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How public health policy can be informed by neuroscience

  • ANDREW B. WOLF (a1) (a2) and GIDON FELSEN (a1) (a2) (a3)

Abstract

Many public policies are designed to counteract commonly made decisions that result in poor health. These policies have primarily been informed by the behavioural economics of decision making. Underappreciated in this conversation has been the perspective from neuroscience, despite its recent success – and the likelihood of future progress – in advancing our understanding of the neural basis for health-related decisions. Using tobacco control as an example, we provide a concise overview of how public health policies can and should be informed by neuroscience. We propose that such input can improve policies by increasing their effectiveness, improving screening efficiency and informing relevant ethical considerations. Finally, we recognise limitations and highlight roles that key stakeholders can play in incorporating neuroscientific evidence for the benefit of public policy.

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Copyright

Corresponding author

*Correspondence to: Department of Physiology and Biophysics, University of Colorado School of Medicine, 12800 E. 19th Ave., Aurora, CO 80045, USA. Email: gidon.felsen@ucdenver.edu

References

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Ariely, D. (2008), Predictably Irrational: The hidden forces that shape our decisions, New York: Harper Press.
Azagba, S. and Sharaf, M. F. (2013), ‘The effect of graphic cigarette warning labels on smoking behavior: evidence from the Canadian experience’, Nicotine & Tobacco Research, 15(3): 708717.
Behavioural Insights Team. (2010), Applying behavioural insight to health. UK Cabinet Office. Available from: https://www.gov.uk/government/publications/applying-behavioural-insight-to-health-behavioural-insights-team-paper
Berman, M. L. and Kim, A. E. (2015), ‘Bridging the gap between science and law: the example of tobacco regulatory science’, Journal of Law, Medicine, & Ethics, 43(s1): 9598.
Blumenthal-Barby, J. S. and Burroughs, H. (2012), ‘Seeking better health care outcomes: the ethics of using the “nudge”, The American Journal of Bioethics, 12(2): 110.
Bode, S., Murawski, C., Soon, C. S., Bode, P., Stahl, J. and Smith, P. L. (2014), ‘Demystifying “free will”: The role of contextual information and evidence accumulation for predictive brain activity’, Neuroscience & Biobehavioral Reviews, 47: 636645.
Bovens, L. (2009), ‘The Ethics of Nudge’, in Grüne-Yanoff, T. and Hansson, S. O. (eds), Preference Change, Volume 42, Netherlands: Springer, 207219.
Brewer, N. T., Hall, M. G., Noar, S. M., Parada, H., Stein-Seroussi, A., Bach, L. E., Hanley, S. and Ribisl, K. M. (2016), ‘Effect of pictorial cigarette pack warnings on changes in smoking behavior: a randomized clinical trial’, JAMA Internal Medicine, 176(7): 905912.
Christman, J. (2009), The Politics of Persons: Individual Autonomy and Socio-historical Selves, Cambridge: Cambridge University Press.
Cohen, A. and George, O. (2013), ‘Animal models of nicotine exposure: relevance to second-hand smoking, electronic cigarette use, and compulsive smoking’, Frontiers in Psychiatry, 4: 41.
Custers, R. and Aarts, H. (2010), ‘The unconscious will: how the pursuit of goals operates outside of conscious awareness’, Science, 329(5987): 4750.
De Martino, B., Kumaran, D., Seymour, B. and Dolan, R. J. (2006), ‘Frames, biases, and rational decision-making in the human brain’, Science, 313(5787): 684687.
Dworkin, G. (1988), The Theory and Practice of Autonomy, Cambridge: Cambridge University Press.
Euston, D. R., Gruber, A. J. and McNaughton, B. L. (2012), ‘The role of medial prefrontal cortex in memory and decision making’, Neuron, 76(6): 10571070.
Falk, E. B., O'Donnell, M. B., Tompson, S., Gonzalez, R., Cin, S. D., Strecher, V., Cummings, K. M. and An, L. (2016), ‘Functional brain imaging predicts public health campaign success’, Social Cognitive and Affective Neuroscience, 11(2): 204214.
Farah, M. J., Illes, J., Cook-Deegan, R., Gardner, H., Kandel, E., King, P., Parens, E., Sahakian, B. and Wolpe, P. R. (2004), ‘Neurocognitive enhancement: what can we do and what should we do?’, Nature Reviews Neuroscience, 5(5): 421425.
Felsen, G., Castelo, N. and Reiner, P. B. (2013), ‘Decisional enhancement and autonomy: public attitudes towards overt and covert nudges’, Judgment and Decision Making, 8(3): 202213.
Felsen, G. and Reiner, P. B. (2011), ‘How the neuroscience of decision making informs our conception of autonomy’, The American Journal of Bioethics – Neuroscience, 2(3): 314.
