New policy brief: sustainable behaviours for health and the environment

Globally, as much as 24% of all deaths are related to the environment. Air pollution, unsafe water and the overarching threat of climate change are not just devastating for the environment, but also have critical impacts on our health and well-being. It is well acknowledged that behaviours can play an important role in addressing these challenges, from reducing the risk of environmental exposures when they occur to reducing the impact of human behaviours and consumption patterns on the environment.

To mark this year's Earth Day and address the urgent need to tackle environmental and health challenges, WHO/Europe has launched a new policy brief that explores how more evidence-based and cost-effective methods can be applied to enable, support and promote sustainable behaviours for health and the environment.

Behaviours are at the heart of environmental and health challenges

From transport, energy use and daily diets to preparing for and responding to forest fires and heat waves, behaviours are critical to improving or worsening environment and health-related issues. Understanding what drives behaviours is key. The actions and decisions of communities, companies, government bodies and leaders play an important role in enabling or hindering positive behaviours through the shaping of physical and social environments.

The behavioural and cultural insights (BCI) approach enables a systematic understanding of behaviours and facilitates the changes needed to disrupt the negative impacts and promote positive environmental impacts on our health. This field of work uses evidence-based and people-centred methods to find effective solutions.

"The potential of BCI in the environment and health sphere remains underexplored," emphasized Katrine Bach Habersaat, WHO/Europe's Regional Advisor for BCI. "Still, there is an alarming lack of robust evidence on how environment and health-related behaviours can be effectively promoted, enabled, supported and restricted."

Using BCI to drive positive environment and health-related behaviours

The new policy brief outlines the following key elements of BCI application to the environment and health, in line with the WHO-developed Tailoring Health Programmes approach:

• exploring and understanding the individual and contextual factors that affect environment and health-related behaviours;

• using these insights to develop interventions that are tailored to the needs and circumstances of those who are affected, so that they effectively support, enable and promote the behaviours; and

• evaluating the impact of interventions, policies, services and communications to ensure their effectiveness, and to add to the global evidence base.

Considerations for policy-makers

Building on the 3 core BCI elements, the policy brief includes 6 considerations for policy-makers. Three of these relate to the process of applying BCI to the field of environment and health: 1) exploring the drivers and barriers; 2) using person-centred and participatory methods; and 3) employing rigorous techniques to evaluate feasibility and effectiveness.

The 3 remaining areas of implementation where there is a scope for learning from BCI-related evidence and methods are: 4) maximizing support for environment and health-related policies; 5) tackling misinformation and science denialism; and 6) addressing behaviours within the health system.

Case examples: increasing renewable energy choices

Household energy consumption significantly contributes to climate change, but switching to green energy can help to mitigate its impact. BCI research suggests that people tend to stick with default choices because they are perceived as the easiest and recommended option. A supporting approach is the use of BCI messages in communications, illustrated in the case studies below.

• In line with the Swiss energy strategy, green energy suppliers defaulted their customers into a green energy package, with the option to switch to a conventional one if they preferred. This simple change led to 80% of households and businesses staying with green energy despite the higher cost.

• In a trial in the Republic of Moldova, a one-off letter containing the social norm feedback that the recipients' energy usage was higher than their neighbours' - plus advice on reducing energy consumption - resulted in a 1.7-2.1% decrease in energy consumption for at least 3 months.

Looking ahead

Francesca Racioppi, Head of the WHO European Centre for Environment and Health, said: "In the years ahead, delivering on these commitments will also rely on our collective heightened capacity to integrate BCI approaches to increase the effectiveness of policies and actions of social, political and economic actors and individuals, along with the provision of conducive infrastructure, service and information, legislation and regulation."

"Nothing changes unless behaviour changes," said Robb Butler, Director, Division of Communicable Diseases, Environment and Health. "The rigorous methods and evidence that a BCI approach can offer are critical for facilitating the changes needed to disrupt the negative impacts and promote the positive impacts of environmental changes on our health."

The policy brief was developed jointly by WHO/Europe's BCI Unit and the WHO European Centre for Environment and Health.

Training modules on applying BCI to the environment and health are available on the online LEARN BCI platform.

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