Okay, last module, lecture four. This module's on game theory.

Not often talked about in social epidemiology, but I think it provides some important insights for social epidemiologists trying to understand how society works. And then how these workings of society produce health of populations. Again, remember, no reading assignment for this week. Instead, what I want you to do is look for components of social theory and go to the discussion boards, and we'll have some group communication about this. As we're finishing up this week, a cou-, a quick reminder. Why are we doing theory at all? Remember, it tells us where to look, and what to focus on, provides a framework for logic and inference, or drawing conclusions, it illuminates, and perhaps mitigates [SOUND] confirmation bias. That is looking for data, to prove what you already know to be true. That's a bad thing in science. And finally, theory is an integral part, of the process of science, there's always debate whether, data or theory comes first, but there's no debate, that theory is critically important for science. Now we're going to talk about something called game theory. And it's not about playing Monopoly per se, it's richer than that. And it's the study of strategic or interactive decision making. And it tries to help us understand what we can expect as a social outcome. Given incentives for the individual actors were the rules of the game. It's used in evolutionary biology, in economics and other social sciences. And I'd encourage you to do some work on the Web, Google game theory, maybe check out Wikipedia. There's lots to go over. And I also want to emphasize, I'm just offering you a little simplistic tidbit of this, because that's all I can do in this course format. I just want to get it going and get some ideas in your head. Game theory helps us understand given private or personal motivations. And the incentives, what result the system will yield. So that's important distinction. Individuals doing what's good for them

individually, what happens at the group or system level? That's why I like game theory, and I think it's helpful for social epidimiology. And then critically we can image if we altered the rules of the game or the incentives what might we expect the system to produce very concretely given the rules of the game what kind of health do we imagine for the population. If we alter the incentives for the game. What might the difference be in the health of the population? So that's what we're really after here. Lets start with a simplistic classic one. I'm just going to walk you through these quickly, and it's just to illuminate some of these. Core aspects of game theory. The first is called the Prisoner's Dilemma, and the story is this: There's two criminals that get jailed. Their jailed and put in separate cells, their not allowed to communicate at all. Their sort of by themselves and the sheriff, or the jailer comes to each of them independently and says If you tell me your partner was the actual criminal, you'll get to go free. He'll spend more time in jail. The critical piece here is that the sheriff or jailer says this to each of the criminals independently and they don't know it. They cannot communicate with each other. So the dilemma, so called prisoners dilemma, is what do the prisoners do, and then what's the social or group outcome? This can all be translated into some simple and complex math. We're going to keep it simple. So first, just imagine this scenario. We have one prisoner and he can either be silent, that is not speak about his accomplice, being the reason or the actual criminal. Or he can betray, or sometimes call it rat out, his accomplice. So prisoner one has a choice. Be silent and not speak. Or betray or rat out his accomplice. If the prisoner is silent, doesn't rat out his accomplice, he might spend some time in jail. Because the jailer says, well, you didn't give up your friend, you spend time in jail and he might spend a year in jail. The numbers themselves don't matter, it's the differences in numbers.

If he betrays, and says, oh yeah, the other guy did it. Then he gets to go free. Now the fun part, prisoner two gets the same deal. If he's silent, he spends some time in jail. If he rats out or betrays his friend. He gets to go free. Now remember, there two prisoners cannot communicate. How much trust do they have in one another? Because the scenario becomes this, prisoner one is silent, spends a year in jail. Prisoner one betrays, spends no time in jail, prisoner two, silent. One year in jail, betrays no time in jail. But now, let's get more complicated. If prisoners one is silent, and prisoners two is silent. They both spend just one year in jail, not optimal. So, if prisoner one betrays, rats out his colleague, and prisoner two remains silent, prisoner one walks, and prisoner two spends, say five years in jail. That's a bummer, prisoner one wins, prisoner two loses. On the other hand, if prisoner two betrays and prisoner one remains silent, then prisoner two walks and prisoner one spends time in jail, so now it gets interesting. We have this scenario, where both have incentive to betray each other and walk free. If they're both silent, they spend one year in jail which is more than walking free, but not as bad as if the other one betrays. So what happens here is this lower diagonal box is where the system will yield. Both prisoners end up betraying each other, because they're afraid the other one will betray them. And so both spend three years in jail. That's the expected outcome of this prison's dilemma setup. And it's all a function of the rules of the game or the incentives for each player and the fact that they cannot communicate. So what's the point? That the rules of the game or individual rationality people trying to maximize their own welfare yields collective

