Nick Bansback1, Mark Harrison1, Mohsen Sadatsafavi1, Anne Stiggelbout1, David G T Whitehurst1. 1. School of Population and Public Health (Bansback), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Bansback, Harrison); Centre for Clinical Epidemiology and Evaluation (Bansback, Sadatsafavi, Whitehurst), Vancouver Coastal Research Institute; Faculty of Pharmaceutical Sciences (Harrison), University of British Columbia; Faculty of Medicine (Sadatsafavi), Gordon and Leslie Diamond Health Care Centre, Vancouver, BC; Leiden University Medical Center (Stiggelbout), Leiden, Netherlands; Faculty of Health Sciences (Whitehurst), Simon Fraser University, Burnaby, BC.
Abstract
BACKGROUND: Risk is a ubiquitous part of health care. Understanding how people respond to risks is important for predicting how populations make health decisions. Our objective was to seek preliminary descriptive insights into the attitude to health risk in the Canadian population and factors associated with heterogeneity in risk attitude. METHODS: We used a large market-research panel to survey (in English and French) a representative sample of the Canadian general population that reflected the age, sex and geography of the population. The survey included the Health-Risk Attitude Scale, which predicts how a person resolves risky health decisions related to treatment, prevention of disease and health-related behaviour. In addition, we assessed participants' numeracy and risk understanding, as well as income band and level of education. We summarized the responses, and we explored the independent associations between demographics, numeracy, risk understanding and risk attitude in multivariable models. RESULTS: Of 6780 respondents, 4949 (73.0%) were averse to health risks; however, but there was considerable heterogeneity in the magnitude of risk aversion. We found significant gradients of risk averse attitudes with increasing age and being female (p < 0.001) using the multivariable model. French-speaking participants appeared to be more risk averse than those who were English-speaking (p < 0.001), as were individuals scoring higher on the Subjective Numeracy Scale (p < 0.001). INTERPREATION: In general, Canadians were averse to health risks, but we found that a sizeable, identifiable group of risk takers exists. Heterogeneity in preferences for risk can explain variations in health care utilization in the context of patient-centred care. Understanding risk preference heterogeneity can help guide policy and assist in patient-physician decisions.
BACKGROUND: Risk is a ubiquitous part of health care. Understanding how people respond to risks is important for predicting how populations make health decisions. Our objective was to seek preliminary descriptive insights into the attitude to health risk in the Canadian population and factors associated with heterogeneity in risk attitude. METHODS: We used a large market-research panel to survey (in English and French) a representative sample of the Canadian general population that reflected the age, sex and geography of the population. The survey included the Health-Risk Attitude Scale, which predicts how a person resolves risky health decisions related to treatment, prevention of disease and health-related behaviour. In addition, we assessed participants' numeracy and risk understanding, as well as income band and level of education. We summarized the responses, and we explored the independent associations between demographics, numeracy, risk understanding and risk attitude in multivariable models. RESULTS: Of 6780 respondents, 4949 (73.0%) were averse to health risks; however, but there was considerable heterogeneity in the magnitude of risk aversion. We found significant gradients of risk averse attitudes with increasing age and being female (p < 0.001) using the multivariable model. French-speaking participants appeared to be more risk averse than those who were English-speaking (p < 0.001), as were individuals scoring higher on the Subjective Numeracy Scale (p < 0.001). INTERPREATION: In general, Canadians were averse to health risks, but we found that a sizeable, identifiable group of risk takers exists. Heterogeneity in preferences for risk can explain variations in health care utilization in the context of patient-centred care. Understanding risk preference heterogeneity can help guide policy and assist in patient-physician decisions.
Authors: Nancy D Berkman; Stacey L Sheridan; Katrina E Donahue; David J Halpern; Karen Crotty Journal: Ann Intern Med Date: 2011-07-19 Impact factor: 25.391
Authors: Angela Fagerlin; Brian J Zikmund-Fisher; Peter A Ubel; Aleksandra Jankovic; Holly A Derry; Dylan M Smith Journal: Med Decis Making Date: 2007-07-19 Impact factor: 2.583