The Uncontrollable Mortality Risk Hypothesis: Theoretical foundations and implications for public health

Abstract

The 'Uncontrollable Mortality Risk Hypothesis' employs a behavioural ecological model of human health behaviours to explain the presence of social gradients in health. It states that those who are more likely to die due to factors beyond their control should be less motivated to invest in preventative health behaviours. We outline the theoretical assumptions of the hypothesis and stress the importance of incorporating evolutionary perspectives into public health. We explain how measuring perceived uncontrollable mortality risk can contribute towards understanding socioeconomic disparities in preventative health behaviours. We emphasize the importance of addressing structural inequalities in risk exposure, and argue that public health interventions should consider the relationship between overall levels of mortality risk and health behaviours across domains. We suggest that measuring perceptions of uncontrollable mortality risk can capture the unanticipated health benefits of structural risk interventions, as well as help to assess the appropriateness of different intervention approaches.

Keywords: health behaviours; perceived control; public health; risk perceptions; socioeconomic inequality; uncontrollable mortality risk.

Figure 1.

Infographic representing the Uncontrollable Mortality Risk Hypothesis of health behaviour.

Figure 2.

Infographic highlighting the benefits of cross-domain tracking of behavioural health changes resulting from structural risk interventions.

Figure 3.

Infographic showing the benefit of comparing perceptions of uncontrollable mortality risk with objective measures of risk when assessing the suitability of interventions (using the example of the risk of interpersonal violence).