Come along on a thought experiment with me please. Pause a moment and think of Aotearoa New Zealanders, who are we? Note down your description.

I’m currently reading Full House: The Spread of Excellence from Plato to Darwin by Stephen Jay Gould. I’ve read part one (of four parts) so my understanding of the premise might not be fully formed just yet…

My current understanding of the book’s theme is that we default to considering systems using an average representation of some kind. However, if we actively considered the variation of the systems instead of boiling down to an average essence, we could see the systems in a different light. In the book, Stephen Jay Gould is considering what I’ll call ‘average thinking’ here and the fallacy of seeing progress (in evaluation, for example).

Last night as I was reading, I started seeing connections between representation of systems and how we treat (or ignore) chronic conditions in our societies. If we do have a cognitive bias (way of thinking) to represent the average and fail to account for variation, then it is no wonder that chronic pain and other chronic conditions are often invisible and stigmatised.

I asked you at the beginning who are Aotearoa New Zealanders. Did you describe an average person or a range of people? Please comment below, I’d love to know. I originally titled this Pinch, “All of Us, Not the Average Us” but decided that might bias your thinking straight off!

If we are thinking of averages of groups when we think of Aotearoa New Zealanders, women, Pākeha, Wellingtonians (using some of my categorisations here), then we likely ignore the variation in those groups and neglect thinking, or consideration, of the extremes of that variation.

Cognitive biases exist because they are helpful, unconscious, ways of thinking when navigating the world¹. However, when planning public health responses or planning our cities they don’t help us to consider all of us. Potentially this automatic thought pattern leads us to neglect parts of our people when planning vaccine rollouts, or accessibility of housing, public transport, buildings and streets. Maybe this cognitive bias to average thinking contributes to our decision makers’ consistent decisions to not apply universal design in their planning.

Going against cognitive biases requires conscious, effortful thinking; going against the automatic¹. Going against average thinking requires visibility of the variation. I bet others have more eloquently and systematically studied average thinking and its applications…

I can think of one relatively recent example to illustrate my ponderings. A situation where I don’t think it had occurred to decision makers to consider people with chronic pain, illness or disability; to consider anyone beyond the average. In Aotearoa New Zealand, we have been using QR codes as a way of ‘checking in’ our movements for Covid-19 contact tracing purposes. Last year I wrote to the company who runs the train and bus services I regularly use:

I am emailing to ask you to review your Covid-19 QR code-positioning on buses and trains with accessibility in mind.

I experience chronic pain, which impacts my coordination and how fast I can move. On public transport this means that I need to be seated as quickly as possible so I’m not jerked around by the movement of the bus or train while standing.

In terms of scanning QR codes, the positioning of them often means that I can’t scan in. On trains the QR codes are mostly on the windows. If I am seated next to a window that is fine. If I’m not (the majority of my journeys), I can’t scan in as I can’t physically and easily reach across people. On the buses there are more QR codes; on the windows and some on the poles. If I am seated next to a window or a pole with a QR code, I can scan. If I’m not, I can’t.

There are smaller QR code stickers available now. Could you please put these on the back of every seat on buses and trains in addition to your current QR codes available? I won’t be the only person with a disability who can’t scan on most journeys. Different people will have different experiences. Please look at your QR codes with the abilities of different bodies in mind.

I did have the option of making a manual entry in the contact tracking app but doing so meant I would not get any alerts sent; reducing the effectiveness and timeliness of any contact tracing.

I just don’t think it had occurred to the people planning the roll out of QR codes on these public transport services that the people using their trains and buses were not all the same in terms of how they could move or reach to scan a QR code. Potentially they fell into average thinking.

What are the implications of average thinking to visibility and consideration of people with chronic pain and other chronic conditions? People with chronic pain, for example, who are nearly one in five of the New Zealand population¹, are likely not part of many average representations. If the QR codes’ positioning had been planned with conscious attention to variation, the result would have been a system that worked better for more people; including the average! Plan for all of us, not the average us.

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1. Many, many papers by D. Kahneman & A. Tversky. For a summary of this set of work and an engaging exploration of human cognition, see Kahneman, D (2011). Thinking Fast and Slow. Farrar, Straus and Giroux.
2. Ministry of Health (2021). Annual Data Explorer 2020/21: New Zealand Health
   Survey. Wellington: Ministry of Health.