The Relationship Between Perceived Uncontrollable Mortality Risk and Health Effort: Replication, Secondary Analysis, and Mini Meta-analysis.

ABSTRACT

BACKGROUND: The Uncontrollable Mortality Risk Hypothesis (UMRH) states that those who are more likely to die due to factors beyond their control should be less motivated to invest in preventative health behaviors. Greater levels of perceived uncontrollable mortality risk (PUMR) have been associated with lower health effort in previous research, but the topic remains understudied. PURPOSE: To examine the evidence for the UMRH by replicating a previous study investigating the effects of PUMR on social gradients in health effort, and conducting a mini meta-analysis of the overall relationship between PUMR and health effort. METHODS: We replicated Pepper and Nettle (2014), who reported a negative relationship between PUMR and health effort, and that the positive effect of subjective socioeconomic position on health effort was explained away by PUMR. We also compared the predictive effect of PUMR on health effort with that of dimensions from the Multidimensional Health Locus of Control scale-a well-used measure of a similar construct, which is frequently found to be associated with health behavior. Finally, we conducted a mini meta-analysis of the relationship between PUMR and health effort from the available research. RESULTS: PUMR was negatively associated with health effort, and mediated 24% of the total effect of subjective socioeconomic position on health effort, though this mediation effect was weaker than in Pepper and Nettle (2014). PUMR was shown to be a substantially stronger predictor of health effort than the relevant dimensions of the MHLC scale. Finally, our mini meta-analysis indicated a medium-sized negative relationship between PUMR and health effort. CONCLUSIONS: Our findings offer support for the role of PUMR in mediating the relationship between subjective socioeconomic position and health effort. The results highlight the importance of measuring and understanding PUMR in studying socioeconomic inequalities in health behaviors. We discuss potential areas for future research, including determining the accuracy of PUMR, investigating influential cues, examining the role of media in shaping risk perceptions, and understanding individuals' awareness of their own perceptions of mortality risk.

Previous research suggests that people who are more likely to die due to uncontrollable factors are less motivated to look after their health. This is because they are less likely to live to see the long-term benefits of a healthy lifestyle. The purpose of this study is to examine and expand upon previous research investigating the relationship between perceptions of uncontrollable mortality risk and the amount of effort people devote to their health. Our findings support past research and show that the more people feel their risk of dying is out of their control, the less effort they put into looking after their health. Our analysis suggests there is a medium-strength relationship between perceived uncontrollable mortality risk and health effort, which we argue warrants further empirical investigation. The strength of this relationship emphasizes the importance of improving the safety of people's living environments and highlights the positive impact that this can have on health behaviors.