Exploring the Health Belief Model
Our health is influenced by many factors, including genetics, environment and lifestyle. But one critical factor often overlooked is how our personal beliefs shape our willingness — or reluctance — to follow expert health advice.
We call this phenomenon the “health belief model,” and it can help us understand why some individuals ignore life-saving recommendations from healthcare professionals, scientists and public health officials.
To illustrate its relevance, let’s explore tuberculosis (TB), which remains the world’s deadliest infectious disease despite effective prevention and treatment methods.
Tuberculosis: A Deadly Disease That Lingers
In the early 20th century, tuberculosis was one of the deadliest diseases in the United States. In 1900, it was responsible for the deaths of 194 out of every 100,000 Americans. By 1945, that number had dropped to 40 out of every 100,000 due to improved treatments and living conditions. The introduction of the antibiotic isoniazid in the 1950s further lowered TB mortality rates.
Despite these advances, researchers in the 1950s made a curious discovery: Even as TB screenings became more accessible — thanks to mobile X-ray units traveling through residential neighborhoods — many people chose not to participate.
Today, TB continues to affect millions worldwide. Each year, about 10 million people contract TB, and about 15% of them die from it, even though the disease is both preventable and curable.
But why would people avoid testing and treatment for such a devastating disease? The health belief model may offer some perspective.
What Is the Health Belief Model?
The health belief model was developed in the 1950s by social psychologists Godfrey Hochbaum, Irwin Rosenstock, S. Stephen Kegels and Howard Leventhal while they were working for the United States Public Health Service. It explains how personal beliefs influence health decisions and why people sometimes fail to use available resources to prevent illness.
The framework has evolved over time but remains a powerful tool for promoting greater adoption of recommended health practices and improving public health outcomes.
Key Concepts of the Health Belief Model
The modern health belief model identifies six factors that shape health-related decisions:
- Perceived susceptibility
How likely a person believes they are to contract an illness influences their decision to choose healthy behaviors.
Example: Avoiding crowds during respiratory illness outbreaks.
- Perceived severity
When a person believes that an illness could have serious consequences, they’re more motivated to change their behavior.
Example: Reducing sugar intake to avoid diabetes.
- Perceived benefits
Understanding how proactive behaviors can improve health increases the likelihood of their adoption.
Example: Getting a flu shot at the beginning of each flu season.
- Perceived barriers
Concerns about cost, inconvenience or discomfort may deter people from taking action.
Example: Skipping HIV testing despite free and discreet options like at-home saliva tests.
- Self-efficacy
A person’s confidence in their ability to perform a health-related task correctly encourages action.
Example: Following a prescribed medication schedule.
- Cues to action
Internal or external cues prompt people to take steps towards better health.
Examples: Recognizing symptoms or seeing public service announcements about a specific illness.
Why the Health Belief Model Matters Today
The ongoing threat of tuberculosis — even years after effective testing and treatments were developed — underscores why understanding the health belief model is essential for addressing public health challenges. This framework helps identify common mindsets that hinder progress and provides strategies for overcoming these barriers through evidence-based practices.
Help Remove Barriers to Better Health
Implementation science focuses on bringing evidence-based health interventions from the laboratory into daily practice. By addressing perceived barriers and emphasizing perceived benefits, implementation science can play a vital role in ensuring these interventions reach communities effectively.
The University of Florida’s LCME-accredited College of Medicine offers an online Implementation Science Graduate Certificate Program that can equip you to work on the front lines of this critical field, from conducting clinical trials to working directly with the communities who’ll benefit from them most. See potential careers here.
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