High rates of mortality due to vascular diseases and concurrent increasing prevalence of modifiable behavioral risk factors call for better comprehension of health risk perception and its utilization in vascular health prevention. The purpose of this study was to explore distortions between objective and subjective risk and to develop assessment tools to improve vascular preventive practice.
An assessment questionnaire was designed based on a previous online survey, measuring personal and general risk perception (1. intuitive risk perception: reporting the most important death cause and risk factor, 2. risk ranking of various death causes and risk factors), socio-demographic characteristics, health status, knowledge, lifestyle and personality. The objective mortality risk and population-attributable-risk rates were eruated from data of the German Federal Office of Statistics and calculated with individual data based on Framingham general CVD-algorithm. Respondents were categorized into age and (low-moderate-high) risk groups. Thus, deviations between actual and perceived risk of death causes and risk factors were compared age- and risk-specifically, providing a multifaceted analysis of health risk perception and its determinants.
As to intuitional perception, mortality risk of traffic-accidents was overestimated as were genetic predisposition and family history, whereas vascular incidents were underestimated. Given reasons were uncontrollability, dreadfulness, exposure, experience, and probability. Significant deviation between objective and subjective risk was present in the age group 40-upwards regarding vascular death causes. Though hypertension was correctly ranked, knowledge and ranking of lifestyle-related risk factors were deficitary. Optimistic bias was observed in all age groups. Best performance was present among people with either experience, exposure to diseases or risk factors, longtime healthy lifestyle, or elevated health knowledge.
Risk perception is a complex and multidimensional construct influenced by various determinants to be addressed in everyday practice of internists dealing with target-age groups. We suggest integrating individual-specific personalized approaches into primary prevention in order to increase accuracy of risk perception and contribute to effective health promotion, and further research on improving health perception.