Socio-economic disparities in science knowledge, biomedical self-efficacy, and public participation in medical decision-making

The thesis consists of three self-contained articles that empirically investigate socio-economic differences in, and interrelationships amongst, science knowledge, biomedical self-efficacy, and participation in medical decision-making. Chapter 2 investigates age-related bias in the science knowledge questions in the Wellcome Trust Monitor Survey Waves I and II. It also examines what evidence there is for three dimensions of knowledge. Chapter 3 studies the influence of Internet use and paying attention to medical stories online in reducing science knowledge and biomedical self-efficacy gaps between low and high educational groups. Wave II of the Wellcome Trust Monitor Surveys is employed in this chapter. Chapter 4 scrutinises the influence of various socio-economic factors, biomedical self-efficacy, and trust in physicians and other medical practitioners on public willingness and confidence to take part in the medical decision-making process. Chapter 4 uses Wave III of the Wellcome Trust Monitor Survey. Chapter 2 finds evidence for age-related bias in the science knowledge battery of questions; no evidence of a misinformed group of respondents was found; a group who consistently said they didn’t know instead of providing an answer that was wrong was found; a sensitivity analysis showed that using the summed score approach leads to the same substantive conclusions as a model taking into account age-related non-invariance. Chapter 3 finds evidence of education-based knowledge and efficacy gaps. It also finds some evidence that the Internet can help reduce that democratic deficit in information. Chapter 4 finds evidence that people are generally confident to participate. Those who are more self-efficacious are also more confident to participate in medical decisions. The opposite held true for those who place high trust in doctors. Women were found to be more confident than men.