Behavioral Economics and Health Decision-Making: A Study on Preventive Health Behavior in Urban Communities

Authors

  • Pratiwi Indariani Fakultas Ekonomi dan Bisnis Universitas Negeri Manado (UNIMA)
  • Achmad Fauzan Mahfuds Fakultas Ekonomi dan Bisnis Universitas Negeri Manado (UNIMA)

DOI:

https://doi.org/10.37899/mjde.v2i3.222

Keywords:

Behavioral Economics, Preventive Health, Urban Communities, Cognitive Biases

Abstract

Preventive health practices play a vital role in reducing the risks of chronic diseases and enhancing population well-being. Despite this, preventive measures such as immunization, regular check-ups, balanced diets, and exercise remain underutilized in metropolitan areas. This study adopts a behavioral economics perspective to examine how cognitive biases shape urban residents’ decisions regarding preventive health behaviors. A quantitative survey was conducted among 392 respondents across diverse socioeconomic backgrounds, focusing on present bias, status-quo bias, and bounded rationality. The results revealed significant negative correlations between these biases and preventive health practices. Specifically, present bias strongly predicted delays in medical check-ups, status-quo bias hindered the adoption of healthier routines, and bounded rationality contributed to the misinterpretation of health-related information. Socioeconomic status further moderated these outcomes, with higher-income individuals more likely to engage in preventive measures. The findings underscore the importance of applying behavioral insights such as framing effects, default options, and simplified health communication to improve uptake of preventive practices in urban environments. Policymakers are urged to integrate behavioral nudges with equity-oriented health initiatives to address persistent disparities.

References

Acuff, S. F., Strickland, J. C., Smith, K., & Field, M. (2024). Heterogeneity in choice models of addiction: the role of context. Psychopharmacology, 241(9), 1757-1769. https://doi.org/10.1007/s00213-024-06646-1

Alsalem, M. A., Mohammed, R., Albahri, O. S., Zaidan, A. A., Alamoodi, A. H., Dawood, K., ... & Jumaah, F. (2022). Rise of multiattribute decision‐making in combating COVID‐19: A systematic review of the state‐of‐the‐art literature. International Journal of Intelligent Systems, 37(6), 3514-3624. https://doi.org/10.1002/int.22699

Altwaijri, S. A., Alotaibi, A. M. F., ALahmadi, F. S., & Alyamani, A. M. A. (2017. Preventive Medicine and Its Role in Enhancing Public Health: the Critical Importance of Routine Health Screenings. International Journal of Health Sciences, 1(S1), 339-360. https://doi.org/10.53730/ijhs.v1nS1.15429

AlWaer, H., Speedie, J., & Cooper, I. (2021). Unhealthy neighbourhood “syndrome”: a useful label for analysing and providing advice on urban design decision-making?. Sustainability, 13(11), 6232. https://doi.org/10.3390/su13116232

Eisenstadt, L. F., & Haugh, T. (2024). Nudging diversity: Merging law and behavioral science to reduce workplace discrimination and increase diversity. Emory LJ, 74, 249.

Gigerenzer, G., & Gaissmaier, W. (2011). Heuristic decision making. Annual Review of Psychology, 62, 451–482. https://doi.org/10.1146/annurev-psych-120709-145346

Gomes, O. (2023). Behavioral economics and finance: a selective review of models, methods and tools. Studies in Economics and Finance, 40(3), 393-410. https://doi.org/10.1108/SEF-06-2022-0304?urlappend=%3Futm_source%3Dresearchgate

Hallsworth, M., Snijders, V., Burd, H., Prestt, J., Judah, G., & Halpern, D. (2017). Applying behavioral insights: Simple ways to improve health outcomes. World Bank Group. https://openknowledge.worldbank.org/handle/10986/26792

Kahneman, D. (2011). Thinking, fast and slow. Farrar, Straus and Giroux.

