Control over mortality risk and health disparities

In affluent societies, socioeconomic disparities in health and mortality are well-documented phenomena, largely influenced by differences in behaviours (Pampel, Krueger, & Denney, 2010). However, the underlying causes of these socioeconomic disparities remain inadequately understood. Individuals of lower socioeconomic status often exhibit present-oriented behaviours, which have adverse health consequences.

Drawing on evolutionary approaches to aging (e.g., Abrams & Ludwig, 1995; Cichoń, 1997), and specifically on the uncontrollable mortality risk hypothesis (Pepper & Nettle, 2017; Brown & Pepper, 2023), my research also considers how the concept of uncontrollable mortality risk informs individuals' decision making regarding health investment. This hypothesis posits that individuals adjust their behaviors based on their perception of mortality risk, with higher perceptions of uncontrollable mortality risk leading to present-oriented behaviors and reduced investment in long-term health. Within this framework, present-orientation may represent a contextually appropriate response to the limited control over mortality risk experienced by those living in deprivation. As the perceived control over mortality risk diminishes, individuals may discount future rewards and exhibit reluctance towards adopting future-oriented behaviors, including investing in their health.

My dissertation employs a mixed-methods approach to investigate the psychological mechanisms influencing individuals' decisions regarding health investment, as well as the environmental cues guiding their perceptions of mortality risk control. This research combines survey-based quantitative analysis with qualitative interviews.

In the first part of my dissertation, I examine the mediating role of perceived uncontrollable mortality risk in shaping socioeconomic disparities in health behaviors. Additionally, I aim to identify potential cues influencing perceived uncontrollable mortality risk, particularly focusing on family mortality history. Furthermore, I investigate the relationship between perceived control over mortality risk, time perspective, and locus of control.

The second part of my dissertation delves deeper into these findings through semi-structured qualitative interviews. These interviews seek to elucidate how individuals construct their perceptions of control over mortality risk, their time horizons, and the cues informing their estimations. Additionally, the interviews explore the motivating and deterrent factors influencing individuals' health behaviors.

References

Brown, R. D., & Pepper, G. V. (2023). The Uncontrollable Mortality Risk Hypothesis of Health Behaviour: A Position Paper [Preprint]. Open Science Framework. https://doi.org/10.3219/osf.io/py7dw

Cichoń, M. (1997). Evolution of longevity through optimal resource allocation. Proceedings of the Royal Society of London. Series B: Biological Sciences, 264(1386), 1383–1388. https://doi.org/10.1098/rspb.1997.0192

Mell, H., Baumard, N., & André, J. B. (2021). Time is money. Waiting costs explain why selection favors steeper time discounting in deprived environments. Evolution and Human Behavior, 42(4), 379-387.

Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010). Socioeconomic disparities in health behaviors. Annual review of sociology, 36, 349-370.
Pepper, G. V., & Nettle, D. (2017). The behavioural constellation of deprivation: Causes and consequences. Behavioral and Brain Sciences, 40, e314. https://doi.org/10.1017/S0140525X1600234X