Lens of "constrained choice" can foster new policy options

A new book by RAND sociologist Chloe Bird and Harvard sociologist Patricia Rieker presents a fresh way of viewing individual choices about health that could provide a useful way of examining a range of social policy issues. In their book Gender and Health: The Effects of Constrained Choices and Social Policies, a model of “constrained choice” reveals how family, work, community and government shape individuals’ opportunities, thus constraining their choices.

The constrained choice model shows how policy decisions can have unintended effects on individual behavior. Thus, traits like health are not only an individual responsibility, but one that is also shared by decision-makers at each level of social policy, community actions, work and family. The researchers’ examples show that constrained choice related to health can result from:

National-level social policies that focus on the needs of women and children over those of men




Community decisions about neighborhoods that limit opportunities for walking and exercise




Workplace actions that limit employees’ autonomy over their work and schedule




Health research that overlooks the consequences of the growing complexity of balancing work and family.

With their focus on gender and health, Bird and Rieker use the constrained choice model to answer the question, “Why are some women and men able to create and maintain healthy lifestyles, while others are not?” This model, however, could be applied to other policy areas in which it is helpful to view outcomes as resulting from a web of complex inputs rather than solely individual decision-making.

For instance, the answer to a policy-related question like, “Why don’t all people stay in school so they will earn more money in the long-run?” is not, simply, that some people are irrational decision-makers. Rather, such an answer might be seen more clearly through a lens that analyzes the constraints on the choices of the decision-maker that are created by social/government policy, community and family factors.

A constrained choice lens changes the way one searches for policy solutions. While the goal of policy reform would be the same (a healthy society, for example, or increased high school graduation rates), the route to creating policy interventions would have to include questioning whether other policies create unintended negative consequences or disincentives. Additionally, interventions would seek to increase opportunities for people to pursue the positive action in question, thus loosening the constraints on their choices and decision-making.

Individual responsibility’s importance cannot be underestimated, but models that reflect the complex forces that impact decision-making could yield new strategies for addressing social policy problems.