Healthier decisions. Nudges

Abstract

This paper intends to raise the potential interest that the principles and experiences of the so-called behavioral economy have in the field of public health and, more specifically, in behavioral changes, thus substituting harmful behaviors to health for salutogenic behaviors while respecting the final freedom of choice of the person. In this article, we review the foundations of behavioral economics, emphasizing the work of Tversky and Kahneman and their approach to prospective theory and the role of brain activity levels 1 (automatic) and 2 (reflective) in decision making process. On the basis of these approaches, Thaler and Sustein identify a series of biases that will be used as tools to facilitate behavioral changes through a set of actions “that modify people’s behavior in a predictable way without prohibiting any option or significantly changing their economic incentives” based on the so-called libertarian

paternalism. We review its interest in public health, citing some empirical studies that demonstrate its high level of effectiveness and efficiency, reflected in the creation of Nudge Units in various countries, and concluding that this can be an interesting tool to add (not to replace) the classical techniques of health promotion and disease prevention.