disaster. So people try to do good things for themselves, which can often yield good outcomes, can sometimes yield collective inferior or suboptimal outcomes. That's important to know when we think about how society is working to improve health. Everyone doing what's good for them, can yield something that's bad for everybody. In other words, given the rules of the game, we are compelled to do things that sometimes even backfire against us. Recall the outcomes that when we try to do the right thing and save ourselves, we end up worse off. And there's all kinds away that math here can be manipulated and show different outcomes. My point for this course at this time is to remind you that sometimes purposive, individual rationality can yield collective disaster. This also seen in the classic the story of The Tragedy of the Commons. And there's various ways to tell this story. Here we see some cows, sometimes it's described as sheep. And the story is this, that there's a commons in the cow case there's a field, in the sheep it's a field, for health it might be clean water or healthy places or excellent health care. The point is there's some resource that's scarce. In, in a tragedy of the commons,there are farmers, cow herders, or sheep herders, who individually want to have more cows in the field. They have more milk or more meat, and therefore make more money. But the problem becomes when everyone, all the farmers or shepherds. When they all put the extra sheep or extra cow into the field what happens, of course, is the grass, the field becomes depleted and then everybody loses. Same thing can happen in these health issues. When everyone is trying to have clean water and you can't restrict everyone. Then the clean water resource can be depleted. Healthy places, everyone wants a healthy place, more production, you can lose it entirely and the same thing with health care. So the tragedy of the commons applies not only for this sort of fictitious

shepherds or cowherders but applies to health. And again the basic story is, individuals acting rationally, clearly, on their own behalf, can yield collective disaster. So what are the solutions to the tragedy of the commons? There's many, I'm going to give you a few First, maybe people can change their motivation. Instead of being self interested, they could be other regarding, altruists. Maybe there's more peace and love in the world. Wouldn't that be nice? Another solution is to privatize the pasture. Give it to someone, or break it up into sections. And everyone has their own private part. When you own your own private part. You're less apt to over graze it, because then you undermine your own success. You'll only graze as many cows or sheep as the pasture can tolerate. There could be some sort of cooperation where the other farmer grazes more sheep one year. You do more another year. All kinds of cooperation schemes can emerge. Finally, and interestingly, you could create a government, a third body, that sets the rules of the game. Who gets to graze their cows? Who doesn't, and what are the penalties for overgrazing? All related to this is the problem called collective action. Which I think is the core problem in improving the public health. The classic text comes from 1965 by Mancur Olson. And you here, here you see a picture of the book. Here's the story. How do a bunch of people get together to get something done. It's not easy. [COUGH] The first problem, of course, is that people have to find one another. It might be easier in this age of the Internet. But still people who want to get stuff done have to somehow get together. And then they have to decide Hm, do we have the same interest or do we divergence interests. Many people have divergent interest and even if they're the same.

Are they the same enough? So you gotta get together and find some common purpose. That's the first step to solving the collective action problem. And that collective action problem might be providing healthcare for all, might be mitigating environmental pollution, abating lead paint in houses. Coming together to solve major health problems that have big impacts on population health. The other part, though, of the collection action problem is called the free-rider If everyone's going to spend their time, energy, and perhaps money, to solve a problem, why should I do that? Why should I spend any of my time, money, or energy if all of you guys are going to solve it. I can win or have more by not participating, by letting you solve it. So, this is called the free rider, and it comes up all the time, and so one of the key questions for social science, political science in particular, and now for social epidemiology is how do we solve the big public health problems through collective action, wherein first we've got to come together and find common interest. And then once we do, how do we deal with the free-rider? Those who would rather not spend their time and energy. Now what's critical, is when, you don't want to spend your time and energy, why would I want to spend mine? And so the whole effort of collective [UNKNOWN] action or social movement can break down. So, why don't you think about, how to deal with the free-rider problem?