Perceptions Of Mortality Risk Research Articles

Perception of uncontrollable mortality risk is associated with food insecurity and reduced economic effort among resource-insecure college students during COVID-19.

In the framework of the uncontrollable mortality risk hypothesis, resource scarcity intersects with mortality risk, shaping resource allocation strategies with enduring impacts on human health and wellbeing. Despite rising economic and food insecurity among US college students, little is known about how these insecurities relate to mortality risk, or how scarcity and mortality risk interact to shape college students' resource allocation strategies. We examine perceptions of resource scarcity and mortality risk and their associations with food insecurity and resource allocation strategies among economically insecure college students during COVID-19 lockdowns. Participants were recruited through an economic crisis response center at a major public university in the United States. A total of 118 participants completed an online Qualtrics survey assessing sociodemographic characteristics, perceptions of mortality risk and resource availability, food security, economic effort, and time perspective; a subset (n = 51) also participated in a telephone interview assessing psychological distress. In general, participants reported more environmental adversity and economic effort during COVID-19 lockdowns compared to before. Students experiencing higher levels of uncontrollable (and not controllable) mortality risk report lower levels of economic effort, and the association was strongest among students perceiving the fewest resources. We also found significant associations between uncontrollable mortality risk and food insecurity. Our results highlight uncontrollable mortality risk's influence on human well-being. Public health efforts should target the experiences and root structural causes of uncontrollable mortality risk, which among economically insecure college students increasingly involves food insecurity.

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

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. 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. 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. 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. 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.

Patient-Caregiver Dyads' Prognostic Information Preferences and Perceptions in Advanced Cancer.

Prognostic information is considered important for advanced cancer patients and primary informal caregivers to prepare for the end of life. Little is known about discordance in patients' and caregivers' prognostic information preferences and prognostic perceptions, while such discordance complicates adaptive dyadic coping, clinical interactions and care plans. To investigate the extent of patient-caregiver discordance in prognostic information preferences and perceptions, and the factors associated with discordant prognostic perceptions. We conducted secondary analyses of a cross-sectional study (PROSPECT, 2019-2021). Advanced cancer patients (median overall survival ≤12 months) from seven Dutch hospitals and caregivers completed structured surveys (n=412 dyads). Seven percent of patient-caregiver dyads had discordant information preferences regarding the likelihood of cure; 24%-25% had discordant information preferences regarding mortality risk (5/2/1 year). Seventeen percent of dyads had discordant perceptions of the likelihood of cure; 12%-25% had discordant perceptions of mortality risk (5/2/1 year). Dyads with discordant prognostic information preferences (P < 0.05) and dyads in which patients reported better physical functioning (P < 0.01) were significantly more likely to perceive the one-year mortality risk discordantly. Physicians should be sensitive to discordant prognostic information preferences and prognostic perceptions among patient-caregiver dyads in advanced cancer care.

Socially optimal mistakes? debiasing COVID-19 mortality risk perceptions and prosocial behavior

The perception of risk affects how people behave during crises. We conduct a series of experiments to explore how people form COVID-19 mortality risk beliefs and the implications for prosocial behavior. We first document that people overestimate their own risk and that of young people, while underestimating the risk old people face. We show that the availability heuristic contributes to these biased beliefs. Using information about the actual risk to debias people’s own risk perception does not affect donations to the Centers for Disease Control but does decrease the amount of time invested in learning how to protect older people. This constitutes a debiasing social dilemma. Additionally providing information on the risk for the elderly, however, counteracts these negative effects. Importantly, debiasing seems to operate through the subjective categorization of and emotional response to new information.

Socially Optimal Mistakes? Debiasing COVID-19 Mortality Risk Perceptions and Prosocial Behavior

The perception of risk affects how people behave during crises. We conduct a series of experiments to explore how people form COVID-19 mortality risk beliefs and the implications for prosocial behavior. We first document that people overestimate their own risk and that of young people, while underestimating the risk old people face. We show that the availability heuristic contributes to these biased beliefs. Using information about the actual risk to debias people's own risk perception does not affect donations to the Centers for Disease Control but does decrease the amount of time invested in learning how to protect older people. This constitutes a debiasing social dilemma. Additionally providing information on the risk for the elderly, however, counteracts these negative effects. Importantly, debiasing seems to operate through the subjective categorization of and emotional response to new information.

