13 Dec, 11 | by BMJ Group
When I used to teach public health to medical students and other health professionals, I tried to set myself the challenge of helping people learn about populations, prevention, screening, social determinants of health, quality of healthcare, and such things without mentioning the words public health at all. You may know why.
A great paper by Dror Etzion, assistant professor, Desautels Faculty of Management, McGill University (Sustainability by Stealth: four ways to make sustainability more attractive) addresses the same approach with sustainable development, another area that elicits various emotional responses. With his permission, I have taken this excellent paper and expanded it to help us engage others in issues like sustainable development and climate change: areas that make us question our values and beliefs as well as our actions, areas where we should use the precautionary principle: where action is needed when the evidence is sufficient but neither perfect nor complete.
1. Engage people by listening, not by hectoring, haranguing, finger wagging, and inducing guilt. Why be surprised when people at best stop listening, and at worst become actively hostile to your approach?
2. Be positive about the future. Martin Luther King did not say “I have a nightmare.” Many of us fear the future because we fear what we might lose. There are many things about today’s world that would be very good to lose: global debt, global poverty, and sitting in a traffic jam for an hour every day, to mention just three. Relying on doom and gloom will elicit that most powerful coping mechanism we all have: denial.
3. Avoid the long term if possible; we are nearly all creatures of the here and now. Long term commitment is tricky as those who diet will tell you. Start by offering a succession of attractive, positive actions that have short term rewards attached (saves money, enhances status, and reputation…).
4. Don’t rely on reason: we are driven by complex emotions, values, and rewards, not logic.
5. Remember that many challenging and complex goals (such as a world which develops sustainably) are often easier to attain when pursued indirectly (See John Kay’s book: Obliquity). Don’t change healthcare simply to make it more sustainable; change it to make it more preventative, more (cost) effective, or more patient centred (or all three), and the result will often be more sustainable too.
6. Find out what motivates others at a personal level: keeping your children healthy may be more immediately motivating than keeping the planet healthy, despite the obvious connection.
7. Make the sustainable choices easier than the alternative, not more worthy. That way, they become increasingly default options. If it’s cheaper to buy, easier to access, and fits in better with people’s image of themselves, then it’s more likely to actually happen.
8. Make it fun. If you’ve seen the YouTube clip of piano stairs in Sweden, you’ll know exactly what this means.
And, as Dror Etzion says, you will help create a better place for everyone without even mentioning the word sustainability.
David Pencheon is a UK trained public health doctor and is currently director of the NHS Sustainable Development Unit (England).