Risky Behaviors Constitute Growing Threats to Global Health


November 20, 2013 – A new World Bank report, Risking your Health: Causes, Consequences and Interventions to Prevent Risky Behaviors, warns that risky behaviors are increasingly prevalent globally, particularly in developing countries, and constitute a growing threat to the health of individuals and their populations.

The report looks at how individual choices that led to five risky behaviors –smoking, using illicit drugs, alcohol abuse, unhealthy diets, and risky sex— are formed, and then uses empirical evidence to examine what works and what doesn’t. Legislation and taxation, for example, tend to be effective, especially when combined with strong enforcement mechanisms. Cash transfers also have proven to be promising in some settings.  Behavior change campaigns, such as school-based sex education and calorie labeling laws, are often less effective on their own.

Engaging in risky behaviors, according to the report, exerts a significant toll on the individual’s productivity in the long run. Society also loses as immediate peers of those who engage in risky behaviors also experience declines in their productivity. Children are at particular risk, for example if they have to stop schooling due to a sick parent or if development of their cognitive abilities is compromised due to early exposure to harmful substances.

The report concludes that costs and spillovers associated with risky behaviors justify public interventions and that certain policy interventions, when done properly, can improve overall welfare.  Evidence suggests that legislation tends to be effective, especially when enforcement mechanisms are strong. The report highlights that tax policies can be efficient mechanisms to prevent smoking and alcohol consumption. Most of the evidence comes from developed countries, but emerging evidence from developing countries - for example from China and Indonesia for tobacco taxes and from Kenya for alcohol prices - points in the same direction.

Many developing countries have successfully used demand-side interventions such as conditional cash transfers and other financial incentives as mechanisms to elicit socially desirable behaviors. Other forms of interventions, such as information education and communications programs, have been less effective in changing behaviors. Calorie labeling laws and school-based sex education programs inform consumers about the risks associated with certain behaviors, but translating that knowledge into concrete behavioral changes seems harder to achieve. These efforts tend to be effective if the messages are targeted and reinforced at regular intervals and complemented with broader risk behavior change programs.