Learning from Public Health about Behavior Change
CEE intern Emmy Waldhart is a graduate student in the Environmental Health program at the University of Minnesota School of Public Health. Her focus is on policy and risk assessment and she’s interested in the relationship between energy and public health. Prior to graduate school, she worked as the assistant recycling coordinator at the University of Tennessee-Knoxville, where she implemented and managed various programs to improve recycling rates. Emmy holds a B.A. in Psychology and a minor in Conservation and Environmental Sciences from the University of Wisconsin-Milwaukee. In this post, she describes how energy efficiency initiatives could adopt and modify behavior change strategies from public health campaigns.
When it comes to changing behavior, the field of public health has produced some notable successes. Consider the decline in smoking rates. From 1965 to 2009, smoking rates have decreased drastically in the US adult population, by more than one half (from over two out of five people who smoke to under one in five). Anti-smoking campaigns contributed to this decrease by making use of media, labeling on products, and the tobacco tax. For those of us trying to change energy use behaviors among the public, we need to answer the question: “what makes public health campaigns successful in changing behaviors?”
The Five Strategies to Change Behavior
The UK National Institute for Health and Clinical Excellence (NICE) summarizes five ways that public health campaigns ultimately change behavior:
- Changing attitudes and motivations, e.g. through messages aimed at young people about the harm smoking does to skin and appearance
- Increasing physical or interpersonal skills, e.g. through programs as Drug Abuse Resistance Education (D.A.R.E.)
- Changing beliefs and perceptions, e.g. using health-based messaging to change optimism ratings for smokers
- Influencing social norms, e.g. by changing public perceptions of second-hand smoke
- Changing structural factors and influencing the wider determinants of health, e.g. cigarette tax, warning labels, building-policies, advertising policies
These strategies are not ground-breaking to those working on behavior change. Many entities, ranging from the military and universities including Berkeley and Stanford, to the State and Local Energy Efficiency Action Network and utilities such as Xcel Energy have been working on changing energy consumption behaviors and have explored many of the tactics in detail.
What makes public health campaigns so successful is not the use of these strategies, but overarching aspects across them.
The Four Approaches of Public Health Campaigns
Four specific approaches were taken by public health campaigns to achieve these strategies.
- First, define and target specific demographic segments. The nature of public health is that many problems are specific to certain populations. Experts must target vulnerable groups to be successful, e.g. women for breast cancer screening and men for prostate cancer screening
- Second, use nationwide approaches. Many public health campaigns have a nationwide focus with the targeted demographic groups and experts must find messaging and programs that will be will be effective enough to reach everyone.
- Third, make the issue extremely personal. Public health issues are personal by their nature and campaigns are structured carefully around emotional appeals.
- Lastly, show that poor health costs everyone. It is easy to track and report statistics on health care costs. This allows the government to get behind public health campaigns because prevention is usually more cost-effective than treatment. Public health campaigns are supported by funding, regulation, outreach, and penalties (in the form of taxes and increased insurance rates for activities that threaten health).
Applications for Energy Consumption Behavior Change
We can try to make better use of these approaches to help change energy consumption behaviors. Examining what has been already done and making recommendations is beneficial.
1) Targeting Demographics:
There is far more research and historical data on targeting demographics for health behaviors than for energy consumption behaviors. This is likely because the environmental field is comparatively very young. However, there have been advances in targeting demographics for environmentally-related behaviors. An example is the 1990 study conducted by the Roper Organization to identify five categories of consumers based on environmental attitudes. The five categories include “true-blue greens”, “greenback greens”, “sprouts”, “grousers”, and “basic browns” and can be utilized to project willingness to participate in efficiency behaviors. Further research on targeting demographics for energy efficiency behaviors is needed.
2) Nation-wide approaches:
Nation-wide approaches have been successful in improving energy efficiency. Take for example the Energy Independence and Security Act of 2007, the development of ENERGY STAR ratings for appliances, and LEED certifications for green buildings. While these approaches have been successful, there haven’t been many unified efforts focused on individual behavior change. This may be because there is no entity responsible for doing this. In public health, the Environmental Protection Agency (EPA), Center for Disease Control (CDC), National Institutes of Health (NIH) are tasked with protecting the health of people. Working on individual behavior change is a critical part of this mission. In contrast, while the Department of Energy (DOE) ensures energy security, the agency does not necessarily address public energy consumption through behavioral interventions. Focusing on local and statewide approaches to changing patterns of public energy consumption may be more realistic as needs and usage patterns vary by geographic, political, and economic climate.
Personal appeals have been made to encourage energy efficiency, but usually in conjunction with another appeal such as economics or health. Global climate change, resource depletion, and pollution are not as personal as the money in one’s checking account or health. It would be beneficial to further examine the relationship between energy behaviors and other factors that are personal motivators for people. Public health issues are personal because they affect the self, and they also affect loved ones. It would be beneficial to pursue this concept in creating messages to promote changing energy consumption behaviors (e.g. insulate one’s parents’ home so they will stay warm and save on their utility bills).
4) Costs Everyone:
Energy efficiency behaviors immediately cost individuals and businesses in terms of their gas and electric bills. Yet many are resistant to adopt energy efficient behaviors. In contrast, many health-related behaviors do not affect the individual immediately. For example, there are no insurance penalties for choices like poor diet and the health effects are delayed. However, the government is able to justify spending on public health campaigns because there is always a prevalence of disease among the population, making the costs measurable and the problem tangible. In contrast, the government has more difficulty justifying spending on energy efficiency campaigns because the costs of global climate are complex and less tangible. They may be arguably just as immediate as public health problems, but appear to be far away. Those working on energy consumption behavior change may benefit by looking at more tangible costs than the global burden of climate change. For example, the Common Wealth Fund conducted the case study “Lowering Health Care Costs through Energy Efficiency,” which demonstrated that inefficient energy consumption in hospitals puts them at financial risk, raising the costs of health. This study demonstrates that energy inefficiency “costs everyone” in a tangible way.
Encouraging individuals to adopt energy efficient behaviors is increasingly important in today’s energy climate. Strategies used in public health can be used as a model for those working on this initiative. Stay tuned for a series of blogs that will explore the relationship between public health and energy efficiency.
in other words: Market Segmentation
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