Two health designs

We highlight design because humans are conditional creatures. Certain circumstances make certain actions more or less likely. Living near a huge retirement community in Florida shows this contrast clearly. The involvement in new sports like pickleball, water volleyball, and sand tennis exemplify the design principle: If you build it, they will come.

In talking about his book,Drink?, David Nutt notes how much alcohol is a cultural act. Per Nutt, alcohol’s health impacts are terrible, the societal costs are large, and meaningful outcome changes wouldn’t require that much tweaking to the current system. But we don’t change.

Culture is design too. So to not drink a person needs to counter culture.

“In my book I suggest if people say to you, ‘Why aren’t you drinking?’ quite a good repost is to say, ‘Because I’ve got quite a busy day tomorrow.'” – David Nutt, London Real, February 2020

That’s good communication, it’s in the listener’s language.

The second design is around fasting, an area design helps.

“Right around the five hour mark of a fast you’ll probably get hungry (this being our ‘normal’ time between meals), and that’s the most difficult time. Sleeping through that is the best idea then. If you can start a fast at three p.m., then in the evening you have to stay away from the snacks, but when you wake up you’re in that cruise state of twelve plus hours.” – Matt Tullman, No Meat Athlete Radio, October 2021

In my experience this is true. Fasting pangs are non-linear. Depending on the time, circumstances, and maybe even hydration, a fast can be more or less difficult. Sleeping through those time-based hunger troughs can help.

You are a designer. I’m a designer. We are all designers.


Nutt sounded quite certain in the podcast about the health effects, but a query for “cancer alcohol meta analysis” showed less convincing results. In an attempt to be more Bayesian I’ll update from ‘quite bad for you’ to ‘pretty bad for you’.

Roulette with Bobby

A friend wants to pay off his mortgage in the next three years. He’s got two young kids. He’s younger than me. Meanwhile, I refinanced into a new thirty year mortgage. If he pays off his home debt it will be quite an accomplishment.

Bobby’s plan is different from mine. But I don’t know that he’s wrong. Personal finance is more like cooking than baking. We looked at, for instance, a 15 or 30 year mortgage?

In a way Bobby and I are at the roulette wheel. He’s bet on black. I’ve bet on red. One of us will be right, but we can’t know ahead of time. Most of personal finance is reducing the range of choices to just good options. It feels like we’ve both done that.

The analogy of roulette also works because rather than red or black, the ball could land on green. Despite planning, we both could be wrong.

It’s also important that we have designed our systems. Sometimes we think knowledge leads to action, but around here we know that design rules the day. Bobby has a plan to pay off his mortgage early – that plan is the design. Our family has automatics contributions – that’s our design.

“If someone says financial literacy at a party I basically give them a thirty minute lecture. The idea is that in a perfect world, if someone is taught about FICO and the impact on their life, they would take actions to improve their FICO score. This is just not what researchers have found – and it’s really robust…the punchline is that environment matters.” – Kristen Berman, All the Hacks, October 2021

Roulette, as an investment, is not in the range-of-good-choices. But as an analogy it fits nice. Prepare and pick from prime possibilities but remember the ball might not bounce any of those way.


There’s a lot about design here. It’s one of my 62 favorite ideas.

Dan Carlin’s creative thinking tool

One way to change decision making is to think different. One terrific tweak is to design different processes. “Start with the base rate” would be one way. Another is framing.

“I had a military history professor and one of the greatest things he taught, and I use this tool all the time, take out the most obvious easy solution from your consideration, take it out of the factoring in your thinking and then try to solve the problem.” – Dan Carlin, Common Sense, September 2021

Carlin goes on to say that part-of-the-reason there was no total war during the Cold War was because of nuclear war. Traditional war, Carlin notes, was “off the table”, and we are a creative bunch so a new solution was found.

Sometimes though, the culture of a place is so strong that framing traditional ideas in new ways is not enough. Mike Lombardi told Annie Duke that more organizations should have a “change department”, where an individual’s sole goal is to change your mind.

Sometimes the culture of a place is so so strong that framing or formatting are not enough. A new culture must be formed. This, wrote Clayton Chirstensen, is the innovator’s solution. Christensen’s disruption occurs when an industry leader continues to serve their best customers but the rules of the game change.

