December 2025

IZA DP No. 18301: Cultural Origins of Preventive Health Care Utilization

Jan Bietenbeck, Lukas Maschmann, Therese Nilsson, Devon Spika

We examine whether culturally transmitted time and risk preferences help explain differences in preventive health care uptake. We combine individual-level survey data from 27 European countries with country-level preference measures from the Global Preferences Survey. To isolate cultural influences from institutional and economic confounders, we focus on second-generation immigrants, who were born and currently reside in the same country -- and thus face the same institutional environment and health care system -- but whose parents originate from culturally distinct countries. We find that descendants of more patient cultures are more likely to use preventive services, while those from more risk-taking cultures are less likely to do so. These associations appear across multiple preventive care outcomes and remain robust to a wide range of socio-demographic and country-of-origin controls. The results highlight the role of culturally shaped preferences as a subtle but systematic determinant of preventive health behavior.