A new test of an old hypothesis: The link between women’s perceptions of mortality conditions and their perceptions of modern healthcare amid demographic transition

Demographers have long suspected that ordinary people in societies experiencing rapid demographic transition face difficulties in perceiving mortality decline. Recent empirical accounts have supported this supposition, demonstrating the extent of misperceptions in select transitioning societies and examining the individual life-course experiences that predate them. Yet, the broader significance of individuals misperceiving the presence or degree of mortality decline remains unclear. This paper examines whether individuals' perceptions of mortality conditions are systematically related to their perceptions of modern healthcare, as the old hypothesis suggested. Using data from the Tsogolo la Thanzi study of women in Balaka, Malawi-a context where mortality has declined dramatically alongside the expansion of modern healthcare-this study assesses whether a pessimistic outlook on mortality corresponds with scepticism of modern healthcare. The results emphasize the continued need for demographic research that grapples with individuals' perceptions of mortality decline, given the broader salience of perceptions to population health matters.