Laibson, D. (1997). Golden eggs and hyperbolic discounting. Quarterly Journal of Economics, 112(2), 443–478. https://doi.org/10.1162/003355397555253

Li, J., Song, J., Zhu, X. L., Chen, M. F., & Huang, X. F. (2023). Analysis of status quo and influencing factors for health-promoting lifestyle in the rural populace with high risk of cardiovascular and cerebrovascular diseases. BMC Cardiovascular Disorders, 23(1), 118. https://doi.org/10.1186/s12872-023-03129-7

Loewenstein, G., Asch, D. A., Friedman, J. Y., Melichar, L. A., & Volpp, K. G. (2012). Can behavioural economics make us healthier? BMJ, 344, e3482. https://doi.org/10.1136/bmj.e3482

Long, Y., Jia, C., Luo, X., Sun, Y., Zuo, W., Wu, Y., ... & Lin, Z. (2022). The impact of higher education on health literacy: a comparative study between urban and rural China. Sustainability, 14(19), 12142. https://doi.org/10.3390/su141912142

Marikyan, D., & Papagiannidis, S. (2023). Protection motivation theory: A review. TheoryHub Book: This handbook is based on the online theory resource: TheoryHub, 78-93.

Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365(9464), 1099–1104. https://doi.org/10.1016/S0140-6736(05)74234-3

Milkman, K. L., Patel, M. S., Gandhi, L., Graci, H. N., Gromet, D. M., Ho, H., ... & Duckworth, A. L. (2018). A mega-study of text-based nudges encouraging patients to get vaccinated at an upcoming doctor’s appointment. Proceedings of the National Academy of Sciences, 118(20), e2101165118. https://doi.org/10.1073/pnas.2101165118

O’Donoghue, T., & Rabin, M. (1999). Doing it now or later. American Economic Review, 89(1), 103–124. https://doi.org/10.1257/aer.89.1.103

Olaniyi, O. O., Okunleye, O. J., & Olabanji, S. O. (2023). Advancing data-driven decision-making in smart cities through big data analytics: A comprehensive review of existing literature. Current Journal of Applied Science and Technology, 42(25), 10-18. https://doi.org/10.9734/cjast/2023/v42i254181

Patel, M. S., Volpp, K. G., & Asch, D. A. (2016). Nudge units to improve the delivery of health care. New England Journal of Medicine, 374(20), 1912–1913. https://doi.org/10.1056/NEJMp1602944

Ponce de León Solís, V. (2025). Nudging and Inequality: Examining the Heterogeneous Effects of Behavioural Interventions on Low Socio‐economic Status Individuals. Journal of Applied Philosophy, 42(4), 1094-1110. https://doi.org/10.1111/japp.70015

Rachel, H., Altman, J., & Altman, M. (2023). Bounded rationality, imperfect and costly information and sub-optimal outcomes in the sports and health and fitness industries. In Handbook of Research Methods in Behavioural Economics (pp. 243-267). Edward Elgar Publishing. https://doi.org/10.4337/9781839107948.00024

Rahaman, M. A., Kalam, A., & Al-Mamun, M. (2023). Unplanned urbanization and health risks of Dhaka City in Bangladesh: uncovering the associations between urban environment and public health. Frontiers in public health, 11, 1269362. https://doi.org/10.3389/fpubh.2023.1269362

Rahman, T., Gasbarro, D., Alam, K., & Alam, K. (2024). Rural‒urban disparities in household catastrophic health expenditure in Bangladesh: a multivariate decomposition analysis. International Journal for Equity in Health, 23(1), 43. https://doi.org/10.1186/s12939-024-02125-3

Ruggeri, K. (Ed.). (2021). Psychology and behavioral economics: Applications for public policy. Routledge.

Ruiz Serrano, A., Musumeci, A., Li, J. J., Ruiz Serrano, M., & Serrano Barquin, C. (2025). Rationality and the exploitation of natural resources: a psychobiological conceptual model for sustainability. Environment, Development and Sustainability, 27(6), 13167-13189. https://doi.org/10.1007/s10668-024-04470-3

Samuelson, W., & Zeckhauser, R. (1988). Status quo bias in decision making. Journal of Risk and Uncertainty, 1(1), 7–59. https://doi.org/10.1007/BF00055564

Thaler, R. H., & Sunstein, C. R. (2008). Nudge: Improving decisions about health, wealth, and happiness. Yale University Press.

Umapathy, T. (2024). Behavioral Economics: Understanding Irrationality In Economic Decision-Making. Migration Letters, 21(S2), 923-32.

Volpp, K. G., Loewenstein, G., Troxel, A. B., Doshi, J., Price, M., Laskin, M., & Kimmel, S. E. (2008). A test of financial incentives to improve warfarin adherence. BMC Health Services Research, 8, 272. https://doi.org/10.1186/1472-6963-8-272

World Health Organization. (2021). Global report on urban health: Equitable, healthier cities for sustainable development. WHO Press

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Published

2025-10-14