Health Behavior and Behavioral Economics: Economic Preferences and Physical Activity Stages of Change in a Low-Income African-American Community

Abstract

Purpose To examine the relationship between physical activity stages of change and preferences for financial risk and time. Design A cross-sectional, community-based study. Setting A low-income, urban, African American neighborhood. Subjects 169 adults Measures Self-reported physical activity stages of change—precontemplation to maintenance, objectively measured BMI and waist circumference, and economic preferences for time and risk measured via incentivized economic experiments. Analysis Multivariable ordered logistic regression models were used to examine the association between physical activity stages of change and economic preferences while controlling for demographic characteristics of the individuals. Results Individuals who are more tolerant of financial risks (OR=1.31, p<0.05) and whose time preferences indicate more patience (OR=1.68, p<0.01) are more likely to be in a more advanced physical activity stage (e.g. from preparation to action). The likelihood of being in the maintenance stage increases by 5.6 and 10.9 percentage points for each 1 unit increase in financial risk tolerance or 1 unit increase in the time preference measure, respectively. Conclusions Greater tolerance of financial risk and more patient time preferences among this low-income ethnic minority population are associated with a more advanced physical activity stage. Further exploration is clearly warranted in larger and more representative samples.

How financial strain affects health: Evidence from the Dutch National Bank Household Survey

“…Changes in time preferences could plausibly 25 mediate this pathway as individuals become more present-biased when stressed (Haushofer et al, 2015) and higher rates of intertemporal discounting are associated with cigarette smoking (Adams, 2009), frequent alcohol consumption (MacKillop and Kahler, 2009), illicit drug use (Coffey et al, 2003), lack of physical exercise (Leonard et al, 2013) and health outcomes such as obesity (Ikeda et al, 2016) and mortality (Boyle et al, 2013).…”

Utilizing Behavioral Economics to Understand Adherence to Physical Activity Guidelines Among a Low-Income Urban Community

“…smoking, diet), yet scant research has examined its association with physical activity. 11,13 In an earlier study, focusing on a smaller sample, 12 we found time preferences to be related to the intention to be physically active (via the stages of change model). In contrast, Adams and Nettle (2009), examining data collected from a web-based survey of urban locations in the US, did not find an association between time preferences and physical activity.…”

“…31 For the case of physical activity, providing regular physical activity breaks during the work day coupled with immediate and tangible incentives from the employer and/or insurer might be a feasible avenue to improve health and productivity, particularly for individuals with less patient time preferences. 9,12 Further, clinicians and public health professionals may seek to design innovative interventions that allow for tailoring based on individual time preferences. In the public health realm, it is acceptable practice to place individuals on a continuum from precontemplation to maintenance of health behaviors (i.e.…”

“…12,16 The primary study aim was to assess the impact of public investment on behaviors and outcomes of Fair Park neighborhood residents.…”

“…reduced risk for hypertension) are delayed and appear uncertain. 12 Thus, due to this intangible and often delayed benefit, individuals with less patient time preferences might not engage in physical activity. A lack of patient time preferences has been associated in numerous studies with unhealthy lifestyle behaviors, such as smoking and heavy drinking.…”