The Economy’s Effect on Hazard Avoidance

The classic and contemporary stress literature connects environmental stressors to illness through the presumed effects of stressors on the endocrine and immune systems. Stressors, however, may affect health through other avenues, such as the effects of stressors on hazard avoidance.

We have a fixed capacity to assess, manage, or reduce hazards in our physical and social environments. We budget this capacity in that not all hazards receive equal attention. Candidates for less attention include hazards with the least potential for pain. Potential for pain is the product of the expected value of pain and our discount rate.

The expected value, in turn, is the product of the likelihood of succumbing to the hazard and the pain that doing so would inflict. The discount rate gauges the difference in fear of pain experienced now compared to that experienced in the future. We most likely neglect hazards that promise relatively little pain, have a low probability of occurring, and occur farthest in the future.

If a contracting economy confronts us with new and immediate hazards, those already low on our list for attention may fall off the list all together. Screening for the early signs of treatable disease or compliance with treatment regimens, for example, may decline among persons attending to hazards posed by lost income.

Attending to new hazards at the expense of old might not change the incidence of illness in a population if hazards came into and left our lives for reasons peculiar to each of us. Some of us would be experiencing new hazards while others were losing old ones, leaving the net effect in the population at or near zero. Incidence would, however, vary over time if the environments we share became more or less hazardous. We all share the constantly shifting economic environment.

The early detection of breast cancer provides an example of how the economic environment may affect the incidence of serious illness by causing shifts in attention across hazards. Ninety-three percent of women discovered with local breast cancer survive 5 or more years, but only 18% of those discovered with remote tumors do so. It appears that living in a contracting economy reduces the likelihood that women will discover tumors in the local stage.

Women apparently seek less screening when coping with the sequelae of economic contraction. They do not, in other words, have sufficient capacity to attend to both the new hazards inflicted upon them by economic contraction and the old hazards farther down the list of priorities.

As noted earlier, changing economies have income effects such that expansion enables individuals to consume more while contraction tends to reduce consumption. Some individuals may use added income to pursue activities that expose them to more hazards than would otherwise be the case. Indeed, ecological associations between rapid economic growth and the incidence of trauma may reflect the risk taking enabled by economic expansion.