Friday, October 3, 2008

Avoiding isolation... Influencing social norms

In this post we talk about the need to avoid social isolation and help change social norms.

Let's start with some basic questions:

In North America, why are so few people vegan?
And why are there many people who claim to be vegetarian, but actually eat meat?

The answer to both questions has a lot to do with social norms.
The dietary social norm in America is to eat and enjoy meat, milk and other animal-based products. The vast majority of people in wealthy nations follow this same social norm. And even those who identify with another dietary ideal (e.g. being vegetarian), often still follow this same social norm. Why?

Social norms are incredibly powerful.

Science is gradually waking up to this realization. Sure, we've known for ages that children learn by mimicking others. And we're quick to point out that most people follow trends and behaviors blindly "like sheep", victims of fashion and gadget fads. Strangely, we forgot to notice that even "free thinking and independent" adults cave-in to powerful social pressures, which have a measurable impact on our health and well-being.

Nicholas Christakis, a physician-scientist at Harvard Medical School, along with his colleagues has demonstrated this nicely with several recent studies. One study examined the evolution of a large social network over 30 years in the famous Framingham Heart Study - which revealed that obesity actually spreads through a social network the same way that an infectious disease might spread - i.e. through close contacts and friends. The take home here was that the health behaviors that lead to weight gain are in effect contagious. Ultimately, people do what their friends do because they want to be "normal."

((More recently Christakis and colleagues demonstrated that your happiness is actually influenced by the happiness of your friend's friends. (This by the way is one reason I left Boston and moved to San Francisco!) In other words, emotions are contagious.

More on Christakis's work: an Edge interview; NYT article on happiness study; NYT on spread of obesity))

If you really stop to think about it, you will be forced to agree that the way we think is profoundly influenced by others. The vast majority of what we "know" is knowledge told to us by others. Our language is a product of how those around us speak. And so to our actions. More often than not we do what other people do.

So, it's really not surprising that most Japanese eat Japanese food, that Americans eat very similarly to each other, and that Europeans typically gain weight when they move to America. Social norms exert influence on all humans to some degree.

On vegans and social norms:

Vegans are different. It takes a certain kind of person to be able to say "I don't care what most people think or do, I'm going to do what I think is right and best, even if that makes me different and weird in the eyes of society."

Many vegans, at least those who were not raised as such, share this characteristic. I'm not trying to say that all vegans are the same. Far from it. But by nature of the current dietary social norms, to be vegan is to choose to be different.

My concern is that for some (if not many) vegans, being different from the rest of society lends itself to a certain amount of social isolation. This social isolation may have some costs that we should understand and mitigate. Costs that are probably less than the benefits but which may need to be managed.

Even more importantly: learning to minimize social isolation may be the best tool for helping us change the current societal dietary norms.

On eating and social isolation:

Food is central to almost everything we do. Sharing food is incredibly important for social bonding and maintaining relationships (be they business, intimate or plutonic). This is why saying "no" to eating someone's food (say because it's steak and you're vegan) is often interpreted as a personal rejection even when it's rationalized.

Does this mean vegans can't have close non-vegan friends or are destined to be lonely? Of course not. Many of my closest and dearest friends eat meat, and they readily support my vegan-ness in any way they can.

Still, one can't help but feel a little isolated when you're eating with friends at a restaurant and everybody else is merrily sharing chunks of animal flesh, talking about this great steak they ate last week and you are in the corner eating something scrumptious but different, sharing only with yourself.

My point: as a vegan, a certain amount of social isolation is unavoidable if you are living among and with omnivores. We can pretend this isolation is minimal or doesn't exist, or we can explore it and learn how to mitigate it.

The cost of social isolation

Is it possible that the cost of social isolation, even if it's subtle, includes decreased health?

Perhaps. It has always seemed curious to me that studies among vegetarians and vegans who are not shunning the social norm - for instance, among large populations of Seventh Day Adventists (SDA) - demonstrate consistent and marked health benefits compared with SDA's who eat meat and other animal products. Whereas there is more variability in the results of studies that assess vegans or vegetarians who are living mostly among non-vegetarians (generally the results are positive, but not often as robust as we'd expect).

