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The effect of 'lifestyle stigma' on public support for NHS-provisioned pre-exposure prophylaxis (PrEP) and preventative interventions for HPV and type 2 diabetes: a nationwide UK survey

Hildebrandt, Timothy, Bode, Leticia and Ng, Jessica S.C. (2019) The effect of 'lifestyle stigma' on public support for NHS-provisioned pre-exposure prophylaxis (PrEP) and preventative interventions for HPV and type 2 diabetes: a nationwide UK survey. BMJ Open. ISSN 2044-6055 (In Press)

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Abstract

Objectives: This study examines how the perceived role of poor lifestyle and irresponsible behaviour in contracting HIV, HPV, and diabetes affects public support for government-provisioned prevention efforts in Britain. It assesses whether public attitudes on healthcare spending are broadly sensitive to ‘lifestyle stigmas.’Methods: We conducted an online survey of 738 respondents in Britain and embedded three separate survey experiments to measure support for government-provisioned interventions for HIV, HPV, and type 2 diabetes. In each experiment, we manipulated language used to describe the extent to which the diseases are caused by lifestyle choices. Most respondents participated in all three experiments, but assignment was randomized within each condition. Analysis compared support amongst respondents exposed to ‘lifestyle’ treatment (information emphasising the disease’s lifestyle causes) versus control treatment. We estimated three separate t-tests in which support for government provision of interventions is the dependent variable.Results: Support for government-provisioned prevention was high for all three diseases. There was no statistical difference between treatment and control conditions for HIV (treatment mean = 3.73, control mean = 3.86, p=0.38). But in both HPV (treatment mean = 3.96, control mean = 4.43, p<0.01) and type 2 diabetes (treatment mean = 3.53, control mean = 4.03, p<0.01) experiments, support for government-provisioned interventions was significantly lower under lifestyle treatment conditions. Conclusions: Public opinion on healthcare expenditures in Britain is unexpected and uneven. Consistent participant support for PrEP shows public attitudes are not always sensitive to lifestyle stigmas—but for other diseases, perceived relationships between individual behaviour and poor health can still shape public opinion about health expenditures. Policymakers and practitioners should remain attentive to how health problems are framed and discussed to ensure broad public support, but also take advantage of policy windows like with PrEP as they may close.

Item Type: Article
Additional Information: © 2019 The Author(s)
Divisions: Social Policy
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 25 Jun 2019 09:45
Last Modified: 20 Jul 2019 23:11
URI: http://eprints.lse.ac.uk/id/eprint/101062

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