When and Why People Conceal Infectious Disease

Wilson Merrell; Joshua Ackerman; Soyeon Choi

Abstract

People sick with infectious illnesses face negative social outcomes like exclusion and may take steps to conceal their illness from others. In ten studies of past, current, and projected illness, we examined the prevalence and predictors of infection concealment in U.S. samples of university students, healthcare employees, and online, crowdsourced workers (total N=4,110). About 75% reported concealing illness within interpersonal interactions, possibly placing others in harm’s way. Concealment motives were largely social (e.g., wanting to attend events like parties) and achievement oriented (e.g., completing work objectives). Disease characteristics including potential harm and illness immediacy also influenced concealment decisions. People imagining harmful (versus mild) infections concealed less frequently, whereas actually sick participants concealed frequently regardless of illness harm, suggesting state-specific biases underlying concealment decisions. Disease concealment appears a widely prevalent behavior whereby concealers trade off risks to others in favor of their own goals, creating potentially important public health consequences.