Can behavioral science help in Flint?
Sarah Stillman has a lengthy and interesting article in the New Yorker:
A week after Donald Trump’s election, a thirty-year-old cognitive scientist named Maya Shankar purchased a plane ticket to Flint, Michigan. Shankar held one of the more unorthodox jobs in the Obama White House, running the Social and Behavioral Sciences Team, also known as the President’s “nudge unit.” When she launched the team, in early 2014, it felt, Shankar recalls, “like a startup in my parents’ basement”—no budget, no mandate, no bona-fide employees. Within two years, the small group of scientists had become a staff of dozens—including an agricultural economist, an industrial psychologist, and “human-centered designers”—working with more than twenty federal agencies on seventy projects, from fixing gaps in veterans’ health care to relieving student debt. Usually, the initiatives had, at their core, one question: Could the growing body of knowledge about the quirks of the human brain be used to improve public policy?
For months, Shankar had been thinking about how to bring behavioral science to bear on the problems in Flint, where a crisis stemming from lead contamination of the drinking water had stretched on for almost two years. She wondered if lessons from the beleaguered city could inform the Administration’s approach to the broader threat posed by lead across America—in pipes, in paint, in dust, and in soil. “Flint is not the only place poisoning kids,” Shankar said.
In recent years, behavioral science has become a voguish field. In 2002, the Israeli psychologist Daniel Kahneman won a Nobel Prize in Economic Sciences for his work with a colleague, Amos Tversky, exploring the peculiarities of human decision-making in the face of uncertainty. (Their collaboration is the subject of a popular new book by Michael Lewis, “The Undoing Project: A Friendship That Changed Our Minds.”) A basic premise of the discipline they’d helped to create was that people’s cognition is bias-prone, and susceptible to the cognitive equivalent of optical illusions. As a result, small tweaks of presentation or circumstance could make a major difference: if a judge rendered a decision about granting parole just before a meal, the inmate’s odds for a favorable outcome dipped to near zero; just after the judge ate, the chances rose to around sixty-five per cent. Grocers had learned that they could sell double the amount of soup if they placed a sign above their cans reading “limit of 12 per person.”
But, for all the field’s potential, its advances seemed mostly to have served the private sector. (And there they often veered toward sly consumer coercion.) A prominent exception was the “nudge,” a notion advanced by the legal scholar Cass R. Sunstein, now at Harvard Law School, and the University of Chicago behavioral economist Richard Thaler, in their 2008 best-seller “Nudge: Improving Decisions About Health, Wealth, and Happiness.” They stressed the role of “choice architecture”: the countless factors that coalesce around a given decision, often shaping outcomes in crucial, if barely visible, ways that could be rearranged. Sunstein and Thaler described the concept with public policy very much in mind. The subtle context in which we make choices, they theorized, could and should be stacked in favor of the social good. In the public sector, this meant gently nudging citizens toward certain choices, through techniques like automatic enrollment and reminder prompts, that take into account the fact that most of us, as Thaler told me, are “more like Homer Simpson than like Albert Einstein.”
President Obama saw the appeal of the nudge. In 2009, he tapped Sunstein to head the most bureaucratic-sounding of bureaucracies, the Office of Information and Regulatory Affairs. During the next three years, Sunstein worked to bring behavioral insights into the government’s approach to policy. But the reach of these ideas remained limited. The nudge’s most appealing feature, its simplicity, was also among its constraints. Though the tweaks had vast potential implications, their small-bore design made it difficult to address the larger forces behind stubborn structural challenges. “We can’t take on some big problems, like climate change, and solve them entirely with nudges,” Thaler told me.
Shankar agreed, and, in her White House role, she wanted to test a wider range of tactics and delve deeper into problems. For the first two years, her team focussed mostly on programs that were narrowly defined, even though they could still affect thousands or millions of Americans: for instance, easing health-insurance enrollment, or helping veterans access education benefits. But Shankar was eager to see how her team might weigh in on more systemic, seemingly intractable problems associated with inequality, from homelessness to racial bias in policing. Flint seemed like a good place to find out. The city’s water crisis was tied up in deeply entrenched, even multigenerational, issues: “its racial history, its socioeconomic circumstances, all of it,” Shankar told me. Early last year, the team began gathering research relevant to Flint, drawing, in part, from public-health scholarship. In October, she and a colleague, an economist named Nate Higgins, visited the city for the first time, in conjunction with the Environmental Protection Agency, to ask residents about their evolving needs.
Then, on November 8th, Donald Trump was elected. For days, Shankar walked around shell-shocked. Her team, if it even continued to exist in the new Administration, would soon belong to one of the most anti-science President-elects in history, who has called climate change a “hoax,” spread unproven claims about vaccinations’ ties to autism, and mocked new brain-science-backed N.F.L. guidelines to prevent concussions, saying that football has grown “soft.”
In 2010, the United Kingdom became the first country to set up a government office devoted solely to making use of behavioral science. Backed by the new Conservative government, a hodgepodge crew of social scientists, psychologists, and data nerds, calling themselves the Behavioural Insights Team, tried to find opportunities for government savings and other improvements through simple tweaks. People were less tardy with their taxes, for instance, when they were shown that most of their neighbors paid on time. Many of the British team’s projects aimed to use behavioral research for social uplift. In one, it conducted a randomized controlled trial to determine which of eight different prompts was most effective in soliciting participation in organ donation. (The winning message: “If you needed an organ transplant would you have one? If so please help others.”)
