The lifestyle paradox: adverse effects of Internet use on self-rated health status

ABSTRACT

How individuals subjectively rate their health status stands in close relationship with both actual health status and mortality. Previous research has shown that Internet use in general, and online health information seeking in particular, increases self-rated health status. However, this relationship may not always hold true: Albrecht and Devlieger’s [(1999). The disability paradox: high quality of life against all odds. Social Science & Medicine, 48(8), 977–988] disability paradox captures that those with severe health conditions may still perceive their health as very good. This paper introduces the lifestyle paradox as another exception to the generally positive relationship: those without health conditions may still perceive their health as inferior based on general and health-related Internet use. This paper corroborates the lifestyle paradox empirically using quantitative data from the Oxford Internet Surveys connected to the national census through spatial microsimulation, and 43 qualitative interviews conducted with a subsample of the participants from the quantitative strand. A theoretical explanation for this phenomenon is provided based on the concepts of agenda setting and reference groups: the online realm may make lifestyle topics more salient, and provides a variety of opportunities for comparing oneself to others, thereby influencing how people evaluate their own health. Through describing, verifying and explaining the lifestyle paradox, this paper contributes theoretical and empirical insights into the relationship between Internet use and self-rated health status, and thereby adds to the scientific debate around tangible outcomes of Internet use.

KEYWORDS:

• eHealth
• health information seeking
• health perception
• self-rated health status
• lifestyle paradox
• disability paradox

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Dr Ulrike Deetjen is a Research Associate at the Oxford Internet Institute, University of Oxford. Over the last years, she has worked extensively on questions at the intersection of Internet use and health using a wide range of qualitative and quantitative methods. Most recently, she researched effects of health information seeking on health service use and self-rated health status, benefits and success factors for e-prescriptions, and big data applications in dementia research [email: [email protected]].

Notes

1 All names are pseudonymised to protect participant identities.

Additional information

Funding

This work was supported by the Economic and Social Research Council and the Clarendon Fund.