Felsen, G. and Reiner, P. B. (2015), ‘What can neuroscience contribute to the debate over nudging?’, Review of Philosophy and Psychology, 6(3): 469479.
Frankfurt, H. G. (1971), ‘Freedom of the Will and the Concept of a Person’, The Journal of Philosophy, 68(1): 520.
Gabrieli, J. D. E., Ghosh, S. S. and Whitfield-Gabrieli, S. (2015), ‘Prediction as a humanitarian and pragmatic contribution from human cognitive neuroscience’, Neuron, 85(1): 1126.
Gold, J. I. and Shadlen, M. N. (2007), ‘The neural basis of decision making’, Annual Review of Neuroscience, 30: 535–74.
Grüne-Yanoff, T. (2012), ‘Old wine in new casks: libertarian paternalism still violates liberal principles’, Social Choice and Welfare, 38(4): 635645.
Grüne-Yanoff, T. (2016), ‘Why behavioural policy needs mechanistic evidence’, Economics & Philosophy, 32(3): 463483.
Hansen, P. G., Skov, L. R. and Skov, K. L. (2016), ‘Making healthy choices easier: regulation versus nudging’, Annual Review of Public Health, 37(1): 237251.
Heekeren, H. R., Marrett, S. and Ungerleider, L. G. (2008), ‘The neural systems that mediate human perceptual decision making’, Nature Reviews Neuroscience, 9(6): 467479.
Jamal, A., Homa, D. M., O'Connor, E., Babb, S. B., Caraballo, R. S., Singh, T., Hu, S. S. and King, B. A. (2015), ‘Current cigarette smoking among adults — United States, 2005–2014’, Morbidity and Mortality Weekly Report, 64(44): 12331240.
Jones, O. D. (2014), ‘Why behavioral economics isn't better, and how it could be’. Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2504776
Jung, M. (2016), ‘Implications of graphic cigarette warning labels on smoking behavior: an international perspective’, Journal of Cancer Prevention, 21(1): 2125.
Kahneman, D. (2011), Thinking, Fast and Slow, New York: Farrar, Straus, and Giroux.
Karmarkar, U. R. and Yoon, C. (2016), ‘Consumer neuroscience: advances in understanding consumer psychology’, Current Opinion in Psychology, 10: 160165.
Levy, D. J. and Glimcher, P. W. (2012), ‘The root of all value: a neural common currency for choice’, Current Opinion in Neurobiology, 22(6): 10271038.
Loewenstein, G., Asch, D. A., Friedman, J. Y., Melichar, L. A. and Volpp, K. G. (2012), ‘Can behavioural economics make us healthier?’, BMJ, 344: e3482.
Marteau, T. M., Ogilvie, D., Roland, M., Suhrcke, M. and Kelly, M. P. (2011), ‘Judging nudging: can nudging improve population health?’, BMJ, 342(3): 263265.
Marteau, Theresa M., Hollands, G. J. and Fletcher, P. C. (2012), ‘Changing human behavior to prevent disease: the importance of targeting automatic processes’, Science, 337(6101): 14921495.
Noar, S. M., Hall, M. G., Francis, D. B., Ribisl, K. M., Pepper, J. K. and Brewer, N. T. (2015), ‘Pictorial cigarette pack warnings: a meta-analysis of experimental studies’, Tobacco Control, 25(3): 341354.
O'Connor, C., Rees, G. and Joffe, H. (2012), ‘Neuroscience in the public sphere’, Neuron, 74(2): 220226.
Seymour, B. and Vlaev, I. (2012), ‘Can, and should, behavioural neuroscience influence public policy?’, Trends in Cognitive Sciences, 16(9): 449451.
Sharot, T. (2012), The optimism bias (Presentation). Available from: https://www.ted.com/talks/tali_sharot_the_optimism_bias
Sharot, T., Korn, C. W. and Dolan, R. J. (2011), ‘How unrealistic optimism is maintained in the face of reality’, Nature Neuroscience, 14(11): 14751479.
Sunstein, C. R. (2015), ‘The Ethics of Nudging’, Yale Journal on Regulation, 32(3): 413450.
Thaler, R. H. and Sunstein, C. R. (2008), Nudge: Improving decisions about health, wealth, and happiness, New Haven: Yale University Press.
Tom, S. M., Fox, C. R., Trepel, C. and Poldrack, R. A. (2007), ‘The neural basis of loss aversion in decision-making under risk’, Science, 315(5811): 515518.
Wang, A.-L., Lowen, S. B., Romer, D., Giorno, M. and Langleben, D. D. (2015), ‘Emotional reaction facilitates the brain and behavioural impact of graphic cigarette warning labels in smokers’, Tobacco Control, 24(3): 225232.
Weisberg, D. S., Keil, F. C., Goodstein, J., Rawson, E. and Gray, J. R. (2007), ‘The seductive allure of neuroscience explanations’, Journal of Cognitive Neuroscience, 20(3): 470477.
Whelan, M. E., Morgan, P. S., Sherar, L. B., Orme, M. W. and Esliger, D. W. (2017), ‘Can functional magnetic resonance imaging studies help with the optimization of health messaging for lifestyle behavior change? A systematic review’, Preventive Medicine, 99: 185196.
White, M. D. (2013), The Manipulation of Choice: Ethics and Libertarian Paternalism, Palgrave Macmillan.

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