Department of Anthropology, University of California, Los Angeles, USA.
Department of Anthropology, University of California, Los Angeles, USA.
Soc Sci Med. 2024 Dec;362:117461. doi: 10.1016/j.socscimed.2024.117461. Epub 2024 Oct 29.
Extensive work in the social sciences suggests that vaccination decisions are subject to incentives, biases, and social learning processes, including prestige bias transmission. High status figures, like doctors and public health officials, can be effective messengers for vaccination information and uptake under certain conditions. In communities where there is significant medical mistrust and less interaction with markets and formal medical systems, prestige bias social learning may operate through different channels. Here, we examine the role of prestige bias on vaccine decisions in two ethnic groups (Himba and Herero) with varying levels of market integration and experiences with formal healthcare systems. Participants completed a ranking task, comparing the influence of four prestigious individuals on vaccine decisions and a survey on medical mistrust. Using Plackett-Luce models, we compare the influence of location, ethnic affiliation, and other covariates on rankings. A multi-level model compared the influence of those within and outside one's ethnic group, as well as specialist (doctor/healer) and generalist (chief/governor) prestige figures. Results indicate changes in the rank of prestigious individuals across the rural-urban gradient. Our results demonstrate significant variability in prestige-biased social learning about vaccine decision making. Medical mistrust did not impact rankings. Contrary to previous work, we find that whether a prestigious individual is locally prominent is more important than their expertise in the relevant domain (health and healing). These findings emphasize the need for more context-specific studies of prestige bias, which can improve our understanding of healthcare decision-making and guide public health messaging across diverse contexts.
社会科学的广泛研究表明，接种决策受到激励、偏见和社会学习过程的影响，包括威望偏见的传递。在某些条件下，高地位的人物，如医生和公共卫生官员，可以成为接种信息和接种率的有效传播者。在存在严重医疗不信任和与市场及正规医疗体系互动较少的社区，威望偏见的社会学习可能通过不同的渠道运作。在这里，我们研究了在市场融合程度和正规医疗体系体验不同的两个族群（辛巴族和赫雷罗族）中，威望偏见对疫苗决策的影响。参与者完成了一项排名任务，比较了四位有声望的人对疫苗决策的影响，以及一份关于医疗不信任的调查。我们使用 Plackett-Luce 模型，比较了位置、族裔隶属关系和其他协变量对排名的影响。多层模型比较了同一族裔内部和外部人士以及专家（医生/治疗师）和通才（酋长/省长）的威望人物的影响。结果表明，在城乡梯度上，有声望的个人的排名发生了变化。我们的结果表明，在疫苗决策方面，基于威望的社会学习存在显著的可变性。医疗不信任并没有影响排名。与之前的工作相反，我们发现，有声望的个人是否在当地知名比他们在相关领域（健康和治疗）的专业知识更为重要。这些发现强调了需要对威望偏见进行更具体情境的研究，这可以提高我们对医疗保健决策的理解，并指导在不同背景下的公共卫生信息传递。
