Perceptions of control over different causes of death and the accuracy of risk estimations

Abstract

Background A large number of deaths could be avoided by improving health behaviours. The degree to which people invest in their long-term health is influenced by how much they believe they can control their risk of death. Identifying causes of death believed to be uncontrollable, but likely to occur, may provide actionable targets for health interventions to increase control beliefs and encourage healthier behaviours. Method We recruited a nationally representative online sample of 1500 participants in the UK. We assessed perceived control, perceived personal likelihood of death, certainty of risk estimation, and perceived knowledge for 20 causes of death. We also measured overall perceived uncontrollable mortality risk (PUMR) and perceived prevalence for each of the Office for National Statistics’ categories of avoidable death. Findings Risk of death due to cancer was considered highly likely to occur but largely beyond individual control. Cardiovascular disease was considered moderately controllable and a likely cause of death. Drugs and alcohol were perceived as risks both high in control and low in likelihood of death. However, perceptions of control over specific causes of death were found not to predict overall PUMR, with the exception of cardiovascular disease. Finally, our sample substantially overestimated the prevalence of drug and alcohol-related deaths in the UK. Conclusions We suggest that more can be done by public health communicators to emphasise the lifestyle and behavioural changes that individuals can make to reduce their general cancer risk. More work is needed to understand the barriers to engaging with preventative behaviours and maintaining a healthy heart. Finally, we call for greater journalistic responsibility when reporting health risks to the public.

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

“…For our replication of Pepper and Nettle, we used data from Brown et al (2023), the findings from which are published in “ Individual characteristics associated with perceptions of control over mortality risk and determinants of health effort ” and “ Perceptions of control over different causes of death and the accuracy of risk estimations ” [ 21 , 22 ]. For these data, we recruited a nationally representative online sample of 1,500 UK participants via Prolific [prolific.com] (see Table 1 for sample characteristics).…”

“…More recently, an online survey of a nationally representative sample of 1,500 UK adults investigated the relationships between PUMR, health effort, and perceptions of control over specific causes of death [ 21 , 22 ]. The findings supported the previous negative relationship between PUMR and health effort.…”

The Uncontrollable Mortality Risk Hypothesis

“…Furthermore, the behavioural ecological model from Nettle [ 19 ] underlying the Uncontrollable Mortality Risk Hypothesis, along with subsequent research [ 18 , 35 , 41 , 42 ], previously referred to ‘extrinsic mortality risk’, whereas ‘uncontrollable mortality risk’ has been used more recently to refer to mortality risk that cannot be reduced by behaviour [ 43–46 ]. This is because the definition of ‘extrinsic mortality risk’ employed by evolutionary models for understanding senescence [ 47–51 ] differs from that of human health behaviour literature relevant to the Uncontrollable Mortality Risk Hypothesis [ 15 , 18 , 19 , 41 , 44 , 46 , 52–54 ]. The former typically defines ‘extrinsic mortality risk’ as an age and condition-independent component of environmental risk caused by external hazards such as predation, parasitism and inclement weather [ 19 , 51 ].…”