Fear of germs is one of the most commonly used reasons to change behaviour. From getting people to brush their teeth, and not defecating in the open to washing one’s hands regularly with soap, the fear of germs has been instilled in our minds.
Ever since Joseph Lister discovered in the 1860s that carbolic acid can destroy germs, various companies and government and non-government agencies have spent billions of dollars to increase awareness about the existence and the consequences of germs. Has this communication blitz helped in changing behaviour?
Lister first propagated the use of antiseptic methods among surgeons to prevent large number of deaths due to sepsis, caused by germs. The use of anesthesia, which was discovered around the same time as antiseptic, was spread extensively across the world in a matter of a few months after its discovery. But history has shown that even doctors, the most knowledgeable about germs, do not use antiseptic properly, even 178 years after its discovery. If so, how do we expect ordinary people to wash their hands regularly or brush their teeth at night?
The billions spent over the years have surely built awareness about germs even in the rural areas. But the sad truth is that behaviour change commensurate with that level of awareness is poor. Germ theory is a clear example of a huge awareness-action gap.
The proponents of germ theory have not taken into consideration the irrational nature of human beings. The human brain has evolutionarily fine-tuned its senses to detect dangers that are immediate. Neither the existence nor the removal of germs can be detected by the sensory system. So the brain uses the mental model—“what is visibly clean is clean”—to help decide the course of action. Other than those who are clinically diagnosed with obsessive compulsive disorder, it is difficult to make someone believe that a plate that is washed with water still needs to be washed further to remove the millions of germs that are still on it.
The human brain tends to discount risk, more so risks that could happen far in the future. Most germ-related risks happen far in the future, and even when they happen, it is almost impossible to link them back to germs. So, from a scientific point of view, the germ story may be a credible platform to build behaviour change strategies. But from the point of view of the human brain, it is not strong enough to inculcate new behaviours. We need a more efficient, alternative strategy for that. Crafting new social norms around new behaviours one wants to inculcate in society could be the alternative.
One could learn from the campaign to reduce smoking around the world. Similar to germ theory, in the initial stages, anti-smoking campaigns focused on the individual smoker and its health hazards in the future. But the pace of decline of smoking behaviour took a clear downward path only when the anti-smoking campaign took a different path—smoking was made a social problem. The focus moved from the health hazard to the smoker, to the health hazard the smoker was causing others—the non-smokers. Slowly but surely a social norm was created—that smoking was not a socially desirable behaviour.
Norms are social patterns that govern behaviour. The forces of peer pressure and the need for conformity create new behaviours—the new normal way of behaving in that society. Norms make sure that a community’s characteristic patterns of thought and behaviour emanate not from any individual’s core self but from their shared social context. According to philosopher Cristina Bicchieri, the defining characteristic of social norms is the sanction that follows a violation—it is very difficult for a person not to follow social norms because they risk being considered a social pariah.
Social norms help create appropriate social behaviours which, in turn, impact individual behaviour. Studies have shown that whether people walk on the right or the left side of the hallway depends on whether they come from a society that drives on the right side of the road or the left side.
Initially, norm adherence will start as a way to avoid feeling guilty. Over time, people tend to follow norms to express their personal values. A conscious creation of an in-group (those who follow the norms), and a corresponding out-group (those who do not follow the norms) will help increase the levels of conformity within the in-group and heighten differentiation with the out-groups. Recently, we found an excellent example of this when a district official made the village heads of those villages that were not open defecation-free (ODF) sit separately from those that were ODF, and gave priority to those who headed ODF villages.
The influence of institutions like schools and religion, combined with the demonstration power of rituals, can be used to create new social norms. Schools where intervals were renamed “toilet break” and where washing of hands was done in a group at the end of the break, were seen to adopt the hand-washing behaviour better than when the behaviour was inculcated at an individual level. The priests in Kerala churches deciding to wash their hands before giving communion and to give communion in the hand instead of the age-old tradition of giving it on the tongue in the wake of recent Nipah virus scare are examples of institutional attempts to create social norms.
It is not easy to create new social norms. But it is definitely better than trying to make people believe in the invisible germs whose consequences happen far in the future.
Biju Dominic is the chief executive officer of Final Mile Consulting, a behaviour architecture firm.
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