What’s Different About Designing For Health?

A question I’ve been thinking about more recently is, what makes health behavior change so special? And surprisingly enough for someone who’s spent over a decade focusing on health behavior change, I think the answer is: It’s not. The more I explore other behavior change challenges, the more I see that designing for health isn’t  really different from other types of behavior change interventions.

Think about three other areas where behavior change can be critical:

  • Education: Learning new information or skills, particularly as part of a structured program with a specific goal such as a degree or certification
  • Finance: Planning for future financial security, including saving money for emergencies, investing for retirement, and planning for short- and long-term goals
  • Safety: Being alert to risks in the workplace or while operating machinery such as a car, understanding how to minimize or avoid those risks, and taking appropriate precautions when a risk is encountered

All of these areas have several key characteristics in common with health.

They involve a long-term outlook or a distant goal. Whether it’s stepping through lessons and coursework en route to a degree, managing money to achieve a dream, or exercising caution to avoid injury, the ultimate aim of each type of intervention exists months or years in the future.

They require cutting out immediate actions that feel good but don’t help achieve the long-term goal. Students need to exercise the discipline to complete assignments even when a more fun task awaits. Someone saving money for a goal may need to eschew impulse purchases. A new driver has to learn to avoid the lure of the phone while controlling a car. Immediate pleasures take a back seat to the long-term goal.

They involve complicated topics that most laypeople don’t fully understand. By the nature of education, students enter the situation without a full understanding of the topic. Finances can be incredibly complex; not many people understand the details of investment vehicles or tax codes. And while on the face of it good safety practices may seem self-evident, that’s not always the case; understanding the many potential risks and mitigation strategies on a construction site or the highway requires dedicated study and practice.

They take place within social institutions (such as schools and banks) that are difficult to navigate and not transparent to outsiders.  With health behavior change, the complications of insurance, provider networks, and healthcare systems add another layer to an already difficult challenge. We’re exposed to schools from a young age, but the path from preschool through higher education is not a smooth or clear one for many students. Financial institutions, like health systems, are governed by dense webs of legislation and have multiple specialist departments that don’t interact in obvious ways. Safety behaviors have an edge here, because as tough as they can be, they don’t usually happen within the confines of an institution.

After reviewing the evidence, I have to conclude that health behavior change isn’t so special after all. Critical, yes; fascinating, for sure; but different? Not very.