Control over health and patterns of health-related behaviour

doi:10.1016/0277-9536(89)90161-5

Social Science & Medicine

Volume 29, Issue 2, 1989, Pages 131-136

https://doi.org/10.1016/0277-9536(89)90161-5 Get rights and content

Abstract

This paper empirically examines the relationship between position in the social structure, beliefs about control over health and three different types of health-related behaviour. The data are drawn from two large scale community surveys (N = 4224) carried out in southern England. The results show that the relationship between the Multi-dimensional Health Locus of Control (MHLC) and exercise, cigarette smoking and use of alcohol was never more than modest even within different social and economic contexts. Doubts are cast upon the value of the MHLC for explaining variations in health-related behaviour and more fruitful areas for research are suggested.

References (18)

M. Calnan
Patterns of preventive behaviour: a study of women in middle age
Soc. Sci. Med.
(1985)
M. Calnan et al.
Do health beliefs predict health behaviour?
Soc. Sci. Med.
(1986)
R. Pill et al.
Preventive procedures and practices among working class women: new data and fresh insights
Soc. Sci. Med.
(1984)
J.K. Langlie
Inter-relationships among preventive health behaviours: a test of competing hypothesis
Publ. Hlth Rep.
(1979)
P. Townsend et al.
Inequalities in Health
(1982)
D. Blane
Inequality and social class
R. Illsley
Professional or public health?
M. Blaxter et al.
Mothers and Daughters: A Three Generational Study of Health Attitudes and Behaviour
(1982)
J. Cornwell
Hard-Earned Lives
(1984)

There are more references available in the full text version of this article.

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Citation Excerpt :
Burker et al. (2005) found Internal HLC to be positively associated with the odds of surviving a lung transplant surgery, but null associations were found with Chance and Powerful others. However, associations with some health-related behaviors, including alcohol consumption and smoking, are inconsistent (Callaghan, 1998; Calnan, 1989). Explanations for these inconsistencies include small sample sizes, low statistical power, inappropriate statistical tests, inherent differences between risk-enhancing (e.g. smoking) and risk-reducing (e.g. regular exercise) behaviors and the multiple factors that affect them, as well as conceptual concerns with the HLC construct (reviewed in Steptoe and Wardle, 2001).
Indigenous people worldwide suffer from higher rates of morbidity and mortality than neighboring populations. In addition to having limited access to public health infrastructure, indigenous people may also have priorities and health perceptions that deter them from seeking adequate modern healthcare. Here we propose that living in a harsh and unpredictable environment reduces motivation to pursue deliberate, costly action to improve health outcomes. We assess whether variation in Health Locus of Control (HLC), a psychological construct designed to capture self-efficacy with respect to health, explains variation in treatment uptake behavior among Tsimane Amerindians (N = 690; age range: 40–89 years; 55.8% female; data collection: 2008–2012), a high mortality and morbidity indigenous population in the Bolivian Amazon, Beni Department. Comparisons with two industrialized populations in Japan (Miyagi prefecture; e₀ = 76.6 years) and the United Kingdom (Caerphilly county borough; e₀ = 81.2 years) confirm that Tsimane (e₀ = 54.1 years) have a more externalized HLC. Multilevel level models were used to investigate whether HLC predicts treatment uptake, and mediates the relationship between modernization and treatment uptake. External HLC scores were predictive of treatment outcomes: Powerful others scores were positively associated with probability of receiving modern treatment (adjusted odds ratio [OR] = 1.33), while Chance scores were negatively associated with probability of receiving modern treatment (adjusted OR = 0.76). We found no effects, however, of Internal HLC or educational capital on treatment uptake. Overall, our findings indicate that health-related decision-making is influenced more by a psychological orientation affecting self-efficacy, shaped in part by perceptions of environmental unpredictability and harshness, than by limited knowledge, education or other indicators of modernization.
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This paper reports a study examining the relationship between health locus of control and exercise behaviour in a representative sample of over 13 000 adults in Wales. It was predicted that recent leisure-time exercise behaviour would be positively correlated with internal health locus of control beliefs and negatively correlated with powerful others and chance health locus of control beliefs. Moreover, as Wallston (1992) argues, the relationships between health locus of control beliefs and exercise behaviour should be stronger among individuals placing a high value on their health. The results indicated weak but significant correlations between the health locus of control dimensions and exercise behaviour in line with predictions. However, a hierarchical regression analysis revealed no evidence in support of the moderating role of health value. In addition, the amount of variance explained in exercise behaviour was small. The results are discussed in relation to the need to consider other potential reinforcements and other expectancy beliefs when predicting exercise behaviour.
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View full text

Control over health and patterns of health-related behaviour

Abstract

Soc. Sci. Med.

Soc. Sci. Med.

Preventive procedures and practices among working class women: new data and fresh insights

Soc. Sci. Med.

Inter-relationships among preventive health behaviours: a test of competing hypothesis

Publ. Hlth Rep.

Inequalities in Health

Inequality and social class

Professional or public health?

Mothers and Daughters: A Three Generational Study of Health Attitudes and Behaviour

Hard-Earned Lives