The Altruism Prescription and the Health Argument for Social Good

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December 30, 2015; The Atlantic

Since the 17th century, philosophers and scientists have tried to fit altruistic behavior into human social models and evolutionary theory. The term “altruism” has different meanings across disciplines, but the concepts more or less revolve around the different ways an organism derives benefit from other-directed behavior at a personal cost. But a growing body of research on the positive health effects of altruism has given new impetus for promoting altruistic acts for public health, the practical implications of which are very unclear. Nonprofits should probably be more concerned with prosocial behavior (the results of actions) than altruism itself (the motivation behind the action).

This recent article from The Atlantic gives a rundown of the health benefits of volunteering, such as weight loss, improved cholesterol and lower levels of depression. In a study published this month in Social Science & Medicine, Eric Kim and Sara Konrath found that older adults who volunteer are more likely to use preventive health services and spend fewer nights in hospital. Konrath, who is an assistant professor of Philanthropic Studies at the Lilly Family School of Philanthropy, thinks this body of research is robust enough that doctors should prescribe volunteering along with diet and exercise to improve health. Her argument is that volunteering results in similar health outcomes to smoking cessation, yet doctors don’t advise people to volunteer as they advise them to quit lighting up. “What [doctors] ignore is that most of the context of our day-to-day lives is embedded within relationships. The number and quality of those relationships strongly influences health.”

While Konrath makes a great point, I can think of a few reasons why volunteering doesn’t make for an effective health prescription. Volunteering is just one expression of altruism, and research has shown health benefits for other altruistic acts, such as charitable giving. Research even shows the benefit of an optimistic attitude, and as The Atlantic article also suggests, it isn’t the act of volunteering itself behind the health benefit but rather “a sense of purpose.” Konrath’s previous research has shown that subjects who volunteer out of self-interest don’t gain the same health boost. In light of the various ways that positivity and charity improves health, the prescription of “volunteering” on its own would at least require a highly specific protocol, to be sure.

Volunteering and quitting smoking also aren’t the apples to apples they’re made out to be here, as the adverse health effects of smoking are not the same as those of not volunteering. If you quit smoking, you breathe easier pretty much right away. But the health impacts of “doing good” (such as fewer days in hospital) are not as perceptible in their immediacy. One could also argue against the altruist prescription in favor of family role-modeling and conversations, as socialization can promote these practices and, in theory, their health benefits as well.

Not surprisingly, Konrath admitted to The Atlantic that she’s not sure what winning people’s hearts over to the health benefits of volunteering would look like. For nonprofits, this means that selling people on the health benefits of altruism is probably not a good goal. For starters, nonprofits aren’t really in the business of promoting altruism but rather of harnessing prosocial behavior, which may arise from real altruism but also from a variety of other conscious and unconscious motivations, which can change from person to person. As explained in this paper on the science of generosity, “Research suggests that there are both internal and external factors in the development of prosocial tendencies—also called the prosocial personality […]—and these two sources can either reinforce or challenge one another.” Furthermore, the neural rewards of giving (or the “helping high”), personal growth, skills development, and the promise of new knowledge and abilities may not lead to a health benefit because of their self-directed motivation, but they are benefits nonetheless for individual satisfaction and, by extension, social enhancement.

Complicating the matter is that fast-and-true theoretical constructs of altruism are hard to come by, as the “largest hurdle in an effort to conceptualize generosity is the lack of conceptualization and theorization of even the most standard concepts in the prosocial literature.” The Oxford Handbook of Prosocial Behavior, published in April 2015, attempts to overcome this problem by extensively outlining prosocial concepts and their components. For example, in discussing the neurobiology of the caregiving system, which theoretically serves to “provide the motivation for sustained parenting,” Cialdini and Brown suggest that the right question is not how altruism and prosocial behavior impacts individuals but rather how “our social world dials down, thwarts or even turns off our prosocial nature.”

Grand social ideals aside, nonprofits must of course be concerned with promoting prosocial behaviors to achieve their missions and effect social good. Learning how people respond to the principles of influence (as described in Robert Cialdini’s popular book) can help nonprofits trigger prosocial behavior that has psychological, physical and social benefits for givers, receivers and society. It would also be in a specific nonprofit’s best interest to show the impact of the prosocial behavior associated with its cause, either in terms of traditional philanthropy (for example, out of duty or an emotional connection) or the current trend of “effective altruism.”

The altruism prescription sounds like a great idea but for the moment seems untenable from a large-scale public health perspective. For nonprofits, altruistic motivation for philanthropy is more icing on the cake than something they should spend resources promoting. Overall, families can serve as role models for giving and volunteering and would probably do a better job in the long run for altruism-associated health results compared to people in white coats whose main goal is often to get us to eat more vegetables and get up off the couch.—Amy Butcher