More recently, the team addressed British doctors’ overprescribing of antibiotics, contacting outliers who’d written prescriptions at the highest rates. The letter it sent did little more than note the recipient’s status on the far end of the statistical spectrum, but the prescription rates dropped by three per cent during the next six months. Some critics dismissed such accomplishments as overhyped fluff; others warned of a rising nanny state. Even the team’s guiding mantra—“Make It Easy, Attractive, Social and Timely”—could be seen as nothing more than common sense.
Shankar got interested in the field as a teen-ager. The daughter of Indian immigrants, she once thought she’d become a classical violinist. (For several years, she was taught by Itzhak Perlman.) A hand injury derailed her musical aspirations, and, while recovering at home, in Connecticut, she happened upon a book by the psychologist Steven Pinker and became enamored of cognitive science. As a undergraduate at Yale, she conducted research on primates, travelling to a tropical island to study rhesus macaques, with the aim of mapping a feature of cognition known as “essentialism”: “Does a monkey know what makes a coconut a coconut, and an apple an apple?” (On the island, she learned to dodge monkey urine from the tree canopy overhead; the macaques carried a version of herpes B that could be lethal to humans.) Later, as a Rhodes Scholar and doctoral student at Oxford, she visited a famous flavor factory in Ohio, where she tested whether she could hijack the sensory perceptions of professional flavorists: giving them a lime-tinted beverage, say, that had the taste of tangerines.
After Shankar did her postdoctoral research, at Stanford’s Decision Neuroscience Lab, she began looking for a job. In the field of cognitive science, many of the opportunities for an aspiring researcher were of a particular type, geared toward helping to make big companies richer, or rich people thinner, or thin people more alluring on algorithm-based dating sites. Behavioral science’s bro-culture adaptations—the life hack, the quantified self—had proliferated. Shankar worried about her next steps. She didn’t want to spend her life in a suit, or in a lab, or on a remote island, dodging monkey excretions.
One day in 2012, she flew from California to a friend’s wedding in Connecticut. While there, she had tea with her college mentor, the Yale psychologist Laurie Santos. “I feel like the job I want doesn’t even exist,” Shankar told her. She added, sheepishly, “I guess I’ll go into consulting?”
Santos mentioned that she’d just returned from a conference, where she’d heard about the Department of Agriculture’s efforts to put behavioral science into practice to aid children from low-income families. Through a small nudge—a government initiative that automatically enrolled kids in free federal school-lunch programs, by simply cross-checking their eligibility for preëxisting Supplemental Nutrition Assistance Program (snap) benefits—hundreds of thousands of children were fed, without the shame and the bureaucratic hassle that kept parents from signing them up.
The idea that a minor government modification could decrease a child’s hunger—and perhaps, in turn, improve his or her trajectory in school—stuck with Shankar. It was simple, even obvious, as the best behavioral insights often are. Later, she learned that the Department of Agriculture supported a whole slew of behavioral projects. One, conducted by Cornell University’s Food and Brand Lab, found that if school cafeterias rebranded plain vegetables with catchy names—X-Ray Vision Carrots, say, or Power Punch Broccoli—consumption soared.
Shankar felt that she’d found her path. She reached out to Sunstein, who had returned to Harvard, and asked if he knew of any openings in government. He gave her the name of a contact at the White House Office of Science and Technology Policy. Shankar sent what seemed like a long-shot pitch to the deputy director, Tom Kalil, to join the office and find ways to weave behavioral insights into the heart of public policy. They met, and, to her surprise, Kalil hired her as a senior science adviser. Shankar was twenty-six.
She moved to Washington, D.C., in early 2013, leaving her bike and her books in California, “in case things didn’t work out.” Even before her new job began, she e-mailed Kalil with the outlines of a broader aspiration. “One of my more ambitious, longer-term goals,” she wrote, “is to begin laying down the foundation for the creation of a U.S.-based behavioral insights team.”
By the start of 2014, with guidance from some of the field’s big names, Shankar had recruited her first five experts from academic institutions and nonprofits. They began working closely with a growing list of agencies, including the Departments of Veterans Affairs, Agriculture, and the Treasury.
That year, the team sought to put together small collaborations that could garner quick results. It formed a partnership with the Department of Education and a nonprofit, uAspire, to find a way to lessen “summer melt.” Typically, twenty to thirty per cent of students in urban districts who were accepted to college didn’t matriculate, owing to last-minute burdens like financial-aid deadlines. The team helped devise a pilot program in which students were sent eight personalized text messages over the summer, prompting them to follow through. Matriculation rates increased by several percentage points. Shankar’s group offered to help other agencies with similar tweaks, to facilitate microloans to farmers, or to reduce the overprescribing of antipsychotics and other drugs by Medicare providers.
Then, on September 15, 2015, President Obama gave the team the ultimate nudge: an unusual Executive Order, titled “Using Behavioral Science Insights to Better Serve the American People.” It formalized the team as an official entity, and urged all federal agencies to “develop strategies for applying behavioral science insights to programs and, where possible, rigorously test and evaluate the impact of these insights.”
Four months later, the President declared a state of emergency in Flint. Shankar saw her chance to test the mandate’s reach. . .