Beijing time on May 11, according tomedia reports, we have hundreds of millions of people who never wash their hands. Why do they not want to develop such simple hygiene habits? How can we change their minds? Pete Hegseth, a well-known American presenter, said on a television show last year: “My determination in 2019 is to be on stage. “
Then he said a shocking remark that shocked the entire online world: “I don’t think I’ve had my hands washed in 10 years.” “
While not washing hands for 10 years is a record feat, as long as you watch carefully, people who don’t wash their hands in the toilet are almost everywhere. One study estimated that in 2015, only 26.2 percent of people worldwide who went to the toilet and “may have been exposed to faeces” then washed their hands with soap. Hand washing sounds so simple, but public health experts have been working hard for 25 years to get people into the habit of washing their hands frequently, but few people can do it.
This, of course, can be explained to some extent by the lack of adequate hand-washing facilities and soap in less developed areas. In the least developed countries, only 27 per cent of people have access to these items. (WHO and UNESCO estimate that about 3 billion people have no home.) But even in many high-income countries, washbasins and soaps are plentiful, and only 50 percent of people use them after going to the toilet. Knowing this, you may never want to shake hands with someone else again.
The data are chilling because hand washing is considered one of the most life-saving inventions in human history. Today’s life expectancy is around 80 years old, and in 1850, when hand washing became widely available, life expectancy was only about 40 years old, a progress that is inseparable from the habit of washing hands.
In addition, hand washing, a simple hygiene habit, can help us avoid the threat of superbugs and infectious diseases. A 2006 study found that frequent hand washing reduced the risk of respiratory infections by 6 to 44 percent. Since the outbreak of COVID-19, scientists have found that a country’s hand-washing culture is a good predictor of the extent to which the outbreak is spreading in the country.
The question is, why do some people are so active about washing their hands and hoarding hand sanitizer at great expense, while others are so stubborn that they refuse to wash their hands with soap? If even rumors such as the mysterious virus and the “Do you know how much faeces are on the hotel TV remote” can’t convince people to wash their hands, what else can we do?
Don’t wash your hands after going to the toilet, and you may not be able to blame laziness alone. From a person’s way of thinking to blind optimism, from the need to feel “all right” to the intensity of nausea, there are many psychological factors that play a role in the subconscious, leading to people’s reluctance to wash their hands. By understanding these hidden cognitive biases, experts hope to persuade more people to develop hygiene habits for hand washing.
There is a problem with hand washing, and it is especially true in developed countries: you never get sick even if you don’t wash your hands often. By the time you’re really sick, it’s probably been a few days, and you’re not going to associate illness with “not washing your hands.”
Beware of optimism
Optimism is also a factor in people’s hand washing habits, researchers said. “Optimism bias” includes a lower probability of believing that bad things happen to you. This inexplicable optimism is everywhere, spread across a variety of human cultures, genders and age groups, and even some animals produce this attitude. This can lead us to misjudge the probability of something bad, such as cancer, divorce, and so on.
This hallucinations may partly cause people to smoke, credit card debt, and not wash their hands. A study conducted at a large New York university during the 2009 H1N1 flu outbreak found that students with high levels of blind optimism washed their hands less often. Also, people who are highly confident in their self-control tend to live out of control.
Trainee nurses also have this optimism bias, often overestimating their knowledge of maintaining hand hygiene. Food industry practitioners also have this mentality, always underestimating the risk of causing food poisoning in others.
Social norms matter.
To understand the role of psychological factors in hand washing habits, the first thing to know is that the treatment of hand hygiene varies widely across cultures. In a study conducted in France, 6,402 participants from 63 different countries answered “Do you agree that washing your hands with soap after going to the toilet is a natural act?”” Only half of the participants from China, Japan, South Korea and the Netherlands agreed. Saudi Arabia had the highest approval rating, with 97 percent saying they would habitually wash their hands with soap.
Even within countries, people’s health concepts vary.
For example, several studies have shown that women wash their hands much more often than men. In a study she conducted, Unger found that women are twice as likely as men to wash their hands in highway service areas. This trend has occurred even in recent new corona outbreaks. A recent survey found that 65 percent of women said they washed their hands regularly, while only 52 percent of men said they would.
This difference in hand washing may come down to social norms, which are well-a-bet rules among social groups. Social norms are a complex set of psychological systems that depend on what we see others doing, what we think of themselves, and whether we feel pressure to replicate what others are doing. “
If we see someone washing their hands in the bathroom, we will do our own way. But if no one is washing their hands, they are under no pressure to wash their hands. If you wash your hands, you will look different. A 2018 study did find that the frequency with which others wash their hands in some one’s eyes can greatly affect how often they wash their hands.