These are design choice. “Starting with the base rate” may not lead to adjusted conclusions but it will be closer to them than not. And we are all designers.


Design is one of the 62 favorite ideas. Read them all in a daily email drip on for five bucks. Find it on Amazon too.

What’s this place optimized for?

Everything around us, notes Jason Crawford, is a solution. It may be a ‘local maxima’ rather than a ‘global maxima’, but everything around us is the best idea we’ve had yet (given the culture and incentives).

And these solutions all influence our decision. The punchline to behavioral sciences, says Kristen Berman is environment, environment, environment. The question to ask then is: A solution for who?

“If you go to a mall how could you not spend money? People have thought deeply about how to get you to spend money, they’ve thought deeply about getting you to buy something. It’s a hard fight, and it’s getting harder. Amazon Prime is the gold standard for this. They’ve figured out something about human behavior and it’s going to be hard to fight that.” – Kristen Berman, October 2021

Cinnabon is a tasty brick and mortar example of how place matters. The stores are in places of captured traffic and infrequent visits. Da Buns, said Kat Cole, are treats. So the frequency of customers affects the type of product.

Another instance is that oh-you-know-it smell. That wonderful waft was an accident. The first location lacked enough room for the oven to go in the back – per best practice prescription – so it was jammed in the front. Learning their lessons, the second location prioritized moving the oven out of the way. Whoops. Luckily for us all, they fixed that.

I’m not as strongly behavioral as Berman (though I did update) but her idea of wise designs hits home. In 2014 our family went on a Disney Cruise. We had a blast. But one evening my wife scheduled dinner with a Disney Vacation Club (their timeshare component) representative. It was there, in that office, sweating bullets that I realized something about myself. I’m bad at ‘No.’

This guy was good. Each objection he countered. Each escape he blocked. Each obstacle he climbed. Somehow, like Aladdin, we escaped.

Now I know about ‘No’ and good design and Berman’s advice.

Just a monkey with a fasting app

The Matrix (1999):
Kung Fu

This came to mind when a friend asked my advice on fasting. I told her what worked for me, what I thought were best practices, and suggested the Zero fasting app.

The app has 330,000+ ratings. It’s in the top 100 Heath and Fitness apps. Which is kind of crazy because, it’s a timer.

Designs matter a lot in our actions. Using the app I make probably 90% of my fasting goals. Days without the app and the number is probably 25%.

One design theory is to consider appropriate information. If fasting is new to someone they need baby steps: an app that shows how much time has elapsed, guides to the ‘right’ fast, and advice, tips, community, etc.

Appropriate information feels like a weird concept until we see it. It’s like, oh, this other way of describing the world exists too Huh. Temperature is one of these areas. What’s the best way to convey information about thermal energy: Celsius, Fahrenheit , or Kelvin? It depends! What’s the gap between the individual and the information? Celsius and Kelvin work great for science and scientists because the information-individual gap has been narrowed by years of education. For the consumer though, Fahrenheit rules the day as the most legible.

Another is how to classify an avalanche. What’s the gap between an individual and the information? The US and Canada, for instance, use different systems. In the States avalanches have five levels according to “the path”: sluff, small, medium, large, major.

“These categories are in relation to path size, so a size or class number is not so meaningful without information on, or familiarity with, the path.” – Avalanche Institute

Locals have a small information-individual gap because they know the area. Compare the American system to the Canadian system, which also has five categories: relatively harmless, could bury or kill a person, could destroy a small building, could destroy a rail car, and largest known. There’s no information-individual gap when the warning is largest known.

It makes sense then that “just a timer” works for so many people. It’s not just a timer. It’s a tool to close the information-individual gap. Oh, I get it now. And even though the gap seems small (Siri set a sixteen hour timer), it’s large enough to matter.


per avalanche-center.org there’s also an international classification system.

the “just a monkey with a…” idea comes from Erik Jorgenson’s Navalmanack curation.

Show the way or in the way

One common mistake in our understanding of “how the world works” is to think that lack of action is due to a lack of information. If people just knew how important X was they would definitely do it.

