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The effects of a tailored health warning on socio-economic behaviours and health outcomes

量身定制的健康警告对社会经济行为和健康结果的影响

基本信息

批准号：
ES/N012038/1
负责人：
Adeline Delavande
金额：
$ 19.46万
依托单位：
University of Essex
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2016
资助国家：
英国
起止时间：
2016 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FN012038%2F1
关键词：
effects tailored health warning socio

项目摘要

A number of common and long-term health conditions such as diabetes and high blood pressure display no signs even at advanced stages and so people may carry the disease without being aware of it. In fact, evidence shows that this is a common occurrence across the developed and developing world. Medical guidance indicates that if people were aware of their clinical status, then they would be able to mitigate the long-term effects of diseases on their health by making lifestyle changes through the use of medication and making changes in health behaviours (e.g. exercise, fruit-veg consumption, salt consumption). People may also be able to mitigate the effects of the disease on their wellbeing by modifying non-health behaviours (labour market choices, retirement planning, spending, financial planning). In the face of this growing public health problem, a number of organisations have enacted campaigns that promote health checks (e.g. NHS health check, Diabetes UK and the British Heart Foundation offer health diagnostic checks for heart disease, stroke, diabetes, kidney disease, hypertension and cholesterol concentration) so that individuals diagnosed with a condition can make lifestyle choices at an early stage. One dimension underpinning these campaigns is a belief that if individuals knew they had the condition then they would act differently but currently there is little evidence to say whether or not people do change their lifestyles in response to receiving personalised health information. Wide-spread health checks place a large strain on the public purse (estimated annual cost of NHS health checks is £320m) and so it is important to know whether such interventions are likely to bring savings through the improved wellbeing of the nation. In this project we will make a step towards filling this evidence gap by providing causal evidence on the extent to which individuals change their health and other socio-economic behaviours in response to receiving personalised health information.Relatedly, there is evidence to suggest that health information campaigns that target at risk groups of the population, such as a Food Standards Agency campaign to reduce salt consumption, have been unsuccessful. One reason that these campaigns may not work is if individuals believe that the group level information does not apply to them as they are "healthier-than-average" (such better than average effects have been shown in other areas, for example, where one study found that 93% US drivers think they are better drivers than the median). The evidence that we will provide in this project will be useful in understanding whether information campaigns that deliver personalised information (and not population level health information) are better at getting people to change their behaviours.The condition we consider is high blood pressure which is a global public health issue. Lowering blood pressure through medication and lifestyle choices is feasible and significantly reduces the risk of death due to heart disease and stroke (leading causes of death in the UK and worldwide) and the development of other debilitating conditions. But often people are unaware that they are afflicted with hypertension and it has been called a 'Silent Killer'. We first provide evidence that would help with the targeting of health campaigns on the extent to which low income households maybe more likely to have high blood pressure (clinically diagnosed) but less likely to know it. We then go on to present evidence from a personalised information treatment that gave respondents of the Understanding Society Survey a blood pressure reading from a trained nurse. We make innovative use of two novel features of this data: that it contains clinically measured indicators of health linked to a rich set of socio-economic variables; and perhaps more unusually that it provides us with subsamples of individuals that have and have not been given personalised health information.

许多常见和长期的健康状况，如糖尿病和高血压，即使在晚期也没有任何迹象，因此人们可能在没有意识到的情况下携带了这些疾病。事实上，有证据表明，这在发达国家和发展中国家都是一种普遍现象。医学指导表明，如果人们了解自己的临床状况，那么他们就能够通过使用药物改变生活方式和改变健康行为（例如运动、水果-蔬菜消费、盐消费）来减轻疾病对其健康的长期影响。人们还可以通过改变非健康行为（劳动力市场选择、退休计划、支出、财务规划）来减轻疾病对其福祉的影响。面对这一日益严重的公共卫生问题，一些组织发起了促进健康检查的运动（例如，国民保健制度健康检查、英国糖尿病协会和英国心脏基金会提供心脏病、中风、糖尿病、肾病、高血压和胆固醇浓度的健康诊断检查），以便被诊断患有某种疾病的个人能够在早期阶段选择生活方式。支持这些运动的一个方面是，人们相信如果个人知道他们有这种情况，那么他们会采取不同的行动，但目前几乎没有证据表明人们是否会因为收到个性化的健康信息而改变他们的生活方式。广泛的健康检查给公共财政带来了巨大压力（NHS健康检查的估计年度成本为3.2亿英镑），因此了解这种干预措施是否有可能通过改善国家福祉来节省开支是很重要的。在这个项目中，我们将通过提供关于个人在接受个性化健康信息后改变其健康和其他社会经济行为的程度的因果证据，朝着填补这一证据差距迈出一步。与此相关的是，有证据表明，针对人口中危险群体的健康宣传运动，如食品标准局减少盐消费的运动，是不成功的。这些活动可能不起作用的一个原因是，如果个人认为群体层面的信息不适用于他们，因为他们“比平均水平更健康”（这种比平均水平更好的效果已经在其他领域得到证明，例如，一项研究发现，93%的美国司机认为他们比中位数更好）。我们将在这个项目中提供的证据将有助于理解提供个性化信息（而不是人口层面的健康信息）的信息运动是否更能让人们改变他们的行为。我们考虑的情况是高血压，这是一个全球性的公共卫生问题。通过药物和生活方式的选择来降低血压是可行的，并且可以显著降低因心脏病和中风（英国和全世界的主要死亡原因）以及其他衰弱疾病的发展而导致的死亡风险。但人们往往不知道他们患有高血压，它被称为“无声杀手”。我们首先提供的证据将有助于针对低收入家庭可能更有可能患有高血压（临床诊断）但不太可能知道它的程度的健康运动。然后，我们继续展示来自个性化信息处理的证据，该信息处理为“理解社会调查”的受访者提供了一位训练有素的护士的血压读数。我们创新性地利用了这些数据的两个新特征：它包含与一系列丰富的社会经济变量相关的临床测量健康指标；也许更不寻常的是，它为我们提供了个人的子样本，这些人有和没有得到个性化的健康信息。