DEVIATE: Using positive deviance to reduce economic and health inequality

Economic and behavioral policies aimed at reducing inequality are typically based on what works for middle- and high-income individuals. That approach misses practical challenges facing low-income individuals, such as systemic barriers, limited resources, and lack of opportunity. This research reverses that trend by studying positive deviants: individuals who overcame inequalities and other disadvantages. It begins with observing behaviors such as financial savings despite limited incomes or getting flu shots even with limited access to care or when social norms discourage it. Those observations lead to more practical interventions, which are tested in many settings and across multiple behaviors to understand how different environments may worsen inequalities, even when disadvantaged individuals make what appear to be good choices. This will be the first comprehensive behavioral research to use the positive deviance approach with an explicit aim to reduce economic inequalities.Behavioral research on structural disadvantages focuses on the psychological consequences of scarcity as opposed to coping strategies and interventions. Concurrently, most behavioral interventions are designed for the modal person, rendering many large-scale behavior policies entirely ineffective in disadvantaged communities. By focusing on individuals that overcome inequality, known as positive deviants, this research demonstrates to what extent the positive deviance framework can innovate approaches to behavioral policy. In the first phase, extensive healthcare and financial data are used to define and observe positive deviants. Those observations are leveraged into interventions in the second phase. Finally, early career researchers are mobilized to test the replicability of interventions in multiple countries. The third phase will also identify potential differences created by social and systemic factors, highlighting behaviors that are unique to positive deviants compared to where agency in choice is restrained. Studies are focused on six behaviors directly relevant to health and economic inequality: flu vaccinations, preventive care attendance, prescription compliance, debt repayment, windfall management, and financial savings. The researchers test boosts, nudges, standard behavioral interventions (fees/incentives), and mandates, for potential effectiveness at incorporating and facilitating positive deviance.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.