One form is seen in the social media question: What would you add to the high school curriculum? Answers tend to hover around statistics instead of calculus, personal finance, or decision making.

Those are well intentioned suggestions, and on net, students would be better off if we could download a stats module in place of the first derivative. But information is not action.

Orlando Marriott hand washing sign

Geez. We’ve looked at hand washing (twice!) and there’s probably a well designed study that notes signs like that, in bathrooms such as this, change a proxy for health in some-such-way.

But, there’s a better example. It’s a real life example. It’s been tested on thousands. It’s also in Orlando. Arrange hand sanitizers to be avoided. To hijack Ryan Holiday: the obstacle is the way. But after two days people watching in the theme parks it’s very clear, this works.

And the reason for signs showing the way and not sanitizer stations in the way is incentives.

Back to Twitter. Some schools offer personal finance. From Kris’s nephew.

“I have this assignment for school where I have to invest $1,000 into a company’s stock. And I know you’re a stocks person so I was wondering if you know a good company i should invest in. Because the winner gets a prize of who makes the most money.”

Just give every twelfth grader $200. But there’s no action in that. There’s no standards or benchmarks or assessments about net learning in the second quarter of the school year. So in a way, Kris’s nephew is getting exactly what the system incentivized.

This is the system. In education it’s hard to measure “financial literacy”. In public health it’s hard to measure “healthy place”. In these systems optics are rewarded. Theme parks are in the optics business too, but for them results like: Person Gets Sick at World Famous Theme Park matter more. It’s important to know the rules if we want to play the game.


In finance there’s paper returns and there’s “moolah in the coola”, that’s another analogy. Paper returns are optics. Money in the pocket is an outcome.

Day to day designs

There’s a lot of advantages to designing day-to-day decisions. It’s may seem unglamorous but changes add up. For instance, try to leave your phone out of reach.

But the internet is on there!

The heart of design is to change a situation so that something is more or less easy. The beauty of design is that the change is not always in proportion to the effect. And we need designs because as Byrne Hobart notes, we have a lot of muscle memory.

“There’s a lot of muscle memory typing ctrl-t Reddit dot com. It is really important to resist that stuff because it is a continuous tax on your ability to accomplish things. This is a good reason to buy physical books or magazines. If can force yourself to focus for awhile, you can get non-linear benefits from learning a whole lot about narrow topics and understanding new topics by using analogies from previous ones.” – Byrne Hobart, World of DaaS, August 2021

Here Hobart offers a couple of useful ideas in an interesting way. One is design but he also frames Reddit as a tax. This is clever.

Tax is normally associated with money and with being bad. Tax reframed here keeps the bad part but shifts the focus to time. That works with travel budgets too.

Personal productivity is another one of the Large N small p cases. It may not seem like we are ‘doing a lot’ but small changes add up each day.

Local maxima

When stuck-at-home in 2020 my kids (12, 10 then) and I enrolled in the Marc Rober Creative Engineering course on Monthly. It was mostly above my engineering (and their in-depth interest) level but it was still great. We got to see Rober’s structure for brainstorming, more of the build process, and his thinking along the way. The hours of course video were like a documentary, a ‘Making of’ video.

One thing we saw was how Rober prototypes his builds. In the case of a making a candy launching device Rober made one using springs, one using compressed air, and one using hydraulics. The reason to prototype, Rober said, it to not get stuck at a local maxima.

Rober's sketches

We all have an idea for solving a problem and a lot of times we just do that. However in the situation we get more information. Rober suggests imagining a series of wooded hills. From the ground we don’t know which is highest (the best solution). So we need to hike up our best guess and look around from there. The hike up to, and the view from the top give us information on how best to act.

Rober’s process has come, in-part, from his years at Apple and NASA and making things like squirrel obstacle courses and glitter bombs. He’s a YouTuber with a very small staff, (no groupthink) so how might an organization avoid local maxima?

Rory Sutherland suggests following the bees. What’s great about Rory’s recounting is the structure. Organization direction is based on culture and incentives. Sutherland’s structure is one way to change the incentives.

