'Choosing' to Be Unhealthy? How People Think About Choice, Unhealthy Behaviors, and Health Disparities.

摘要

Health behaviors related to nutrition, physical activity, and health care are increasingly recognized as important determinants of health. However, the ability to readily engage in healthful behaviors varies by socioeconomic status, as people with fewer material resources are constrained in their ability to purchase nutritious foods, exercise on a regular basis, and engage in preventive health care due to lack of money, time, and access to safe neighborhoods and health care facilities. To what extent do lay perceivers recognize these situational constraints on others' health choices and take them into account when trying to explain others' unhealthy behavior? The present research explored the hypothesis that individuals who perceive a great deal of choice in their own lives are more likely to perceive situationally constrained others as having a high level of choice in their health behaviors. Those perceiving choice in others' unhealthy behavior, in turn, were hypothesized to be more likely to attribute that behavior to internal causes. Furthermore, the tendency to make internal attributions was hypothesized to relate to decreased support for public policy interventions---such as increasing access to healthy foods---that address situational barriers to health.;Four studies were conducted to test these hypotheses. Participants' perceptions of the amount of choice in fictional others' unhealthy behavior were found to positively correlate with participants' own perceived freedom of choice. Perceiving others to have more choice was, in turn, associated with making internal attributions for their behavior. Furthermore, a tendency to make internal attributions for unhealthy behavior was found to negatively correlate with support for situational policy interventions to address health disparities. In addition, experimental methods were used to examine ways to increase awareness of situational constraints on health behavior. Asking participants to reflect on aspects of people's situations that might constrain their health behavior was found to be effective in increasing support for situational interventions. Implications of these findings for public policy and health disparities are discussed.