Thanks Steve. Lots.
I'm sorry to keep this string running and I promise this is the last from me for a while, but the cognitive psychology drives so much yet is rarely discussed.
In the UK, at a local or national level, commissioners of health services have a tough time portraying the importance of a population perspective versus the needs of an individual, or indeed a group with a single condition. Ash will testify if required!
Patients, individual clinicians and reporters are all humans and at least a good chunk of the difficulties encountered by commissioners when trying to make their case are because such individuals, and the rest of the population who read about such decisions in the newspapers or see them on TV, are cognitively hard-wired to respond to the distress of individuals, and are less susceptible to the needs of an unspecified population for just the reasons Steve writes about.
I'm reluctant to extrapolate to the health care reform debate in the US, but doesn't some of the stuff I read about the opposition attitudes have at least a partial basis in human nature?
After all, its not likely that the clinicians making a strident case for their patients to get new expensive medicines (ignoring the wider population needs and the reality of finite health budgets) are all unintelligent, lazy, bad or mad. It's MUCH more likely that they are human beings and that their behaviour is better understood within that paradigm.
Bw
Neal
Neal Maskrey
NPC
Liverpool UK
----- Original Message -----
From: Evidence based health (EBH) <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Sent: Tue Dec 15 15:57:28 2009
Subject: Re: using beliefs and narratives to bolster uptake
I am currently reading "Half the Sky: Turning Oppression into
Opportunity for Women Worldwide" by Sheryl WuDunn, and one of the quotes
on page 99 seemed relevant to this discussion.
> Frankly, we hesitate to pile on the data, since even when numbers are
> persuasive, they are not galvanizing. A growing collection of
> psychological studies show that statistics have a dulling effect,
> while it is individual stories that move people to act. In one
> experiment, research subjects were divided into several groups, and
> each person was asked to donate $5 to alleviate hunger abroad. One
> group was told the money would go to Rokia, a seven-year-old girl in
> Mali. Another group was told that the money would go to address
> malnutrition among 21 million Africans. The third group was told that
> the donations would go to Rokia, as in the first group, but this time
> her own hunger was presented as part of a background tapestry of
> global hunger, with some statistics thrown in. People were much more
> willing to donate to Rokia than to 21 million hungry people and even
> a mention of the larger problem made people less inclined to help
> her.
>
> In another experiment, people were asked to donate to a $300,000 fund
> to fight cancer. One group was told that the money would be used to
> save the life of one child, while another group was told it would
> save the lives of eight children. People contributed almost twice as
> much to save one child as to save eight. Social psychologists argue
> that all this reflects the way our consciences and ethical systems
> are based on individual stories and are distinct from the part of our
> brains concerned with logic and rationality. Indeed, when subjects in
> experiments are first asked to solve math problems, thus putting in
> play the parts of the brain that govern logic, afterward they are
> less generous to the needy.
I wrote a brief article about this quote for a wiki publication, Chance
News, and also included the Joseph Stalin quote:
> A single death is a tragedy. A million deaths is a statistic.
http://chance.dartmouth.edu/chancewiki/index.php/Chance_News_58
See item #9, Statistics make you stingy.
--
Steve Simon, Standard Disclaimer
Two free webinars coming soon!
"What do all these numbers mean? Odds ratios,
relative risks, and number needed to treat"
Thursday, December 17, 2009, 11am-noon, CST.
"The first three steps in a descriptive
data analysis, with examples in PASW/SPSS"
Thursday, January 21, 2010, 11am-noon, CST.
Details at www.pmean.com/webinars
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