Endogeneity of Risk Perceptions in Averting Behavior Models

This paper examines the relationship between averting expenditures / choices and perceived health risks. Models in the literature often employ risk perceptions as explanatory variables without addressing the potential endogeneity of the perceived risk. We examine the implications of ignoring endogeneity in this context, using an application to both drinking water choices and expenditures and perceived health risks. Our data are from an Internet-based cross-Canada survey that employs a novel interactive risk ladder to elicit mortality risk perceptions relating to water. We employ two fundamentally different methods to assess the impact of risk perceptions on behavior: an analysis of expenditures on alternate water sources and a model of proportional choice of water sources. Results suggest the presence of averting behavior with respect to perceived mortality risks and that the estimated effect of water risks is greater than 3 times higher when using approaches that correct for endogeneity compared to models that do not.

Patients' perceptions of mortality risk for localized prostate cancer vary markedly depending on their treatment strategy.

Treatment choice for localized prostate cancer (PCa) is a controversial issue, and mortality risk is probably the most decisive factor in this regard. The study aimed to compare prostate-cancer-specific mortality risk estimates for different treatment options assigned by patients managed with active surveillance (AS), radical prostatectomy (RP) and patients who had discontinued AS (DAS). Patients initially managed with AS or RP (N = 370) were matched according to length of therapy. All patients completed mailed questionnaires assessing their mortality risk estimates (in %) and prostate-cancer-specific anxiety. Differences in risk estimates among the three treatment groups were analyzed using ANOVA, relationships of clinical and psychosocial variables with risk estimates using standard multiple regression. In all treatment groups, the prostate- cancer-specific mortality risk was overestimated. This applied whether it was the patient's own treatment or the alternative treatment option. RP patients assigned a mortality risk to AS that was almost three times higher than that assigned to RP (50.9 ± 25.0 vs. 17.8 ± 19.7, d = 1.48; p < 0.001). Anxiety was significantly associated with risk estimates for AS (p = 0.008) and RP (p = 0.001). Compared with clinical data that suggest that the prostate-cancer-specific mortality risk for AS is low and does not significantly differ from that for RP, patients strongly overestimated the mortality risk. This was most markedly so in RP patients, who drastically overestimated the benefits of RP compared to the risk of AS. This overestimation could increase overtreatment and should therefore be corrected by better patient education.

The Impact of AIDS Treatment on Savings and Human Capital Investment in Malawi

Antiretroviral therapy (ART), a treatment for AIDS, is rapidly increasing life expectancy throughout sub-Saharan African countries affected by the AIDS epidemic. This change in life expectancy has potentially profound influences on life-cycle decisions. A longer life expectancy increases the value of human capital investment, while the effect on savings is theoretically ambiguous and life-cycle saving could increase or decrease. This paper uses spatial and temporal variation in ART availability to evaluate the impact of ART provision on savings and investment. We find that ART availability significantly increases savings, expenditures on education, and children's schooling, including among HIV-negative individuals who do not directly benefit from ART. These results are not driven by the direct health effects of treatment or reductions in caretaking responsibilities, but rather by reduced perceptions of mortality risk after ART has become available. (JEL D14, D15, I12, I15, J24, O12)

80 is the new 60: Implications of Irrational Exuberance Regarding Longevity on Prostate Cancer Treatment Decisions

80 is the new 60: Implications of Irrational Exuberance Regarding Longevity on Prostate Cancer Treatment Decisions

Risk perceptions and rationality in measures of risk

Individuals may have biased perceptions of health and safety risks. We conjecture perceptions of mortality risk from various risk measures using parametric and non-parametric methods. We investigate how risk perceptions are measured and what rational explanations can be found for these measures with implication for risk and solvency.

Ethnic and gender differences in perceptions of mortality risk in a Canadian urban centre

Women reportedly do not perceive heart disease (HD) as a major threat to their health; however, men's perceptions are rarely studied. We explored gender and ethnic differences in risk perception of HD mortality. The survey was completed by 976 people 40+ years of age, in metropolitan Vancouver, Canada. Men, compared with women, were more likely not to know the answer to a question about whether HD is the most common cause of death for women; however, women were more likely not to know the answer to a question about whether HD is the most common cause of death for men. Chinese-Canadian and South Asian-Canadian participants were more likely than participants of other ethnic groups not to know the answer to either question, and the Chinese-Canadian participants were more likely to disagree that HD is the most common cause of death for women. There is a need to educate the Chinese-Canadian and South Asian-Canadian communities about HD as a first step in promoting health behavior change. Men and women must be educated about the other gender's risk of HD because all adults play integral roles in making decisions about the prevention of and early intervention for HD.

