Creative Public Health Solutions

One of our grad students just posted this on Facebook:  to both help curb the obesity epidemic and to celebrate their upcoming Olympic games, the Moscow subway is allowing passengers to ride for free if they can do 30 squats.

I love that kind of creative incentivization.  I’ve been messing about with my own similar –and largely crazy–ideas for a while now, trying to encapsulate them into papers.  One of them involves the general farming of unused public lands (such as highway medians) to produce a high caloric crop, while at the same time removing carbon from the atmosphere.  I’ve had several students attempt to model this in a test jurisdiction.  We’re going to try again soon.

Whenever I talk about that idea, I get the predictable complaints: who will do the planting? What if people are run over by cars? How do you decide who gets the food? And so on.  At such times, I’m reminded of a great adage: “It takes a great man to build a barn, but any old jack-ass can knock it down.” I’m striving to be the barn-builder.

Another idea involves the use of municipal gyms to allow people to exercise (e.g., run on a treadmill) and to have their small kinetic output fed into the public electrical grid.  The people would receive a tax break equivalent to the amount of energy contribution they made.  Yes, the actual power generated by 100 people exercising for a day is barely enough to run a house for a few hours.  But the point is that it’s an incentive to be fit.

And again the complaints: but poor people might run themselves to death! Or dishonest people will use dogs to run on treadmills and collect their tax receipts that way.  Or the homeless will be coerced into doing the exercise!  That’s when I give up trying to be clever.

A third idea would see the installation of transponder-like devices under the floors of office buildings, such that the energy of people walking atop them would run the electronics of that building.  (A similar structure already exists in an African village, where the energy of playing children is used to power the local water pump.)  That idea can be scaled up, such that transponders (I’m probably using the wrong word; I’m too tired to look it up) under public roads would channel some of the energy of passing cars into the public grid.

The Russian subway thing is a nice and easy experiment.  The cynic in me tries to picture the same program being implemented here, perhaps in the Toronto subway. Immediately, I can hear the complaints:

• What about legless or disabled people? Shouldn’t they also have the opportunity to ride for free?
• What about the elderly? They can’t be expected to even try! And they’re the ones most in need of a free ride!
• What about the unfit or obese?  If they try, they will fail, and be publicly shamed!
• What if someone hurts himself during a squat? Whose responsibility is that?
• Won’t you just exacerbate the gap between rich and poor?  The rich can afford to ride the subway, but the poor have to do bloody squats.  It’s demeaning to the poor!
• The number “30” discriminates against women because they can’t do as many squats as men!
• The number “30” discriminates against men because they can’t do as many squats as women!

You get the drift.

That’s when I decide that maybe I don’t want to write papers about creative incentives for health.