Cancer and Heart Disease: Can We Control the Risks?

The extent to which we feel in control of the things most likely to kill us influences our health decisions. In this post, we explore the relationships between perceptions of control and health behaviors and discuss new research focusing on beliefs about cancer and heart disease.

Perceptions of control and health behaviors

The Uncontrollable Mortality Risk Hypothesis states that believing we are more likely to die due to factors that are beyond our control makes us less incentivized to invest time and energy in our long-term health. For example, if you believed there was nothing you could do to avoid dying from an incurable disease in the next few years, would eating your five-a-day seem that important? Identifying whether some types of mortality risk are widely perceived as less controllable than others can help us to understand the relationships between perceptions of risk and subsequent health behaviors. Recognizing health risks that we typically (though often incorrectly) believe to be beyond our control can help to identify targets for public health interventions to increase the public’s sense of control and encourage positive health behaviors.

New research from myself and colleagues at Northumbria University surveyed a representative sample of 1,500 UK adults to assess perceptions of control over 20 different causes of death. Participants reported greater feelings of control over their risk of dying from heart disease than all the other types of cancer included in the study (lung, bowel, breast, prostate, and general risk of cancer). Overall, participants considered cancer and heart disease to be the two most likely causes of death.

Cancer

The risk of death due to cancer is generally believed to be highly likely to occur but largely beyond individual control, often resulting in a harmful sense of inevitability. In our study, only catastrophic attacks, natural disasters, and death due to antimicrobial resistance were believed by participants to be less controllable than cancer—the exception being lung cancer, which was considered more controllable than other types of cancer.

Rising rates of cancer have been a significant cause for concern in recent years, with 1 in 2 people now being diagnosed with cancer in their lifetime. This increase in cancer rates has led to increased fear surrounding the threat of illness and death. Public health campaigns have widely broadcast the rising level of risk and have stressed the importance of timely screening and treatment.

Despite the clear importance of proper screening and treatment, this approach has arguably overshadowed the role of lifestyle and behavior changes in preventing cancer. Many health professionals have admitted that the influence of lifestyle on cancer risk is rarely discussed in general practice. By placing more emphasis on the lifestyle changes individuals can make to lower their risk of developing cancer, we may help to increase perceptions of control and ultimately encourage those preventative health behaviors most likely to reduce overall cancer rates.

Heart disease

Despite believing that heart disease is largely controllable, our sample still deemed it to be the second most likely cause of death (after cancer). This may suggest that many people are not currently managing their level of risk through positive health behaviors. This emphasizes the importance of understanding the barriers to a healthy lifestyle.

Pursuing a healthy lifestyle can be difficult to achieve and sustain over time. Psychological factors, such as stress, addiction, and negative emotions, can lead to unhealthy coping mechanisms, such as developing unhealthy relationships with food and other substances. Economic and geographic limitations, such as living in a “food desert” or not having enough money to buy fresh produce, can make it challenging to eat healthily.

Our relationships can also influence unhealthy habits (such as excessive drinking), which are often fostered by friendships and social norms. Finally, self-control and willpower are important factors in maintaining healthy habits but can be difficult to sustain over time. Understanding and addressing these key factors is crucial for developing effective interventions to help individuals adopt and maintain healthy behaviors.

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Perceptions of control over cancer and heart disease play an important role in determining our level of investment in preventative health behaviors. People who believe they have some degree of control over what is most likely to kill them are more likely to invest in their long-term health. We suggest that public health communicators should focus more on promoting lifestyle and behavioral changes that individuals can make to reduce their risk of cancer, in addition to continuing efforts to encourage proper screening and treatment.

Understanding the barriers that prevent people from maintaining a healthy heart is also essential, as well as appreciating the variety of challenges faced by different pockets of society. Psychological strategies such as self-monitoring and self-motivation can help individuals overcome certain barriers to adopting healthier behaviors. However, tackling persistent societal health inequalities requires sustained structural change and improvements to key services.