Gender Differences in Cancer Mortality Risk Perceptions and Screening Behaviors among Adults 40-60 Years of Age

The purpose of this study was to examine gender differences in cancer mortality risk perceptions and preventive screening behaviors as well as perceptions of gender differences in types of cancer risks. A telephone survey was administered to 300 men and 300 women between 40 and 60 years of age, all of whom were contacted via a random digit dialing procedure. Findings showed that 62% of respondents believed that prostate cancer was the most frequent cause of cancer mortality among men (12% actual) while breast cancer was thought to be the most frequent cause reported among 80% of women (17% actual). It was determined that 79% of men and women are discussing or receiving preventive screening for prostate and breast cancer, respectively, and that these frequencies increase significantly after age 50. Finally, most respondents believed that women had higher rates of cancer morbidity and mortality than men. These results suggest that an increase in cancer mortality risk awareness is needed among both men and women. The elevated risks among men need to be made salient, and prevention campaigns that target men’s mortality risks need to be developed.

When do smokers ‘underestimate’ smoking related mortality risks?

This article examines the role of relative mortality risk perceptions in explaining smoking decision making. Some studies have provided evidence that perceptions of risks of smoking are overestimated. However, estimates tend to be sensitive to the estimate it is compared to. Using the same representative survey for Spain, as in other studies, this article finds that though relative mortality risk perceptions explain the decision to smoke and perceived life expectancy loss associated with smoking in Spain was not underestimated, smokers’ mortality risk perceptions seem to underestimate the risks.

Dead reckoning: demographic determinants of the accuracy of mortality risk perceptions.

General patterns of bias in risk beliefs are well established in the literature, but much less is known about how these biases vary across the population. Using a sample of almost 500 people, the regression analysis in this article yields results consistent with the well-established pattern that small risks are overassessed and large risks are underassessed. The accuracy of these risk beliefs varies across demographic factors, as does the switch point at which people go from underassessment to overassessment, which we found to be 1500 deaths annually for the full sample. Better educated people have more accurate risk beliefs, and there are important differences in the risk perception by race and gender that also may be of policy interest.

Dead Reckoning: Demographic Determinants of the Accuracy of Mortality Risk Perceptions

General patterns of bias in risk beliefs are well established in the literature, but much less is known about how these biases vary across the population. Using a sample of almost 500 people, the regression analysis in this paper yields results consistent with the well established pattern that small risks are overassessed and large risks are underassessed. The accuracy of these risk beliefs varies across demographic factors, as does the switch point at which people go from underassessment to overassessment, which we found to be 1,500 deaths annually for the full sample. Better educated people have more accurate risk beliefs, and there are important differences in the risk perception by race and gender that also may be of policy interest.

Mortality risk perceptions: A Bayesian reassessment

This paper uses a Bayesian learning model to assess the respective influence of different risk measurements on mortality risk perceptions. People form risk beliefs using several sources of information, including the actual population mean death risk level, the discounted lost life expectancy, and the age-specific hazard rate considered by Benjamin and Dougan (1997). The appropriate criterion for judging the validity of risk perceptions is not the perfect information case, but rather whether people form their risk beliefs in a rational manner given a world of costly and limited risk information. Although the statistical results support the overall conclusion that the learning process is rational, the character of the learning process differs depending on the risk level. Risk-related variables are much better predictors of larger risks than of small risks, which reflects the role of information costs and the benefits of learning about larger risks.

Mortality risk perceptions: a Bayesian reassessment.

"This study uses data on perceived and actual mortality risks to test several alternative Bayesian models of the factors influencing risk beliefs. The analysis...indicates that while the hazard rate for the individual age group is an influential factor, the overall population death rate and the discounted expected number of life years lost due to the cause of death are also influential in affecting risk perceptions.... The predictive power of a linear perception model increases with the level of the risk and is least accurate for very small risks."