Optimal Policy in the Presence of Social Image Concerns: Experimental Evidence from Deworming

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Access to health services is often viewed as primarily a logistic issue, without considering the role of social norms. Economic theory suggests social image concerns interact with logistical factors like distance and observability, acting as a social multiplier to strengthen or weaken their impact. We examine this interaction in a large-scale field experiment in Kenya, randomly assigning communities to deworming treatment locations at varying travel distances and introducing verifiable signals for adults to broadcast their deworming status. We find that a one-kilometer increase in distance reduces treatment take-up by 16 percentage points in the absence of signals, but this negative effect is mitigated by 6 percentage points when signaling is facilitated. Using a structural model, we show that distance not only changes the private cost of deworming but also alters the observability of actions and equilibrium beliefs about who deworms, thereby affecting social image returns. Combining our model estimates with geographic data, we demonstrate that accounting for a social multiplier, travel distances can be increased by 11% without reducing take-up, highlighting an effective lever for expanding access to health services.

Speaker:

Anne Karing is Assistant Professor at the Kenneth C. Griffin Department of Economics and the College at the University of Chicago. Her research focuses on the economics of healthcare delivery and health-seeking behaviors in low-income countries, applying insights from psychology.