‘I can choose’: the reflected prominence of personal control in representations of health risk in Canada

Abstract

Multidisciplinary research has contributed to a better understanding of the personal and societal correlates of risk perception. However, representations of ‘health risk’ remain to be characterised more fully. Drawing on a Canadian study conducted in 2004, an analysis was conducted to develop better characterisations of individual representations of health risk. The study involved a national telephone survey (N = 1503) and face-to-face semi-structured interviews with individuals across Canada (N = 73) in which participants’ representations of health, risk and health risk were elicited using a word association technique. In the telephone survey, it was found that representations of health risk were most frequently negative, with many participants referring to disease and illness. The concept of health risk was also associated with lifestyle, individual control and personal agency, suggesting that individual health behaviour and personal responsibility for health were prominent features of public discourse on health risk in Canada. However, subtle variations in representations of health risk were observed in analyses of semi-structured interviews, pointing to important differences according to age and gender in this specific discourse. There was agreement among participants that health risks were associated with individual vulnerability and menace to life or health, and that such vulnerability increased with age. However, women were less likely to focus on the idea of actively making choices to control health risks and less frequently made references to the positive aspects of health risks.

Keywords:

• risk
• health risk
• risk perception
• population health
• word association
• mixed methods

Acknowledgements

This project was supported by a contribution agreement from Health Canada on ‘Public perception and acceptable levels of health risk among Canadians’. The authors would like to thank Kevin Brand, Louise Bouchard, Pierre Mercier and Graham Gaylord for their contributions to the project. Louise Lemyre is the McLaughlin Chair in Psychosocial Aspects of Risk and Health. Daniel Krewski is the Natural Sciences and Engineering Research Council of Canada Chair in Risk Science at the University of Ottawa.

Notes

^1. The coding matrices included a list of themes that emerged in responses to the word association questions. These were derived by the primary author and include the themes listed in Tables 1–3 for health, risk and health risk, respectively. To evaluate the coding matrices, a second independent researcher selected the theme from these lists that was the best fit for each response.