Of course, there are many other reasons why epidemiological studies may not show as large an effect (or even no effect) of a vegan diet compared to non-vegan diets. These reasons include methodological factors (e.g. poor sample size, study design, etc.) but they could also be from unknown confounders. (see definition at end*)

Some of these confounders include poor mental health, shunning of other normal health practices (like going to the doctor, or taking vitamins or medication when prescribed), the inability to self-deceive (this is a fascinating concept, perhaps a topic of a future post, but in short people who can pet their dog with one hand, eat a chicken with the other are good self-deceivers. good self-deceivers do better in business and probably in health as well; i.e. in part it's the ignorance is bliss phenomenon), or other genetic or behavioral factors that may be linked with the personality-type that allows people to shun social norms.

Furthermore, social isolation may have a significant impact on whether someone can maintain a vegan/vegetarian diet. I've met hundreds of people who "used to be" vegetarian/vegan. Why did they return to a meat centered diet? "It was too hard." "I felt better when I started eating meat again." "I missed cheese." etc. Some of these folks were experiencing the side-effects of social isolation and how difficult it is do shun the social norm. (As well as some of the addictive properties of animal-foods, but that's for another post!)

Please keep in mind that this is simply an emerging thesis I am describing; one that I think deserves attention and study, but to my knowledge lacks investigation.

Minimizing isolation, changing the social norms:

Think about the small but meaningful changes we have seen in the last 2 decades. Soymilk - once an obscure drink to North Americans - is now mainstream. When a good restaurant served salad it used to be iceburg lettuce, now it's mixed field greens. Tofu and veggie burgers used to be something to make fun of, now it's a question of preference. In a small crowd, foods like quinoa or tempeh will not be new to everyone. Even the word vegan is relatively mainstream and usually no longer denotes someone from an alien planet.

If you've been paying attention, you'll notice that knowledge of these words has spread throughout society and that enjoyment and preference of "new" vegan foods has spread alongside.

How did this happen? It happened because people like you and me decided that it's normal to eat these foods. We purchased them and essentially financed their existence. Other people did the same. Still other people paid attention (consciously or not) to what we were eating, and decided to take a chance on something new. Knowledge and behaviors spread.

The same phenomenon happens in reverse. Red meat, and especially veal, consumption has slowly but steadily declined over the past few decades in North America. Why? Again, because the idea that red meat is unhealthy, inhumane and environmentally disastrous has slowly spread. In short, because it is becoming less normal to consider red meat good or desirable.

The point is this: everything you do influences people around you, whether you like it or not. If you decide to lock yourself in your home, not patronize restaurants that serve meat and avoid delusional meat-eaters then you lose the opportunity to influence them. You also risk maximizing the downsides of social isolation.

Although I don't know this for sure, my guess is that the more normal, happy, successful and healthy you appear to others, the more they will look to mimic your behaviors, be they lifestyle, political or social behaviors. Yes "radical" people do influence others, but perhaps their main function is to stretch the boundaries of known behavior. If you have 100 body piercings, then suddenly someone with 2-4 piercings seems pretty normal.

As we grow older and evolve, we need to decide what role is the most meaningful and enjoyable for each of us to play. No one can tell you how radical or different from the norm you should be. My only hope is that you consciously weigh the pros and cons, and that the concept of social isolation is something you consider.

To be clear: I don't believe social isolation is a reason not to be vegan. I just think it's something to manage.

Along the way, remember that your actions can help "nudge" people to one day do the same thing. And this can happen without "preaching" or revealing your judgment on their behaviors. The more you understand other people, the more they will understand you.

Granted, there's always a time and place when you have to be vocal about your beliefs and convictions. But it's nice to know they are influencing other people even when you are not trying.

* A confounder is something that could appear to be causing an effect/result/outcome, but is really only linked with the outcome for some other reason. For example, people who buy large size clothes tend to gain weight more than people who buy small size clothes; therefore, a misguided person could say "don't buy large clothes because it will cause you to gain weight". It's easy to see how in this case the shopping habit (buying large clothes) is not the cause of weight gain, but actually the result of it. Buying large clothes is a confounder in this analysis.