Social Norms and the Health of Populations.
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Why did so many participants go along with the group, in denial of the evidence? The answer has much to do with social norms.
Social norms are the customary rules of behavior that govern our interactions with others. They are “common standards within a social group regarding socially acceptable or appropriate behavior in particular social situations, the breach of which has social consequences.” Social norms theory suggests that our actions can be influenced by our perceptions, or misperceptions, about how our peers think and act. Importantly, there can be a gap between perceived norms and actual norms. Perceived norms are the beliefs we think our peers have, and the behaviors we think they expect of us. Actual norms are not subjective; they entail what these beliefs genuinely are, and what sort of behaviors are truly prevalent among social groups.
This has important implications for efforts to promote the health of populations. Consider, close to home, the example of college binge drinking, a persistent health hazard affecting millions of students every year. In 2013, 59.4 percent of full-time students between the ages of 18 and 22 were reported to have drank alcohol in the past month; 12.7 percent of these students had engaged in heavy drinking, defined as an excess of five drinks on one occasion, on five or more occasions. Alcohol drinking in college has been linked to a host of challenges on college campuses, including sexual assault and accidents leading to injury or death.
Despite substantial recent attention to the issue, college binge drinking remains a stubbornly difficult problem to solve. There are data to suggest that this difficulty is perhaps more rooted in the power of social norms than in the intrinsic appeal of alcohol. College students have been shown to have a “pluralistic ignorance” of the drinking patterns of their peers, resulting in the unhealthy practice of less-committed drinkers attempting to drink more to keep pace with an incorrectly perceived norm. Put simply, when a student assumes that everyone around them is drinking, they will often conclude that they must drink too.
Interventions based on social norms theory seek to correct problematic behaviors by first understanding the degree of misperception between perceived and actual norms, then by educating populations about these misperceptions through media campaigns, with the goal of changing behavior. The utility of this approach to behavior change has been demonstrated on a number of campuses that have successfully reduced drinking by developing campaigns that portray accurate norms for alcohol consumption and non-use. As a result, at the University of Arizona, a more than 20 percent reduction in high-risk drinking was noted within three years of their campaign. At Northern Illinois University, a 44 percent reduction was noted after 10 years. In these cases, there was a correlation between positive changes in behavior and the correction of perceptions over time.
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Here at SPH, we have among us leaders in the application of social norms theory to the aims of public health. I am thinking, among others, of professor William DeJong’s efforts to reduce college drinking through marketing campaigns. Engagement with social norms, and an appreciation of their powerful influence on the well-being of populations, can be an important part of the work of public health, consistent with our emphasis on prevention, and our aspirations for healthier populations.
I hope everyone has a terrific week. Until next week.
Warm regards,
Sandro
Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Twitter: @sandrogalea
Acknowledgement: I am grateful for the contributions of Revathi Penumatsa, MB, BS, and Eric DelGizzo to this Dean’s Note.
Previous Dean’s Notes are archived at: /sph/tag/deans-note