well. Perhaps we will figure out even better ways to do this, as a result of this profound challenge.
Kathryn Reed is professor emeritus in the Department of Obstetrics and Gynecology, University of Arizona.
Erin Harvey, Ph.D., is an associate professor in the Department of Ophthalmology and Vision Science at the UA.
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