“I think having two budgets, two sets of metrics, and two sets of incentives for exploit and explore. It would be utterly insane to learn something in a test and fail to exploit it by doing more of it. Make the most of what you know, but always invest twenty percent in what you don’t know yet. Bees do this where roughly twenty percent of bees ignore the waggle dance that tells you where to find nectar. The bees understand that if you don’t have these rogue bees the hive gets trapped at a local maxima and eventually starves to death.”

Part-of-the-question with a local maxima is the cadence of change: is a business more like Netflix or a pool construction company? Rober prototypes. Sutherland et al. ‘test counterintuitive things’. Some bees explore, some exploit. Each found a balance and designed a loose solution so not get stuck at the local maxima.

My 62 Favorite Ideas

Are you familiar with “the travel guide”? Before the internet, maybe still – I don’t know, people bought books that acted as guides for the things they wanted to do. My shelves have/had: Italy, Disney, Disney, Orlando, and the Bahamas.

The guides gave a nice overview. Here’s what to know about the Sistine Chapel. It wasn’t a substitute for going and gawking, but the guides were a map, combining: geographic, informational, cultural, and other bits of information. That’s what I made, an idea map.

It’s like a travel guide. Each entry is short and to the point. Each entry also connects with other entries. A travel guide might say something like: “make sure you visit in the morning and stop at the nearby coffee shop after”. That’s a considerate connection, two attractions that are nearby in space and time (low crowds, tasty treat after standing). My guide does that too. Here’s two examples:

Alpha erosion

Alpha erosion is the idea that advantages erode as the market notices a success. When an organization balances the explore and exploit nature of work, it will land on opportunities to deliver value and earn profits. Competitors will notice and attempt to recreate this success. Sometimes competitors will succeed, even outperform, and sometimes they will not. The best way to avoid alpha erosion is to not be noticed. There are at least two ways. First is the path taken by Amazon, where the company was unprofitable but valuable and the desire to imitate was limited. For many competitors, unprofitability was a restricted action. The second is to create alpha in a business where the rewards are unappealing. There are many people who want to be movie producers or winemakers, but many less who want to operate a regional chain of construction dumpsters — even though the latter suffers less erosion.

&

Explore and exploit

Explore and exploit is the idea of a spectrum of work between exploratory work and exploitative work. At any given time there’s a better area on this spectrum to be for an organization as well as an individual. One way to view the explore and exploit spectrum is through two different businesses. One business is a streaming media technology firm. They have a direct relationship with their individual customers and bill them monthly. They also work with the providers of media to create content for the customers. Both the providers and the customers have a JTBD. The providers want freedom. The customers want choice, uptime, and lower bills. The competition meanwhile wants alpha erosion. This business must quickly move back and forth between the explore and exploit ends of the spectrum. They must innovate in delivery, technology, and marketing then implement each. A different business is the regional construction company. They too have customers who want a new kitchen or pool and they have suppliers who specialize, subcontract, or deliver supplies. But the regional construction company has to move back and forth at a different cadence. Someone’s system suggests their location on the spectrum. It is also rare for a situation at either extreme. Even the regional construction company must allocate resources to exploratory ends. The location between explore and exploit can guide a person or organization towards what type of work is best for the moment.

For the ideas in a daily email drip, buy the email-drip, pdf, and ePub in one package on Gumroad. Find it on Amazon too.

Travel budgets

Actions are the children of mindset and environment.

When running his document storage company, AJ Wasserstein created a travel budget. Budgets are good. Budgets are a design tool, and we are all designers.

Wasserstein’s budget wasn’t denominated in dollars, it was in days away from home

“One thing I did while working at Archives One was give myself a travel budget. I gave myself permission to travel a certain number of days a month. It wasn’t a financial budget, rather a nights-away-from-home budget. If I started to exceed that consistently, my role at the company needed to be cleaved and I had to hire someone to do part of what I was doing.” – AJ Wasserstein, Circle of Competence, June 2021

Wasserstein asked a different question. Rather than ask what was financially costly he asked what was socially costly and optimized for that. A lot of times we assume that the important is easily measured. Dollars? Yes. But other things too.