Common drivers of questionable health behaviours identified across 33 countries and five continents
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The global rise in intentional non-adherence to medical advice and the use of traditional, complementary, and alternative medicine poses a burden on public health and national economies. In a large-scale, preregistered study, we found that these two types of questionable health behaviours were positively associated in 32 out of 33 countries and that nearly all of the 15,218 participants had engaged in at least one such behaviour during their lifetime. Both behaviours were consistently predicted by psychological factors—especially negative healthcare experiences and a set of epistemically flawed beliefs including conspiracy, magical health, and extrasensory perception beliefs, along with the personality trait disintegration — with effect sizes often larger than previously reported. Predictiveness of these individual-level factors outweighed that of national health system characteristics. Our findings suggest that health systems should build trust, improve patient experience, and screen for individuals vulnerable to unfounded beliefs that can undermine evidence-based health decisions.
