Mortality risk information and health-seeking behavior during an epidemic

• 成果类型: Article
• 署名作者: Purcell, Helene; Kohler, Iliana, V; Ciancio, Alberto; Mwera, James; Delavande, Adeline; Mwapasa, Victor; Kohler, Hans-Peter
• 署名单位: University of Pennsylvania; University of Glasgow; Universidade Nova de Lisboa; University of Technology Sydney
• 刊物名称: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
• ISSN/ISSBN: 0027-13251
• DOI: 10.1073/pnas.2315677121
• 发表日期: 2024-07-09
• 关键词: subjective expectations; vaccination; literacy; IMPACT; longevity; countries; hiv/aids; Covid-19

摘要

In a context where pessimistic survival perceptions have been widespread as a result of the HIV/AIDS epidemic (Fig. 1 A ), we study vaccine uptake and other health behaviors during the recent COVID-19 pandemic. Leveraging a longitudinal cohort study in rural Malawi that has been followed for up to 25 y, we document that a 2017 mortality risk information intervention designed to reduce pessimistic mortality perceptions (Fig. 1 B ) resulted in improved health behavior, including COVID-19 vaccine uptake (Fig. 1 C ). We also report indirect effects for siblings and household members. This was likely the result of a reinforcing process where the intervention triggered engagement with the healthcare system and stronger beliefs in the efficacy of modern biomedical treatments, which led to the adoption of health risk reduction behavior, including vaccine uptake. Our findings suggest that health information interventions focused on survival perceptions can be useful in promoting health behavior and participation in the formal healthcare system, even during health crises-such as the COVID-19 pandemic-that are unanticipated at the time of the intervention. We also note the importance of the intervention design, where establishing rapport, tailoring the content to the local context, and spending time with respondents to convey the information contributed to the salience of the message.