ArticlePloS one2010
Why are there social gradients in preventative health behavior? A perspective from behavioral ecology.
Article in PloS one, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Sociodemographic intersections and risk of multiple long-term conditions: A systematic review.PloS one · 2025Pooled it
- The Relationship Between Perceived Uncontrollable Mortality Risk and Health Effort: Replication, Secondary Analysis, and Mini Meta-analysis.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2024Pooled it
- Periodontitis severity and its social and clinical determinants: An ACES framework-based NHANES analysis.Journal of periodontology · 2026Article
- The power of powerful others: health locus of control and vaccination behavior in rural Namibian pastoralists.BMC global and public health · 2026Article
- Improving social determinants of health documentation in French electronic health records using large language models.Scientific reports · 2025Article
- What safety can we talk about when all we see is difficulty? The impact of geographic and cultural determinants of unintentional injury in rural and mountainous Mugu, Nepal.Frontiers in public health · 2025Article
- The Uncontrollable Mortality Risk Hypothesis: Theoretical foundations and implications for public health.Evolution, medicine, and public health · 2024Article
- Perceptions of control over different causes of death and the accuracy of risk estimations.Zeitschrift fur Gesundheitswissenschaften = Journal of public health · 2023Article
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- Predicting attitudes towards screening for neurodegenerative diseases using OCT and artificial intelligence: Findings from a literature review.Journal of public health research · 2022Article
- Income-related inequality and decomposition of edentulism among aged people in China.BMC oral health · 2022Article
- COVID-19 preventive behaviours in White British and Black, Asian and Minority Ethnic (BAME) people in the UK.Journal of health psychology · 2022Article
- A qualitative study of perceptions of control over potential causes of death and the sources of information that inform perceptions of risk.Health psychology and behavioral medicine · 2022Article
- Why Hypothesis Testers Should Spend Less Time Testing Hypotheses.Perspectives on psychological science : a journal of the Association for Psychological Science · 2021Article
- Exploring smoke: an ethnographic study of air pollution in rural Malawi.BMJ global health · 2021Article
- Relationship between Morbidity and Health Behavior in Chronic Diseases.Journal of clinical medicine · 2020Article
- Family composition and age at menarche: Findings from the international Health Behaviour in School-aged Children study.Reproductive health · 2019Article
- Are mothers less likely to breastfeed in harsh environments? Physical environmental quality and breastfeeding in the Born in Bradford study.Maternal & child nutrition · 2019Article
- Broadening horizons: Sample diversity and socioecological theory are essential to the future of psychological science.Proceedings of the National Academy of Sciences of the United States of America · 2018Article
- Low perceived control over health is associated with lower treatment uptake in a high mortality population of Bolivian forager-farmers.Social science & medicine (1982) · 2018Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWithin affluent populations, there are marked socioeconomic gradients in health behavior, with people of lower socioeconomic position smoking more, exercising less, having poorer diets, complying less well with therapy, using medical services less, ignoring health and safety advice more, and being less health-conscious overall, than their more affluent peers. Whilst the proximate mechanisms underlying these behavioral differences have been investigated, the ultimate causes have not. METHODOLOGY/PRINCIPAL
findingsThis paper presents a theoretical model of why socioeconomic gradients in health behavior might be found. I conjecture that lower socioeconomic position is associated with greater exposure to extrinsic mortality risks (that is, risks that cannot be mitigated through behavior), and that health behavior competes for people's time and energy against other activities which contribute to their fitness. Under these two assumptions, the model shows that the optimal amount of health behavior to perform is indeed less for people of lower socioeconomic position. CONCLUSIONS/SIGNIFICANCE: The model predicts an exacerbatory dynamic of poverty, whereby the greater exposure of poor people to unavoidable harms engenders a disinvestment in health behavior, resulting in a final inequality in health outcomes which is greater than the initial inequality in material conditions. I discuss the assumptions of the model, and its implications for strategies for the reduction of health inequalities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.