Generations are often defined by shared challenges. In health, Baby Boomers had to confront smoking and, similarly, Millennials will have to confront obesity.
In the chart below, I’ve plotted smoking and obesity rates in the US over the last 50 years (data from CDC and NHANES). Smoking and obesity, both primary risk factors for chronic disease in the US, have virtually switched places. While smoking rates have been cut in half, obesity rates have more than doubled over the last 50 years.
Behaviors contributing to obesity (i.e. lack of physical activity and poor nutrition) are as worrisome today as smoking was 40-50 years ago. Altering these behaviors will demand the same effort and investment that lowered smoking rates. So what can we learn from the success in decreasing smoking rates to help reduce the obesity rate?
There are many reasons that people quit smoking in the US, but essentially, we’ve created lots of negative reinforcement that make it harder to be a smoker. We've made smoking more:
- Expensive. In the last 10 years alone, average cigarette sales tax has more than tripled (data from taxfoundation.org).
- Stigmatized. Millions of dollars are invested every year for anti-smoking media campaigns and tobacco companies are limited on how they can advertise. The end result is that smoking has largely lost the coolness factor.
- Logistically Challenging. Clean Air Laws put up a significant logistical barrier by making people go outside of restaurants and bars to smoke.
I recently talked to someone with many years of experience as an HR consultant about the challenge of lowering the obesity rate. He suggested that the types of initiatives that worked so well in lowering smoking rates would be less successful in the battle against obesity. While it seems reasonable to make a smoker’s life more uncomfortable, doing the same to someone that is obese is obviously not socially acceptable.
I agree with this point, but I think there are still valuable lessons from the success in reducing smoking rates. We can take the same principles that worked for smoking, but reframe them as positive reinforcement rather than negative. For example, make proper nutrition and exercise more:
- Affordable. Some companies are already making a big difference through subsidized healthy cafeterias (e.g. Clayton Homes), but there is a lot more work to be done.
- Socially Reinforced. There are so many fun ways to be sedentary with friends (watch TV, play video games, surf Facebook, etc.). Physical activity may have a long way to go to compete, but it has to be more of a fun, social experience. Running on the treadmill isn’t cutting it.
- Accessible. It’s too difficult to eat healthy and exercise. For example, people often tell us that they dread the logistics involved in going to the gym (packing bag, changing, etc.). Can we remove some of these barriers?
These are just a few ideas. What lessons do you think can be taken from the campaign against smoking to help reduce obesity rates?
Golf is famous for promoting handicaps in competitive play—an inferior player gets an advantage in strokes over the superior player. While this dynamic may work well in many real-world games, where players still fully control the outcome, there may be a good case against providing certain handicaps in virtual and augmented reality game play.
EA Sports' NBA Live has for many generations promoted a "Keep Scores Close" option, which in essence is a method that allows the inferior player to stay within reach of the superior player, no matter how bad that inferior player is. In contrast to the experience of real-world golf, the problem in the virtual/augmented game world is that it's the computer that's cheating--the computer waves a magic wand causing the superior player to miss the basket, lose the ball, succumb to a steal, etc.
While this may benefit the inferior player, this doesn't seem to be the right approach in building a loyal user base. As you get better in the game, you're being penalized. Not a great long-term strategy. Obviously, users have the option of keeping scores close, but even still, the whole concept of "Keep Scores Close" is suspect.
That said, game designers are in a constant struggle between promoting free-market and socialized game dynamics. If inferior players fall too far behind, there need to be opportunities for them to catch up. At the same time, they should not be able to catch up by unfairly handicapping the superior player. Ultimately, while everyone must have reasonable opportunity to win, superior players should be rewarded for their prowess as they are in the real world. Just imagine if every time the real Kobe Bryant tried to dunk the ball in a game, the basket arbitrarily threw the ball back in his face. That would be pretty lame.
I would love to hear your thoughts on this subject. Where's the line between fair and unfair handicaps in the gaming world?
I came across this great term that’s been used to describe some educational games: chocolate covered broccoli. The term refers to games that were primarily about learning, while game mechanics seemed to be layered on top as an afterthought to draw more users. In other words, developers add the not-good-for-you part (gaming), which most people like, on top of the good-for-you part (learning), which many people don’t like. The intentions are good, but the end result is often worse than either part by itself and fails miserably.
I think educational game design has gotten better. Recent games have arguably had more success by transitioning from chocolate covered broccoli to chocolate covered strawberries. It’s probably not quite as good for you, but the combination works and you’ll actually eat it. For example, you won’t learn calculus from games like Sim City or Civilization, but there are certainly ample opportunities to learn something and people love playing these games. The best part is that the user may not even realize that there are benefits beyond entertainment.
Successful educational games have blazed a trail that looks increasingly attractive with an expanding gamer demographic. Can't gaming be part of the solution in other areas beyond education, even for older consumers? Consider that a 50-year old today was still a teenager when video game consoles became popular in the early 1980s. There are a lot of us that grew up with video games and are attracted to game mechanics.
One of the most exciting areas to incorporate gaming from our perspective, obviously, is in health. However, I see health gaming still in the chocolate covered broccoli phase. Too often (not in all cases), health games are nutrition or exercise applications, with things like badges, levels or points haphazardly layered on top. It seems that the starting point is “how can we motivate you to be more healthy or fit and, oh yeah, how do we make it fun too?”
I think a better starting point is “how can we provide an entertaining, fun experience, which also has elements that make you live healthier?” That’s a chocolate covered strawberry and, while easier said than done, it’s where we’d like to end up.