Atin Roy
Health
Five Cognitive Biases That Affect Health and Wellbeing

This article was written by Atin Roy, Senior Vice President of Health and Wellness at Ogilvy India and first published on ET BrandEquity.

Cognitive biases lead to creation of what is known as ‘subjective reality’. Soon this subjective reality, as against objective inputs, begins to dictate human behavior. Often a result of human nature, these biases form against a thing, subject, or a person. For example, the anti-vaccination sentiments during the covid19 pandemic despite enough scientific and real-world evidence of the
vaccine’s efficacy and safety.

(Image — iStock)

By the end of 2022, the human population on Earth is all set to cross the eight billion-mark. Never before, in its entire four-and-a-half billion-year history, have so many human beings existed together on our planet. However, what’s surprising is that during their lifetimes, the way all these human beings will think, act and behave will be remarkably similar. It may seem counterintuitive especially in this era of hyper-individualism where everyone wants to be ‘different’. Yet behavioural scientists have observed several common automatic and unconscious thinking patterns that characterize thinking and behaviours in nearly all human beings.

These thinking patterns or Cognitive Biases as they are called, arise from deep within the self-preserving human brain, shaped by the evolving human environment and belief systems. Cognitive Biases have a direct impact on human interactions and often dictate the way we take decisions, buy things, spend money, and live our lives.

What is a Cognitive Bias?

A Cognitive Bias is defined as a subconscious error in thinking that may lead us to misinterpret information around us and affects the rationality and accuracy of our decisions. They stem from the brain’s efforts to simplify the complex world we live in. In order words, these biases are mental short-cuts (or heuristics) conjured up by our brains to make decision-making faster.

Cognitive biases lead to the creation of what is known as ‘subjective reality’. Soon this subjective reality, as against objective inputs, begins to dictate human behavior. Often a result of human nature, these biases form against a thing, subject, or a person. For example, the anti-vaccination sentiments during the COVID-19 pandemic despite enough scientific and real-world evidence of the vaccine’s efficacy and safety.

Five Cognitive Biases that Affect Health & Wellbeing

Nothing is more important to a human being than health & well-being. Yet, certain cognitive and other cultural biases can impede the access to life-saving health and well-being measures.

Because of these biases, very often the right audience does not accept the required interventions, leading to increased disease and death burden that could easily have been prevented. Although more than 180 cognitive biases have been documented by behavioural scientists, five of those have been mapped below across a typical patient journey to illustrate how these biases can affect knowledge, access and treatment.

1. The Ostrich Effect – “It will never happen to me.”

The Ostrich Effect is a cognitive bias that states that people avoid negative information, including health watch outs. We comfortably bury our heads when we come across public health messages starting from wearing seat belts to avoid accidental health to ill-effects of smoking or drinking or even TB or Cancer signs.

Often cultural conditioning forms a big part of this bias. For example, women play the role of caretaker of the family and in doing so often put themselves last. They slight away any health related warning signs saying “Ah, it’s nothing!”. That’s why a lot of serious yet preventable ailments like breast cancer are usually diagnosed at a much later and severe stages because most women do not prioritise their health monitoring and advice-seeking.

2. Status Quo Bias – “It will get better on its own.”

The Status Quo Bias states that human beings have a preference to continue in the current state or have a preference not to undertake any action. Most people do not pay heed to small health niggles until they become really painful or difficult to tolerate. They fail to realise that these small signs may be precursors to larger red flags when it comes to health and should immediately be reported.

Even when people observe symptoms that they may have been warned about, say, a cough that lasts more than 2 weeks could be TB, they procrastinate and wait believing it will cure itself. This is the reason why most TB cases are reported later, during more severe stages and lead to complications and even death.

3. Stereotyping Bias – “Doctors want to only make money from us.”

Even though the patient may overcome the above two biases, and seek doctor’s advice, there is the Stereotyping Bias that kicks in. The Stereotyping Bias states that people tend to attribute particular qualities to a member of a certain group. The perception of doctors has undergone a change. Earlier doctors were looked upon as next only to God. While they are still highly respected and revered in society, there are doubts that patients have started to harbour commercial interests that doctors may have. This has led to a common perception of “doctors write expensive medicines or many tests only to generate more money for themselves.” This stereotyping bias often leads to ‘silent quitting’ of diagnostic tests or discontinuation of treatment, thus posing a threat to the patient’s health.

4. Anchoring Effect – “I feel better, let’s stop the medication.”

Let’s say the patient has come further in his or her journey and decided to continue with the treatment. As the medicines start to take effect, the patient begins to succumb to the Anchoring Effect. The Anchoring Effect states that an individual’s decision is influenced by the first point of information offered or reference point/‘anchor’.

In this case, the patient feels signs of relief and concludes that he or she is cured not realising that the ailment may still exist in subdued manner and the medications course needs to be fulfilled for full treatment.

This is the leading cause behind the looming Global Antimicrobial Resistance (AMR) Crisis because as people do not complete their prescribed antibiotic courses, the infection causing microbes are not completely terminated. Instead they grow resistance to the microbials and become immune to treatment.

5. Licensing Effect – “I have had my meds. So let’s party!”

Often patients after confirming with the treatment feel invincible and forget to properly adhere to management requirements. This is called the Licensing Effect which states that patient’s think it’s ok to do something “not allowed” since they have already “complied with the
prescribed action.”

This is observed in chronic patients like newly-diagnosed people with diabetes etc., where they are required to adhere to a disease management regime that includes diet, exercise etc. Many patients forgo exercise because they think they are already adhering to the medicine and the diet, so activity is not important. Leading to further aggravation of their condition.

And the List Doesn’t End Here

Apart from the ones mentioned above, there may be several biases that human beings experience, especially in the context of their health. For example, Ambiguity Bias which states that human beings instinctively avoid situations in which there is uncertainty. That’s why a
lot of people skip their regular annual health check-ups to avoid being detected with a particular disease.

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