Perceived extrinsic mortality risk and reported effort in looking after health: Testing a behavioural ecological prediction

10.7287/peerj.preprints.29 ◽

2013 ◽

Author(s):

Gillian V Pepper ◽

Daniel Nettle

Keyword(s):

Health Behaviour ◽

Mortality Risk ◽

Socioeconomic Position ◽

Future Health ◽

Mortality Risks ◽

Extrinsic Mortality ◽

Lower Socioeconomic ◽

Key Factor ◽

Reported Health ◽

Intrinsic Mortality

Socioeconomic gradients in health behaviour are pervasive and well documented. Yet, there is little consensus on their causes. Behavioural ecological theory predicts that, if people of lower socioeconomic position (SEP) perceive greater personal extrinsic mortality risk than those of higher SEP, they should disinvest in their future health. We surveyed North American adults for reported effort in looking after health, perceived extrinsic and intrinsic mortality risks, and measures of SEP. We examined the relationships between these variables and found that lower subjective SEP predicted lower reported health effort. Lower subjective SEP was also associated with higher perceived extrinsic mortality risk, which in turn predicted lower reported health effort. The effect of subjective SEP on reported health effort was completely mediated by perceived extrinsic mortality risk. Our findings indicate that perceived extrinsic mortality risk may be a key factor underlying SEP gradients in motivation to invest in future health.

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Perceived extrinsic mortality risk and health behaviour: Testing a behavioural ecological model

10.7287/peerj.preprints.29v1 ◽

2013 ◽

Cited By ~ 1

Author(s):

Gillian V Pepper ◽

Daniel Nettle

Keyword(s):

Health Behaviour ◽

Mortality Risk ◽

Ecological Model ◽

Large Effect Size ◽

Future Health ◽

Low Socioeconomic ◽

Mortality Risks ◽

Extrinsic Mortality ◽

Intrinsic Mortality ◽

The Relationship

Purpose: Socioeconomic gradients in health behaviour are pervasive and well documented. Yet, outside the evolutionary literature, there is no consensus on their causes. Our previously presented theoretical behavioural ecological model predicted that people of low socioeconomic position (SEP) should perceive greater personal extrinsic mortality risk than those of higher SEP, leading them to disinvest in their future health. We collected data to test this prediction. Methods: We surveyed North American adults for measures of SEP, effort in looking after health and perceived extrinsic and intrinsic mortality risks. We examined the relationships between SEP, perceived mortality risks and effort in looking after health. We then tested whether the association between SEP and effort in looking after health was mediated by perceived extrinsic mortality risk. Results: SEP was associated with effort in looking after health. Lower SEP was also associated with higher perceived extrinsic mortality risk, which in turn predicted effort in looking after health. The effect of SEP on effort in looking after health was completely mediated by perceived extrinsic mortality risk. Conclusions: Our findings support the predictions of our previously presented theoretical model. They show that SEP gradients in perceptions of extrinsic mortality risk mirror known SEP gradients in actual extrinsic mortality risk. The large effect size for the relationship between perceived extrinsic mortality risk and health effort in our sample indicates that perceived extrinsic mortality risk may be a key predictor of health behaviour.

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Health behaviour, extrinsic risks, and the exceptions to the rule

Behavioral and Brain Sciences ◽

10.1017/s0140525x17001145 ◽

2017 ◽

Vol 40 ◽

Author(s):

Caroline Uggla

Keyword(s):

Life History ◽

Health Behaviour ◽

Mortality Risk ◽

Strong Evidence ◽

Extrinsic Mortality ◽

Driving Behaviour

AbstractPepper & Nettle make a compelling case for how evolutionary thinking can help explain behaviours that cluster with deprivation. The role of extrinsic mortality risk in driving behaviour is probably important, but strong evidence is still lacking. By thinking carefully about behaviours seemingly at odds with an evolutionary life history perspective, we can gain important insights that will help refine theory.