Since public toilets are mostly separate for men and women, perhaps the social norms applicable to men and women are different, just as different religious groups do.
Rational thinking vs experience is paramount
One of the reasons scientists are so anxious to understand the psychological factors behind hand washing is that it’s about life, especially for patients in hospitals. Many health workers, who have been trained for years to save patients, ignore the basic habit of hand washing that helps prevent deadly viruses and superbugs.
In 2007, scientists found that doctors at an Australian hospital were only 10 per cent more likely to wash their hands before touching a patient (30 per cent after exposure). Other hospitals have made similar findings. For example, a 2019 study at a hospital in Quebec, Canada, found that health workers wash ediased hands only 33 percent more often. Even in Saudi Arabia, where there is a culture of hand-washing, medical workers often do not wash their hands seriously.
But like the average person, health care workers vary from person to person. A 2008 study found that doctors who said they liked to do things intuitively wash their hands much more often than doctors who said they always thought rationally. This suggests that to persuade people to get into the habit of washing their hands frequently, listing a bunch of reasons why they should wash their hands may not be the best way.
A study conducted in Brazil in March also identified another factor that might be relevant: responsibility. The study found that people with higher sense of responsibility were more likely to keep their social distance from others and wash their hands frequently.
Finally, there is the feeling of nausea. When we see a raw steak, we lose our appetite at once. Similarly, if we see someone blowing our noses on a train, we’ll hide on the other side of the car and avoid sucking in other people’s pathogens, an instinct that’s extremely important.
Even chimps, animals that often eat their own faeces, find the bodily fluids of other chimps sick, suggesting that “nausea” is not a by-product of human culture, but an evolved mind that protects us.
Like other emotions, the degree of nausea varies. It’s a powerful force hidden in our lives that can influence our political decisions (people who are more sensitive to nausea tend to vote more conservatively), and how we view homosexuals, foreigners, and even how much we fear spiders.
As you can imagine, several studies have shown that people who are insensitive to nausea wash their hands less often and wash them less often. A study of hand washing in Haiti and Ethiopia found that individuals’ health knowledge and awareness were less associated with the frequency of hand washing than the intensity of an individual’s nausea.
Keep your cleaning habits
So how can we avoid these cognitive biases?
In the past few weeks, public health agencies, charities, politicians and the general public have joined forces to launch one of the most vigorous hand-washing campaigns in recent years. Famous people have come forward to demonstrate the “right hand-washing posture”, online is full of information on hand washing methods, a series of special videos about the outbreak.
But given the psychological bias described earlier, can these publicity initiatives really persuade people who don’t like to wash their hands to get into the habit of washing their hands frequently?
Researchers prefer to write about “disgusting” than making hand washing look fun or sexy. In 2009, a team of researchers took a test on some students. After asking them about their current hand-washing habits and sensitivity to disgusting things, the researchers asked students to watch one of three videos: a purely educational video, a video with a disgusting picture, and an excerpt from a natural documentary that had nothing to do with the content, as a control group.
About a week later, the researchers brought in the students and asked them to sit at a table. On the table are some sterilizing patches and alcohol-free hand sanitizer. The researchers then took a variety of dirty things, and let the students take them in their hands, including dirty flies, used toilet brushes, and so on, and then asked them to take a cookie from the plate. Guess what, will these students disinfect their opponents before they come into contact with food?
The results were as expected by the researchers. Students who had previously watched the sickvideo were much more likely to clean their hands than the other two groups combined.
The team confirmed in subsequent studies that this is equally effective in the real world. They took a veiled look at people’s hand washing practices in several toilets and found that when people saw posters with disgusting images ( such as faeces on bread and bacteria on their hands ) , they were much more likely to wash their hands . Posters in the pure education category have not worked so well.
No one has ever seen how long this effect lasts, but the findings suggest that simple preaching is far less effective than intimidation. This question is very important. First, we need to motivate people to wash their hands in certain situations, such as through advertising and hand-washing signs, but if this incentive continues, hand washing may become a habit. We just don’t know how long the process is.
The situation is very special. Many people are interested in hand washing due to the new corona outbreak. But the question is, can we get enough people to learn to wash their hands and keep the habit alive?
The answer to this question will not be known until a while. But at least we won’t hear a celebrity brag about how long he hasn’t washed his hands.