Medical Expenses and Cognitive Loads

As mentioned in my previous post, the poor and I dealt with the issue of medical expenses in very different ways. For me, having to pay medical expenses was a minor inconvenience, where a similar sum was much more challenging to achieve for the people that my organization had just surveyed. This very subject has been the focal point of recent research that I think is pushing the bounds of what we know about poverty.

A recent interest of mine looks at applying principles from behavioral sciences to determine social policy. However, this research goes a step further. It looks at how the psychology of individuals is shaped by poverty.

In an experiment, researchers looked at low-income and high-income individuals (I think it was in the States, so the income levels were higher for both groups than what I see in Kenya, but the research is still quite relevant). They had individuals look at an image with two adjacent squares, and in one of the squares, there is either a heart or star. If it’s a star, they are supposed to slap the same square that the star is in. If one of the squares has a heart, they are supposed to slap the opposite square. It’s a simple test, but the idea is that if your mind is elsewhere, you’ll either go slow or make some mistakes.

For both the high- and low-income individuals, they had a treatment and control group. The control group was given the question “Suppose you had a medical emergency, and needed $20 right now, how would you get the money?” Then they took the aforementioned star/heart test. The treatment group was instead asked, “Suppose you had a medical emergency, and needed $1,000 right now, how would you get the money?” and then given the test.

For the high-income individuals, regardless of the question they were asked, they performed equally well on the star/heart test. However, the low-income individuals did considerably worse at the test when asked about the $1,000 expense than when they were asked about the $20 one.

The central takeaway from this research is that living in scarcity actually has a negative impact on individuals’ ability to think. When presented with an enormous financial challenge, individuals were so burdened that they were unable to fully concentrate on the task at hand. Imagine a day when you have had a million things going on and have been very stressed about it. Then someone tries to ask you a question, and you find you’re so frazzled you don’t even hear a word they’re saying. This research suggests in a lot of ways, that’s what it’s like to be poor. There are so many financial challenges present, so many things to worry about, that it’s hard to be sufficiently focused for other day-to-day tasks.

Accordingly, a real challenge for those working in development is thinking about how to ease the cognitive load of those living in poverty. If the poor have a million things to think about and have to address a lot of attention to challenges, the simple reality is they will have a harder time thinking about other issues when they come up. I think the question of the specific policy measures that should be put in place is still an open question (and one I hope to research and try and figure out solutions to) but it certainly seems as though making things simpler, and eliminating the need to constantly be making decisions about every minute aspect of their lives.

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2 Responses to Medical Expenses and Cognitive Loads

  1. The Stork in Winterfell says:

    “There are so many financial challenges present, so many things to worry about, that it’s hard to be sufficiently focused for other day-to-day tasks.”

    I think this relates to the problem of obesity. Certainly lacking the money to afford healthier food is hugely important, but I imagine there is some liminal population that could theoretically find healthier food options that are affordable but financial stress decreases focus and encourages the creation of shortcuts, such as buying cheap, ready-to-eat food.

  2. Fumanchu says:

    Do you think you guys will get around to trying a similar experiment in northern Kenya, or is it just too abstract from the objectives of boma to get funding?

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