Who deserves to be sick? An exploration of the relationships between belief in a just world, illness causal attributions and their fairness judgements Gabriel Nudelman* and Shoshana Shiloh Department of Psychology, Tel Aviv University, Tel Aviv, Israel (Received 28 August 2010; final version received 3 March 2011) This research explored relationships between beliefs about justice, illness causal attributions and fairness judgements of those causes. Participants (n ¼ 200) completed questionnaires assessing their belief in a just world (BJW) and measuring causal attributions and fairness judgements for 42 illness causes classified into behavioural, environmental and hidden (genetic, mystic, psycho- social) categories. As predicted, BJW was correlated positively with all fairness judgements, but with none of the illness causal attributions. Behavioural causes of illness were judged to be fairer than environmental causes, which were judged fairer than hidden causes. Finally, for environmental and hidden causes (uncontrollable illness attributions), positive correlations between causal attributions and their corresponding fairness judgements were found only among participants with high BJW. Implications of these findings for decision makers and health professionals are discussed, with emphasis on the need to consider the combined effect of causal attributions and BJW on illness fairness judgements. Keywords: belief in a just world; BJW; illness attributions; illness causes; fairness judgements Introduction Perceiving an event as unfair can undermine a person’s peace of mind and raise feelings of anger and anxiety (Krehbiel & Cropanzano, 2000), but can also induce helping behaviours (Zuckerman, 1975). An important area in which fairness attributions are relevant is illness, since it may challenge people’s worldviews. People often try to understand the cause of an illness (Salander, 2007) in order to avoid it or come to terms with it. Believing that a certain cause has a particularly strong influence on disease development may generate risk perceptions, which in turn may elicit specific coping efforts and preventive behaviours (Cameron & Moss-Morris, 2004). The aims of this study were to investigate fairness judgements across various illness causes and to examine their associations with beliefs about their importance and a general belief in a just world (BJW) (Lerner, 1980). *Corresponding author. Email: gabyn@post.tau.ac.il Psychology, Health & Medicine Vol. 16, No. 6, December 2011, 675–685 ISSN 1354-8506 print/ISSN 1465-3966 online Ó 2011 Taylor & Francis http://dx.doi.org/10.1080/13548506.2011.569730 http://www.tandfonline.com