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Does skepticism towards medical care predict mortality?

K Fiscella1, P Franks, C M Clancy

  • 1Primary Care Institute, and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY, USA. kfiscella@highland.rochester.edu

Medical Care
|April 23, 1999
PubMed
Summary

Medical skepticism, or doubts about healthcare value, independently predicts early death. This risk is linked to unhealthy behaviors, highlighting a potential public health concern.

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Area of Science:

  • Public Health
  • Medical Sociology
  • Health Services Research

Background:

  • Attitudes towards medical care significantly influence healthcare utilization and patient outcomes.
  • Limited research has explored the impact of skepticism regarding the value of medical interventions on health outcomes.
  • Understanding factors influencing mortality is crucial for public health interventions.

Purpose of the Study:

  • To investigate the association between skepticism toward medical care and mortality.
  • To utilize data from the 1987 National Medical Expenditure Survey (NMES) for this analysis.

Main Methods:

  • A nationally representative sample of 18,240 U.S. adults (aged 25+) was surveyed.
  • Skepticism was quantified using an 8-item scale.

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  • Mortality data were collected via the National Death Index at a 5-year follow-up.

    • Main Results:

    • Skepticism toward medical care was found to be an independent predictor of 5-year mortality.
    • This association remained significant after controlling for demographic factors (age, sex, race, education, income, marital status) and health status (morbidity).
    • The predictive risk of skepticism on mortality was attenuated after accounting for health behaviors but not health insurance status.

    Conclusions:

    • Medical skepticism may represent a risk factor for premature mortality.
    • The observed effect of skepticism on mortality appears to be mediated by unhealthy behaviors.
    • Further research with more robust measurement tools is warranted to confirm these findings.