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Objective risk exposure, perceived uncontrollable mortality risk, and health behaviors

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Perceived uncontrollable mortality risk (PUMR) refers to people's beliefs regarding their risk of death due to factors outside of their control. Previous theoretical models and empirical studies provide evidence that those with greater PUMR are less motivated to invest in preventative health behaviors, but little is known about how accurately people estimate PUMR compared to objective measures of risk exposure, an important consideration for interventions designed to address the link between PUMR and health behavior. Here, we explore how objective risk indices and personal characteristics relate to PUMR.

Subject and methods

We performed a series of pre-registered analyses on a US-representative longitudinal study (N = 915), connecting these results to external data from the Global Burden of Diseases, Injuries, and Risk Factors Study.


We show that (Study 1) PUMR is associated with objective measures of risk exposure, and that (Study 2) perceptions of risk due to disease drive PUMR, and more educated individuals report less perceived risk. Additionally, we find that (Study 3) estimates of PUMR are relatively stable over a 4-month period (R = 0.7), indicating that behaviors influenced by PUMR are likely to persist over time. Finally, we show that (Study 4) those who believe they are at greater risk of dying due to factors outside of their control (i.e., greater PUMR) are less likely to engage in general health behaviors.


By assessing the determinants of PUMR, we can create data-driven policy solutions that lead individuals to more accurate mortality risk assessments and improved health behavior.

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Availability of data, material, and code

All statistical analyses were conducted in R (R Core Team 2021). The R script used for data analysis is available in a public GitHub repository (


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This study was funded by the Interdisciplinary Cooperation Initiative, ASU President's Office, the Cooperation Science Network, the Institute for Mental Health Research, the University of New Mexico, the Indiana University College of Arts & Sciences, the Rutgers University Center for Human Evolutionary Studies, the Charles Koch Foundation, and the John Templeton Foundation. Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of our funders.

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Authors and Affiliations



Conceptualization: Calvin Isch, Richard Brown, and Gillian Pepper. Methodology: Calvin Isch, Richard Brown, and Gillian Pepper. Formal analysis and investigation: Calvin Isch, Richard Brown, and Gillian Pepper. Writing—original draft preparation: Calvin Isch, Richard Brown, and Gillian Pepper. Writing—review and editing: Calvin Isch, Richard Brown, Peter Todd, Athena Aktipis, and Gillian Pepper. Funding acquisition: Peter Todd and Athena Aktipis. Resources: Peter Todd and Athena Aktipis. Supervision: Peter Todd, Athena Aktipis, and Gillian Pepper

Corresponding author

Correspondence to Calvin Isch.

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This study was approved by the internal review board at Arizona State University (HRP-503a). Our predictions, measures, and analysis plan are pre-registered with the Open Science Framework (

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Isch, C., Brown, R., Todd, P.M. et al. Objective risk exposure, perceived uncontrollable mortality risk, and health behaviors. J Public Health (Berl.) (2023).

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