Deadly denial? 1 in 3 ignoring their own health

By Stephen Beech

One in three people avoid information about their own health - especially regarding severe or incurable conditions such as Alzheimer’s disease, according to new research

Lack of trust in the medical system is one of the key factors, say scientists.

The study found that, far from being the exception to the rule, medical information avoidance - including avoiding doctors’ appointments, medical tests, and patient education materials - is widespread, impacting millions of people worldwide, with direct consequences for early detection and treatment decisions.

Early detection is often the key to successful medical treatment, but the study showed that millions of people do not take advantage of preventive care, screening programmes, or check-ups.

Researchers say such reluctance - which they term "deliberate ignorance" - can’t be explained by a lack of information or high costs, as in many countries health insurance firms inform their clients about relevant services and often cover the costs.

The findings of the new study, by scientists at the Max Planck Institute for Human Development in Germany, show that one in three people do not want to know about serious illnesses - even if they might be affected.

Study co-author Professor Ralph Hertwig said: “One possibility is that the choice not to know is a deliberate one.

"We have investigated this phenomenon - which we call deliberate ignorance - in other areas of life and found that there are a wide variety of reasons for it."

The research team analyzed data from 92 studies involving a total of 564,497 participants from 25 countries.

They wanted to know how widespread the avoidance of medical information is, and to understand the reasons behind it.

The studies analyzed looked at conditions including Alzheimer’s, Huntington’s disease, HIV and AIDS, cancer and diabetes.

The researchers defined information avoidance as “any behavior designed to prevent or delay the acquisition of available but potentially unwanted information.”

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That included putting off or not attending doctor’s appointments, refusing medical tests, failing to return for test results, or ignoring patient education information.

The findings, published in the journal Annals of Behavioral Medicine, show that choosing to ignore serious illnesses is by no means unusual.

Avoidance was highest for the two incurable neurodegenerative diseases: 41% for Alzheimer’s disease and 40% for Huntington’s disease.

It was lower for serious but treatable conditions such as HIV (32%) and cancer (29%).

Avoidance was lowest (24%) - but still involved around one in four patients - for diabetes, which is chronic but manageable.

The research team identified 16 key predictors of medical information avoidance.

They were surprised to find that gender, race, and ethnicity were not among them.

The strongest predictors were "cognitive overload," where a diagnosis such as cancer can be both complex and stressful.

Another predictor was a low sense of self-efficacy - a lack of confidence in being able to navigate healthcare decisions.

Fear of stigmatisation - if, for example, an HIV test is positive - was another predictor, along with lack of trust in the medical system, coupled with lower expectations of a positive result of treatment.

The research team says their findings highlight the influence of the current social and structural environment.

Study lead author Dr. Konstantin Offer said: “Our findings suggest that lower trust is associated with higher information avoidance."

He added: “Restoring trust in the medical system could therefore lead to greater engagement with medical information."