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When does deprivation motivate future-oriented thinking? The case of climate change

Behavioral and Brain Sciences ◽

10.1017/s0140525x17001066 ◽

2017 ◽

Vol 40 ◽

Author(s):

Adam R. Pearson ◽

Sander van der Linden

Keyword(s):

Climate Change ◽

Decision Making ◽

Socioeconomic Status ◽

Mortality Risk ◽

Psychological Research ◽

Lower Socioeconomic Status ◽

Extrinsic Mortality ◽

Cross Domain ◽

Lower Socioeconomic

AbstractPepper & Nettle overstate cross-domain evidence of present-oriented thinking among lower-socioeconomic-status (SES) groups and overlook key social and contextual drivers of temporal decision making. We consider psychological research on climate change – a quintessential intertemporal problem that implicates inequities and extrinsic mortality risk – documenting more future-oriented thinking among low- compared to high-SES groups.

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Examining the implications of perceiving one’s future health as a goal or a standard for affect, motivation, and health behaviour

Motivation and Emotion ◽

10.1007/s11031-021-09893-3 ◽

2021 ◽

Author(s):

Brook L. Haight ◽

Michael A. Busseri

Keyword(s):

Health Behaviour ◽

Future Health

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Normalised intrinsic mortality risk in liver transplantation: European Liver Transplant Registry study

The Lancet ◽

10.1016/s0140-6736(00)02603-9 ◽

2000 ◽

Vol 356 (9230) ◽

pp. 621-627 ◽

Cited By ~ 201

Author(s):

René Adam ◽

Valérie Cailliez ◽

Pietro Majno ◽

Vincent Karam ◽

Paul McMaster ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Transplant ◽

Mortality Risk ◽

Registry Study ◽

Transplant Registry ◽

Intrinsic Mortality

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Were VCF patients at higher risk of mortality following the 2009 publication of the vertebroplasty “sham” trials?

Osteoporosis International ◽

10.1007/s00198-017-4281-z ◽

2017 ◽

Vol 29 (2) ◽

pp. 375-383 ◽

Cited By ~ 25

Author(s):

K. L. Ong ◽

D. P. Beall ◽

M. Frohbergh ◽

E. Lau ◽

J. A. Hirsch

Keyword(s):

Mortality Risk ◽

Cox Regression ◽

Compression Fracture ◽

Balloon Kyphoplasty ◽

Data Set ◽

Mortality Risks ◽

Medicare Data ◽

Kaplan Meier ◽

Risk Of Mortality ◽

Insight Into

Abstract Summary The 5-year period following 2009 saw a steep reduction in vertebral augmentation volume and was associated with elevated mortality risk in vertebral compression fracture (VCF) patients. The risk of mortality following a VCF diagnosis was 85.1% at 10 years and was found to be lower for balloon kyphoplasty (BKP) and vertebroplasty (VP) patients. Introduction BKP and VP are associated with lower mortality risks than non-surgical management (NSM) of VCF. VP versus sham trials published in 2009 sparked controversy over its effectiveness, leading to diminished referral volumes. We hypothesized that lower BKP/VP utilization would lead to a greater mortality risk for VCF patients. Methods BKP/VP utilization was evaluated for VCF patients in the 100% US Medicare data set (2005–2014). Survival and morbidity were analyzed by the Kaplan-Meier method and compared between NSM, BKP, and VP using Cox regression with adjustment by propensity score and various factors. Results The cohort included 261,756 BKP (12.6%) and 117,232 VP (5.6%) patients, comprising 20% of the VCF patient population in 2005, peaking at 24% in 2007–2008, and declining to 14% in 2014. The propensity-adjusted mortality risk for VCF patients was 4% (95% CI, 3–4%; p < 0.001) greater in 2010–2014 versus 2005–2009. The 10-year risk of mortality for the overall cohort was 85.1%. BKP and VP cohorts had a 19% (95% CI, 19–19%; p < 0.001) and 7% (95% CI, 7–8%; p < 0.001) lower propensity-adjusted 10-year mortality risk than the NSM cohort, respectively. The BKP cohort had a 13% (95% CI, 12–13%; p < 0.001) lower propensity-adjusted 10-year mortality risk than the VP cohort. Conclusions Changes in treatment patterns following the 2009 VP publications led to fewer augmentation procedures. In turn, the 5-year period following 2009 was associated with elevated mortality risk in VCF patients. This provides insight into the implications of treatment pattern changes and associated mortality risks.

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