Silver Spoons and Platinum Plans: How Childhood Environment Affects Adult Health Care Decisions

Can socioeconomic status in childhood influence desire for health coverage in adulthood? We develop and test a model that yielded two sets of findings across five experiments. First, people who grew up poor were generally less interested in health coverage compared to those who grew up wealthy. This effect was independent of people’s current level of socioeconomic status, emerged most strongly when adults were experiencing financial threat, and was mediated by differences in willingness to take risks between people from poor versus wealthy childhoods. Second, we show that this effect reverses when people are provided with baserate information about disease. When information about the average likelihood of getting sick is made available, people who grew up poor were consistently more likely to seek health coverage than people who grew up wealthy. This effect was again strongest when people felt a sense of financial threat, and it was driven by people from poor versus wealthy childhoods differing in their perceptions of the likelihood of becoming sick. Overall, we show how, why, and when childhood socioeconomic status influences desire for health coverage.