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Understanding Underinvestment in Prevention: A Behavioral Perspective
Mohammad Ali Jamali1, Hatra Voghouei2
1Keiser University, Tampa Campus, 5002 W Waters Ave, Tampa, FL, 33634, USA. mohammad.jamali@keiseruniversity.edu.
Journal of Prevention (2022)
|May 27, 2026
Summary
Individuals underinvest in preventive health due to present bias and mental accounting, affecting both starting and continuing healthy behaviors. This behavioral economics approach explains low participation and adherence to interventions.
Area of Science:
- Behavioral economics
- Prevention science
- Health psychology
Background:
- Preventive health interventions are cost-effective but suffer from low participation and sustained engagement.
- Underinvestment in prevention is often attributed to system-level funding issues, not individual behavior.
Purpose of the Study:
- To offer a behavioral economics framework explaining individual underinvestment in preventive health.
- To integrate present bias and mental accounting to explain failures in initiating and maintaining preventive actions.
- To distinguish individual decision-making from policy maker behavior in prevention science.
Main Methods:
- Conceptual framework integrating present bias and mental accounting.
- Analysis of individual decision-making regarding preventive health behaviors.
- Distinction between initiation and follow-through in preventive actions.
Main Results:
- Underinvestment in prevention is a dual-margin behavioral problem.
- Mental accounting influences perceived affordability (monetary, time, effort, psychological costs).
- Present bias leads to overweighting immediate inconveniences over future health benefits.
Conclusions:
- Behavioral economics provides a lens to understand low participation and adherence in preventive health.
- The framework explains why policies may increase initial uptake but not sustained behavior change.
- Future research should consider distinct strategies for participation versus adherence.
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