Nurturing, nudging and navigating the increasingly precarious nature of cooperation in public health: the cases of vaccination and organ donation

Abstract

Many public health initiatives encouraging positive health behaviours require patient cooperation in the face of perceived costs and health risks. Ongoing public health crises, including the COVID-19 pandemic and the organ shortage, underscore the necessity of incorporating an understanding of human cooperation and the motivators for cooperation into social and public health policy. We explore the costs, benefits and motivators regarding cooperation in the cases of vaccination and organ donation. We likewise explore policy incentives that have successfully encouraged cooperation with these positive health behaviours. We find that appeals to morality, reciprocity and reputation are important behavioural predictors of cooperation. However, we find that cooperation is a fragile state, vulnerable to the individual’s perceptions of the risks, as well as external social, cultural and political forces, such as social media-disseminated misinformation, which can sway attitudes to health behaviours, including cooperation. Drawing from the literature, we conclude by calling for a nuanced understanding of cooperation in a number of policy recommendations. Notably, we underscore: the volatile emotional levers affecting cooperation; the risks of overusing restrictive mandates; the consideration of short- and long-term consequences of social policies; and the need for locally and culturally tailored, as well as nationally relevant, policies.