Health risk aversion, health risk affinity, and socio-economic position in the USA: The demographics of multiple risk

Abstract

Understanding the distribution of behavioural risk factors in the population can improve health promotion. This article reports on a research project which analysed the distribution of numbers of behavioural risk factors among US adults, by race/Hispanic origin, sex, and age. Income, education, and region were examined as potential confounders in observed patterns.The Behavioral Risk Factor Surveillance System (BRFSS) data for 1993 were used to assess the distribution of numbers of risk factors, i.e. smoking, heavy drinking, overweight, inadequate seatbelt use, Papanicolaou (pap) smear screening, mammography, colorectal screening, and in¯uenza and pneumonia vaccination. Two hypotheses were examined: (1) given the distribution of each risk factor in the US population by age and sex, prevalences both of low and of high numbers of risk behaviours (but not of moderate numbers of risk behaviours) are greater than expected within each race/Hispanic origin-sex-age group; and (2) differences in socio-economic position among these groups account for the differences between observed and expected prevalences of numbers of risk factors. The second hypothesis was assessed both graphically by adjustment for income and education, and by multiple linear regression. The research found higher than expected prevalences of both low and high numbers of risk factors among whites and, possibly, among Hispanics. Among Asians prevalences were less than expected with greater numbers of risk factors. Among blacks and American Indians prevalences were lower than expected for low numbers of risk factors and were greater than expected with greater numbers of risk factors. Adjustment for income or education reduced differences between observed and expected prevalences.It appears that risk aversion and risk af® nity vary substantially by race/Hispanic origin and are only partially explained by socio-economic position. Exploration of the causes of high and low risk behaviour may improve risk behaviour interventions.

The Effect of Mandatory Seat Belt Laws on Seat Belt Use by Socioeconomic Position

“…It's been hypothesized that the better‐educated are more efficient at processing information about the risks and benefits of seat belts, or that they may have lower rates of time or risk preference (Blomquist, , ; Hersch, ; Leigh, ; O'Conor, Blomquist, & Miller, ; Rogers, ). Others have suggested that lower seat belt use among low socioeconomic groups reflects a more general pattern of multiple risk behaviors, including risky driving (Wilson, ), and there is indeed evidence that individuals from lower socioeconomic strata are more likely to exhibit multiple risk behaviors (Berrigan et al., ; Hahn, Vesely, & Chang, ; Rogers, Hummer, & Nam, ). Still others have suggested that disadvantaged individuals may be less likely to invest in prevention, be more fatalistic and less likely to believe traffic accidents are preventable, or may use belts less often because their parents did so (Becker, ; Girasek, ; Shin, Hong, & Waldron, ).…”

Incorporating Ethnographic Methods in Multidisciplinary Approaches to Risk Assessment and Communication: Cultural and Religious Uses of Mercury in Latino and Caribbean Communities

“…( 7,8 ) Differences in risk perception have been studied along lines of gender, race and ethnicity, nationality, and socioeconomic status, with risk areas ranging from environmental health to finance to automobile accidents. ( 9–14 )…”

“…(7,8) Differences in risk perception have been studied along lines of gender, race and ethnicity, nationality, and socioeconomic status, with risk areas ranging from environmental health to finance to automobile accidents. (9)(10)(11)(12)(13)(14) The risk literature has not extensively considered risks generated specifically by activities that distinguish one culture from another. Such cases are in great need of study because cultural marginality can create an environment vulnerable to government control of the perceived risky behavior, without formal assessment of those risks.…”

Internal Inconsistency and Risk Aversion: Implications on Smoking Decisions

“…Another issue is that previous research has pointed out that risk aversion and risk affinity might vary substantially by ethnic background and socioeconomic position (Hahn et al, 2000). Cross-sectional data does not allow testing if the differences between two population groups are attributable to observed or unobserved variables.…”