Is it better to sacrifice future health for immediate economic gain, or to invest current economic resources to secure long-term health? Such decisions, which involve different temporal dimensions and domains, are essentially intertemporal decision-making, a process in which individuals weigh costs and benefits at various points in time. Traditional research on intertemporal decision-making predominantly has adopted a single-domain perspective, which fails to fully capture the dynamic and complex interaction between economic and health outcomes in real-world settings. Moreover, intense social competition compels individuals to prioritize immediate economic gains, while increasing rates of chronic diseases and aging populations amplify future health risks. Under these dual pressures, overcoming the lure of short-term economic gains to optimize long-term health decisions represents a critical scientific challenge.

In response, the present study proposes an innovative theoretical framework of “economic-health intertemporal decision-making”. This framework aims to explore the trade-off mechanisms between current economic benefits and future health outcomes. A key factor in this process may be environmental uncertainty, defined as individuals’ perception of rapid and dramatic environmental changes that are difficult to accurately assess and predict. Currently, the escalation of global geopolitical conflicts, financial market turbulence, and the frequent occurrence of extreme climate events collectively heighten individuals’ sense of environmental uncertainty, thereby significantly increasing the complexity of decisions involving current economic benefits and future health outcomes. Investigating how individuals balance current economic benefits and future health outcomes under conditions of environmental uncertainty is of great theoretical and practical significance for understanding economic-health intertemporal decision-making and devising targeted intervention strategies.

Three experiments were designed to explore these issues in depth. Study 1 examined the effect of environmental uncertainty on intertemporal decision-making within a single domain and compared economic discount rates with health discount rates. A total of 140 participants were randomly assigned to either an environmental uncertainty manipulation group or a control group. Participants underwent environmental uncertainty manipulation and verification, followed by economic intertemporal decision-making and health intertemporal decision-making tasks. The results indicated that, in both domains, environmental uncertainty significantly increased individuals’ preference for immediate rewards; furthermore, participants were more likely to disregard future health outcomes than future economic benefits.

Study 2 extended the investigation from a single-domain focus to a cross-domain perspective of economic-health intertemporal decision-making, aiming to determine whether participants in the environmental uncertainty group were more inclined to choose immediate economic benefits over future health benefits. A total of 220 participants were randomly assigned to either the environmental uncertainty group or the control group. During the experiment, participants completed the environmental uncertainty manipulation and verification, followed by a cross-domain economic-health intertemporal decision-making task. The results showed that under conditions of environmental uncertainty, individuals were more likely to opt for current economic benefits rather than future health benefits.

Study 3 employed a dual-scenario experimental paradigm based on a gain-loss framework to investigate the effects of environmental uncertainty, gain-loss framing, and changes in low back pain levels on cross-domain economic-health decision-making. A total of 272 participants were randomly assigned to the environmental uncertainty group or the control group. After undergoing environmental uncertainty manipulation and verification, participants completed a cross-domain economic-health intertemporal decision-making task framed in terms of gains and losses. The results revealed that in both the “current economic gain-future health loss” and “current economic loss-future health gain” scenarios, environmental uncertainty diminished the attention paid to future health. However, in the former scenario, the emphasis on future health was relatively higher.

In summary, this study found that environmental uncertainty generally reinforces the prioritization of immediate economic benefits while weakening long-term considerations for health. These findings provide theoretical support for improving public health decision-making models and enhancing individuals’ awareness and prevention of future health risks.