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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.
Supporting data for Pepper & Nettle (2013) Perceived extrinsic mortality and health behaviour: Testing a behavioural ecological model