Powerful audiences are linked to health information avoidance: Results from two surveys

Soc Sci Med. 2019 Mar:225:51-59. doi: 10.1016/j.socscimed.2019.01.046. Epub 2019 Feb 10.


Objective: We examined the extent to which community members avoid medical information that they may very much want, yet fear that others may use to harm them.

Methods: In two online studies, we surveyed participants (N = 659) about their experiences with insurer and employer harm, past avoidance of medical information, intentions to avoid medical information, and reasons for avoiding medical information. Study 2 was a conceptual replication of Study 1 with some minor variations.

Results: Several key findings emerged. 1) Although reports of past audience harm were relatively rare, reports of past avoidance were common, both for audience reasons and resource reasons. 2) Participants who were younger and who reported avoiding medical tests in the past (for audience or resource reasons) generally reported greater intentions to avoid health information in the future. 3) Participants reported that receiving unfavorable medical test results would elicit more harm from financially powerful audiences (health insurers and employers) than from interpersonally powerful audiences (close friends/family and others). 4) Participants indicated that the prospect of harm from an audience (i.e., negative effects on insurance coverage) rather than the prospect of bad news would dissuade them from seeking a medical test. Finally, 5) Participants reported that they were most inclined to avoid testing for medical conditions that were untreatable, unimportant, embarrassing/stigmatizing, or expensive.

Conclusions: Findings demonstrate that people are concerned with audience perceptions of their health and these concerns may adversely affect decision making and behavior.

Keywords: Audience effects; Audience research; Decision making; Deliberate ignorance; Information avoidance.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Avoidance Learning*
  • Consumer Health Information*
  • Employment
  • Female
  • Humans
  • Insurance, Health
  • Intention
  • Male
  • Middle Aged
  • Power, Psychological*
  • Surveys and Questionnaires