Understanding Concordance in Health Behaviours among Couples: Evidence from the Bowel Cancer Screening Programme in England

Health behaviours depend upon preferences and individuals’ assessments of the long-term costs and benefits to themselves and others. We investigate family spillovers by examining couple concordance in uptake of bowel cancer screening using the English Longitudinal Study of Ageing. We exploit the sharp age cut-off for screening programme eligibility at age 60 and use polynomial regression to study how initial screening participation depends upon partner’s uptake. Individuals with non-screened older partners are no more likely to participate in screening than comparable singles, whereas individuals with screened partners are 42 percentage points more likely to screen than individuals with a non-screened older partner. Eligible but non-screened individuals update their screening behaviour if their younger partners participate in screening once they became eligible. These results and the patterns of heterogeneity in concordance are consistent with learning among partners as likely mechanism driving couple concordance. The findings have important implications for the optimal design of population-wide screening campaigns.

Keywords – health behaviours; cancer screening; family spillover; household behaviour

JEL codes – D1, I1

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