Tuesday, May 23, 2023

On Prosocial Cuing

Saving another thread from twitter, this time it's a really short one from Dr. Lisa Iannattone:

"I'm a little confused at the 'making people feel bad about how their choices harm others is bad advocacy' takes. Didn’t we do that with smoking? Wasn’t the 'secondhand smoke kills' education campaign exactly that? Isn’t 'if you drive drunk you could kill someone' exactly that? Since when is it controversial to point out how our choices could harm other people? Some people seem to think advocacy should never make anyone feel uncomfortable… Do they really not realize that they’re out here shaming the oppressed for making their oppressors feel bad? We’ve created a system of structural violence against the immunocompromised, disabled, and clinically vulnerable. One that now extends to healthcare. We deserve to feel ashamed about it and we should always feel uncomfortable with perpetuating structural violence against others. . . . It's worthwhile to make people aware of the harm. Politicians will not enact change if they think it would be unpopular. So it's absolutely necessary to make everyday people want things to change for the better to have any hope of convincing the deciders to budge. 

I've written of the comparison with Covid and drunk driving and/or smoking a few times (list at the end). We'd never insist that getting lung cancer or getting hit by a car is everyone's individual responsibility. We understood collective action then, so why not now? We were able to ban indoor smoking once people understood the science of how second-hand smoke harms other people (and once a restaurant was successfully sued for a waitress's emphysema). You'd think we could all make the minimal adjustment necessary to grasp that exhaling a harmful virus, which we might have right now without any symptoms, is really harmful to other people in the room, so we should all wear a mask just in case. You'd think!

People don't like to be told what to do. I get that. But that's what happens in a civilization with laws to follow to enable us to better live communally. It's not about shaming people into action, but "prosocial cuing . . . framing messaging around preventing suffering to others" (h/t RevivalCare for this explanation and this study): 

"Authorities seem to have failed to find effective interventions for maintaining prosocial behavior during this or future health emergencies. . . . During collective emergencies, empathy is the basis for interpersonal cooperation and is triggered in the individual by stress. . . . When a person perceives the other as a 'stranger' or 'adversary' in a conflict, an intergroup effect may decrease the empathic response. . . . Bias in empathy eliciting has been found in social determinants, including outgroup and intergroup effect, prejudice and beliefs impact, and the physical/face attributes. Those biases are context dependent and should be considered with caution during stressful events because they could induce inequality in public health policy and interfere with collective decision-making. . . . . Not only affective and motivational empathy but also the cognitive dimension promote willingness to adhere to Covid-19 health policies. Beside individual risk perception a main motive identified by several studies for adhering to Covid-19 restrictive measures was protecting close relationships, including vulnerable categories. . . . 
Compassion is a valid predictor of prosocial behaviors even when the threat perceived by the individual does not necessarily concern them directly. . . . The positive role of empathy in sustaining adherence to public health norms suggests that this is a powerful driver for behavioral response to stressful events such as the current pandemic. Empathy is naturally activated in challenging situations but could decrease over time and lead to emotional exhaustion for individuals exposed to distress. An intertwined top-down and bottom-up psychological mechanism, including cognitive and affective skills, is needed to prevent such negative consequences." 

At this point, most people have likely already spread the virus unwittingly, and alerting them to that reality can be too uncomfortable to manage, forcing them to acknowledge they've caused some harm, but it's much better than letting people continue to cause harm to one another, right?!? It can feel bad, but we have to be held accountable for our actions and the effect we might have on others if we smoke indoors, drive drunk or negligently, or not wear a mask in public spaces while a sneaky virus is putting tons of people in the hospital, disabling 10% of them, and killing one in every thousand.

And a fun song to play us out - and check out this historic news footage that explains how drunk driving and seatbelt laws will turn us into a communist country:


Comparing preventing the spread of Covid-19 to preventing lung cancer from second hand smoke and accidents from drunk driving over the past three years:

June 2020 - On Policing: On Finding the Line - calling out about masks is like taking away car keys
July 2020 - On Laws and Common Sense - on risk assessment of masks and driving drunk
Aug. 2020 - Risk Assessment - masked room of non-masks - like being in the non-smoking section
June 2021 - Paranoid or Prescient? - leave people be who are masking (or driving sober)
March 2022 - On Masks, Ventilation, and Contact Tracing - our city was first to ban smoking
March 2022 - On Removing Mask Mandates - teachers can't smoke in class; ask friends if it's okay
March 2022 - Not Dead Yet! - we have to think of the virus like cigarette smoke
April 2022 - Masks Work - we're all at a greater risk if people drive drunk
May 2022 - So, Where are We Headed? - we're like early anti-smokers, watching people get sick
July 2022 - Covid and Climate Change - people don't like when you take away their car keys
Aug. 2022 - Strap One On for Safety! - on the need for PSAs for driving, smoking, masks...
Sept. 2022 - How Much Harm is Immoral? - on driving drunk vs sober
Sept. 2022 - Teachable Moments - it took a lawsuit in a restaurant to ban indoor smoking
Oct. 2022 - On Being a Bad Person - on making ethical decisions around drunk driving
Oct. 2022 - Campaigning on Covid - waitress won lawsuit for cancer from cigarette smoke
Dec. 2022 - Evidence on Both Sides - school's obligation to promote public health, safe driving
Jan. 2023 - Unmasked People, Unmasked in their Own Way - losing someone to a drunk driver

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