Inter-American Development Bank, Social Protection and Health Division, 1300 New York Avenue NW, Washington, DC, USA.
Sloan School of Management, Massachusetts Institute of Technology, 100 Main St, Cambridge, MA, USA.
BMC Public Health. 2024 Aug 6;24(1):2122. doi: 10.1186/s12889-024-19039-y.
Understanding health-seeking behaviors and their drivers is key for governments to manage health policies. A growing body of research explores the role of cognitive biases and heuristics in health and care-seeking behaviors, but little is known about how a context of heightened anxiety and uncertainty might influence these behavioral drivers. This study analyzes the association between four behavioral predictors-internal locus of control, impatience, optimism bias, and aspirations-and healthcare decisions among low-income women in El Salvador, controlling for other factors. We find positive associations between internal locus of control and preventive health behaviors during the COVID-19 pandemic. For instance, a one standard deviation increase in locus of control is associated with a 10% increase in an index measuring the use of masks, distancing, hand washing, and vaccination. Locus of control was also associated with women's use of preventive health services (one standard deviation improves the likelihood of having a hypertension test in the last six months by 5.8 percentage points). In a sub-sample of mothers, we find significant relationships between the four behavioral drivers and the decisions the mothers make for their children. However, we find these associations are less robust compared to the decisions they make for themselves. Some associations were stronger during the pandemic, suggesting that feelings of uncertainty and stress could amplify behavioral drivers' influence on health-related behaviors. This novel finding is relevant for designing policy responses for future shocks. JEL CODES: I12, D10, D91, I30.
了解健康寻求行为及其驱动因素对于政府管理卫生政策至关重要。越来越多的研究探讨了认知偏差和启发式在健康和求医行为中的作用，但对于在高度焦虑和不确定的环境下这些行为驱动因素可能会产生怎样的影响，我们知之甚少。本研究分析了萨尔瓦多低收入妇女的四种行为预测因素（内部控制点、缺乏耐心、乐观偏差和期望）与医疗保健决策之间的关联，同时控制了其他因素。我们发现，内部控制点与 COVID-19 大流行期间的预防性行为之间存在正相关关系。例如，内部控制点每增加一个标准差，就会导致衡量口罩使用、保持距离、洗手和接种疫苗的指数增加 10%。控制变量也与妇女使用预防保健服务之间存在关联（一个标准差会使过去六个月内进行高血压测试的可能性提高 5.8 个百分点）。在母亲的一个子样本中，我们发现了这四种行为驱动因素与母亲为孩子做出的决策之间的显著关系。然而，与她们为自己做出的决策相比，这些关联的稳健性较差。在疫情期间，一些关联变得更加紧密，这表明不确定性和压力感可能会放大行为驱动因素对与健康相关的行为的影响。这一新颖的发现对于设计未来冲击的政策应对措施具有重要意义。JEL 编码：I12、D10、D91、I30。
