title: Can a nudge keep you warm? Using nudges to reduce excess winter deaths: insight from the Keeping Warm in Later Life Project (KWILLT).
abstract: Nudges are interventions that aim to change people's behaviour through changing the environment in which they choose rather than appealing to their reasoning. Nudges have been proposed as of possible use in relation to health-related behaviour. However, nudges have been criticized as ethically dubious because they bypass peoples reasoning and (anyway) are of little help in relation to affecting ill-health that results from social determinants, such as poverty. Reducing the rate of excess winter deaths (EWDs) is a public health priority; however, EWD seems clearly to be socially determined such that nudges arguably have little role. This article defends two claims: (i) nudges could have a place in tackling even the heavily socially determined problem of EWD. We draw on evidence from an empirical study, the Keeping Warm in Later Life Project (KWILLT), to argue that in some cases the risk of cold is within the person's control to some extent such that environmental modifications to influence behaviour such as nudges are possible. (ii) Some uses of behavioural insights in the form of nudges are acceptable, including some in the area of EWD. We suggest a question-based framework by which to judge the ethical acceptability of nudges.
authors.affiliation: Health and Social Care Research Centre, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield S10 2BP, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Allmark
authors.forename: Angela M
authors.initials: AM
authors.lastname: Tod
mesh_terms: D000368:Aged; D003080:Cold Temperature / Q000009:adverse effects*; D004739:England / Q000453:epidemiology; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008875:Middle Aged; D009026:Mortality; D011203:Poverty / Q000706:statistics & numerical data; D012621:Seasons
keywords: affordable warmth; behavioural economics; excess winter deaths; fuel poverty; nudge; social determinants