Later life health optimism, pessimism and realism: Psychosocial contributors and health correlates

Abstract

Prior research has established positive outcomes of health optimism (appraising one's health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over one's health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.

Keywords:

• health optimism and pessimism
• self-rated health
• ageing

Acknowledgement

This research was partially funded by a Canadian Institutes of Health Research (CIHR) operating grant (CIHR MOP-64335).

Notes

Notes

1. An assumption of these labels is that OH is a health ‘benchmark’ and deviating SH ratings are inaccurate (Ruthig & Allery, 2008; Ruthig & Chipperfield, 2007). However, OH measures such as physician visits can be erroneous if, for example, visits result from patients who are preoccupied with non-existent health problems (Chipperfield, 1993). Despite potential errors in treating OH as the standard benchmark, the labels of health optimism and pessimism effectively indicate the nature of SH and OH differences and provide a conceptual basis for interpreting findings.

2. With the exception of a marginal difference in life event stress, the in-person interview versus mail-out survey mode of data collection yielded no significant differences in any of the demographics, psychosocial predictors, subjective and OH measures, or health-related outcomes.

3. The US Centers for Disease Control and Prevention's BRFSS collects data on behaviours related to chronic diseases as well as demographic information. The telephone survey uses random digit dialing and data stratification to obtain a large representative sample.