Verified by 
The Headcase is winding down his world tour of southern New England for The King's Best Highway. Guest Blogger Cardiff Garcia, who last week told us about authoritarian bosses, now looks at the high cost of bad choices.
Most of us know that our bad choices can eventually kill us, especially when these choices become hard-to-break addictions like smoking or binge drinking or overeating. We're not usually thinking in such morbid terms each time we light up another cigarette or reach for a second piece of chocolate cake, but maybe we should be.
That's the case being made by behavioral economist Dan Ariely in a recent blog post, where he linked to a research paper showing that 44.5% of premature deaths in America are caused by personal decisions (as opposed to, say, accidents or genetic diseases). This is a vast improvement since 1900, when only 5% of deaths were attributable to our mistakes. In other words, postponing a visit from The Reaper is more firmly within our control now than it used to be.
The paper (pdf here), written by operations research professor Ralph Keeney, defined a personal decision as "a situation where an individual can make a choice among two or more alternatives," and where a person is aware of these alternatives. Using data from public agencies and previous studies, the paper links causes of premature death to personal decisions:
The analysis indicates that over one million of the 2.4 million deaths in 2000 can be attributed to personal decisions and could have been avoided if readily available alternative choices were made. Separate analyses indicate 46% of deaths due to heart disease and 66% of cancer deaths are attributable to personal decisions, about 55% of all deaths for ages 15-64 are attributable to personal decisions, and over 94% of the deaths attributable to personal decisions result in the death of the individual making the decisions.
Of the killers we can blame ourselves for, smoking and being overweight are by far the biggest, each accounting for slightly more than 40% of deaths caused by personal decisions. Following them are alcoholism (6%), avoidable accidents like crashing a car while under the influence (4%), and suicide (3%).
If our decisions are now more responsible than ever for premature deaths, that begs an obvious question: What can be done to help us make better ones?
Ariely has spent his career exploring the various dimensions of how we make decisions. He looks at Keeney's study and concludes that "instead of relying on external factors to keep us alive and healthy for longer, we can (and must) learn to rely on our decision-making skills in order to reduce the number of dumb and costly mistakes that we make." He then recommends more research "that examines what kind of methods encourage healthier decision-making and conduct much more research in areas that could help us limit our mistakes."
Surely this is a good idea, but it's also worth emphasizing that not all of this new research should be done without consideration for the external environment that Ariely mentions. There are socioeconomic forces that might also be at play here—forces that not only affect general well-being and survival rates directly, but that perhaps also influence decision-making at the individual (psychological) level.
Consider, for instance, that obesity is a larger problem for the poor than for the rest of the population. Is it simply the case that people in poorer neighborhoods have less money for healthy food and are therefore more likely to be overweight? Certainly that's a big part of it. But as the writer Ta-Nehisi Coates pointed out last year, another possibility is that people in low-income neighborhoods choose to eat less healthy foods because amid all the relentless difficulties of poverty, the temporary boosts given by a fatty or sugary diet are at least something to look forward to each day.
Last week Vaughan Bell linked to an article about the fascinating book, The Persistence of Poverty, written by the philosopher Charles Karelis, whose basic argument is that "poverty leads to poverty." The reasoning goes something like this: If you have so many burdens in your life at the same time—joblessness, obesity, crime—then eliminating just one of them makes a difference so negligible that you'll simply choose not to address any of them. Here is how the Boston Globe's review of the book explained the hypothesis:
When we're poor, Karelis argues, our economic worldview is shaped by deprivation, and we see the world around us not in terms of goods to be consumed but as problems to be alleviated. This is where the bee stings come in: A person with one bee sting is highly motivated to get it treated. But a person with multiple bee stings does not have much incentive to get one sting treated, because the others will still throb. The more of a painful or undesirable thing one has (i.e. the poorer one is) the less likely one is to do anything about any one problem.
This is just one example of how socioeconomic factors might influence the thought process, and for all I know there's nothing to it. According to various reviews of Karelis's book, there doesn't seem to be much actual evidence for this theory. But it is also largely untested. If social scientists are going to be designing new experiments and doing more research about personal decision-making, why not investigate it further?
--
Follow the Headcase on twitter: e_jaffe
Follow Cardiff Garcia on twitter: CardiffGarcia
