Cognitive and Emotional Health Risk Perceptions Among People Living in Poverty

Abstract

Many theories of risk perception and health behavior examine cognitive dimensions of risk (i.e., perceived susceptibility or severity) but not emotional dimensions. To address this gap, the authors examined the emotional component of risk perception (as worry) and its relation to cognitive assessments of risk, self-efficacy and response efficacy, and health protective action. Although people in poverty are at high risk for many health conditions, little is known about how concerned they are about these conditions or how their risk perceptions influence health actions. African Americans and Whites with incomes ≤$35,000 were surveyed (N = 431). Participants reported their worry level for 10 health risks. Among their highest worry risks, they identified the risk they took the most action and the risk they took the least action to prevent. Worry was low or moderate for each health risk and chronic conditions were of the most concern. For high- and low-action risks, response efficacy moderated the relation between cognitive risk perception and health protective action. For low-action risks, decisions to act were affected independently by cognitive and emotional responses. The results support the Risk Perception Attitude Framework and indicate the importance of using cognitive and emotional dimensions of risk in behavior change models.

Acknowledgments

This research was conducted by the Southern Center of Communication, Health and Poverty at the University Georgia and is funded by the Centers for Disease Control and Prevention as a Center of Excellence in Health Marketing and Health Communication (Vicki Freimuth, PI; #5PO1CD000242-03). Shelly Hovick is supported by the Kellogg Health Scholars Program (#P0117943) from the W.W. Kellogg Foundation to the Center for Advancing Health.

Notes

*p < .05. **p < .01.

¹Measured on a 5-point scale ranging from 1 (not worried at all) to 5 (extremely worried).

²Health risks sharing the same subscript letter do not differ from one another on the basis of the Wilcoxon signed-rank test (p ≤ .05).

*Kruskal-Wallis test for between-group difference, p ≤ .05.

^a High school diploma/GED.

^a Marginal effect is the probability that a dependent variable score is below the upper threshold (values <5) with a one-unit change in the independent variable.

^b Linear effect is the change in the dependent variable below its upper threshold (values <5) with a one-unit change in the independent variable.

^c African American = 0, White = 1.

^d Female = 0, male = 1.

^e High school diploma/GED or less = 0, more than high school diploma/GED = 1.

^f Age 22–45 years = 0, age 46–64 years = 1.

*p ≤ .05. **p ≤ .01.