The Effect of a Tailored Health Warning on Socio-Economic Behaviour and Health Outcomes


A number of common and long-term health conditions such as diabetes and high blood pressure display no signs even at advanced stages and so people may carry the disease without being aware of it. In fact, evidence shows that this is a common occurrence across the developed and developing world. Medical guidance indicates that if people were aware of their clinical status, then they would be able to mitigate the long-term effects of diseases on their health by making lifestyle changes through the use of medication and making changes in health behaviours (e.g. exercise, fruit-veg consumption, salt consumption). People may also be able to mitigate the effects of the disease on their wellbeing by modifying non-health behaviours (labour market choices, retirement planning, spending, financial planning). In the face of this growing public health problem, a number of organisations have enacted campaigns that promote health checks (e.g. NHS health check, Diabetes UK and the British Heart Foundation offer health diagnostic checks for heart disease, stroke, diabetes, kidney disease, hypertension and cholesterol concentration) so that individuals diagnosed with a condition can make lifestyle choices at an early stage. One dimension underpinning these campaigns is a belief that if individuals knew they had the condition then they would act differently but currently there is little evidence to say whether or not people do change their lifestyles in response to receiving personalised health information. Wide-spread health checks place a large strain on the public purse (estimated annual cost of NHS health checks is £320m) and so it is important to know whether such interventions are likely to bring savings through the improved wellbeing of the nation. In this project we will make a step towards filling this evidence gap by providing causal evidence on the extent to which individuals change their health and other socio-economic behaviours in response to receiving personalised helth information. Relatedly, there is evidence to suggest that health information campaigns that target at risk groups of the population, such as a Food Standards Agency campaign to reduce salt consumption, have been unsuccessful. One reason that these campaigns may not work is if individuals believe that the group level information does not apply to them as they are "healthier-than-average" (such better than average effects have been shown in other areas, for example, where one study found that 93% US drivers think they are better drivers than the median). The evidence that we will provide in this project will be useful in understanding whether information campaigns that deliver personalised information (and not population level health information) are better at getting people to change their behaviours. The condition we consider is high blood pressure which is a global public health issue. Lowering blood pressure through medication and lifestyle choices is feasible and significantly reduces the risk of death due to heart disease and stroke (leading causes of death in the UK and worldwide) and the development of other debilitating conditions. But often people are unaware that they are afflicted with hypertension and it has been called a 'Silent Killer'. We first provide evidence that would help with the targeting of health campaigns on the extent to which low income households maybe more likely to have high blood pressure (clinically diagnosed) but less likely to know it. We then go on to present evidence from a personalised information treatment that gave respondents of the Understanding Society Survey a blood pressure reading from a trained nurse. We make innovative use of two novel features of this data: that it contains clinically measured indicators of health linked to a rich set of socio-economic variables; and perhaps more unusually that it provides us with subsamples of individuals that have and have not been given personalised health information.
Effective start/end date1/10/1629/03/18