Health, Aging & Wellness The Surprising Way Older Adults Describe Their Health Resilience, gratitude and realistic expectations all play roles
A common myth about aging is that older adults are burdened by illness and feel lousy much of the time. In fact, the opposite is usually true. In fact, most report feeling distinctly positive about their health. Consider data from the 2017 National Health Interview Survey (the most recent available), administered by the U.S. Centers for Disease Control and Prevention. When asked to rate their overall health, 82% of adults ages 65 to 74 described it as excellent (18%), very good (32%) or good (32%) — on the positive side of the ledger. By contrast, only 18% had a negative perspective, describing their health as fair (14%) or poor (4%). “Being healthy means being able to continue doing what I like: going to the theater, organizing programs, enjoying the arts, walking.” This trend toward positivity is also evident among adults age 75 and older: 73% of this group said their health was excellent (12%), very good (28%) or good (33%), while only 27% gave a fair (20%) or poor (7%) evaluation. How could this be true when the majority of older adults — about 60% — have two or more chronic illnesses, such as diabetes, arthritis, hypertension, heart disease or kidney disease, and higher rates of physical impairment than other age groups? For Health, Attitude Is Everything The answer lies in how older adults think about their health. For many, good health means more than the lack of illness or disability. The components of health they tend to value more are vitality, emotional well-being, positive social relationships, remaining active and satisfaction with life, while poor physical functioning plays a
less important role. “Being healthy means being able to continue doing what I like: going to the theater, organizing programs, enjoying the arts, walking,” said Lorelei Goldman, 80, of Evanston, Ill., who has had ovarian and breast cancer. She also describes her health as “good.” “I have all my faculties and good, longtime friendships,” Goldman continued. “I used to be a bad sleeper, but now I’m sleeping much better. Almost every day, there are moments of clarity and joy. I’m involved in a lot of activities that are sustaining.” Even when older adults are coping with medical conditions and impairments, they can usually think of people their age who are worse off than they — those who have died or gone to nursing homes, said Ellen Idler, a professor of sociology at Emory University in Atlanta and a leading researcher in the field of “self-rated health.” By comparison, older adults still able to live on their own may feel “I’m doing pretty well.” At some point, merely surviving can be interpreted as a sign of good health. “People hit their 80s and 90s, look around and feel pretty good about just being alive,” Idler said. Realistic Health Expectations That isn’t true for younger adults, who measure their health against an ideal “there shouldn’t be anything wrong with me” standard. But expectations for what constitutes good health change as people move into later life. “Older people expect some deterioration in health and aren’t thrown off course in the same way when it occurs,” said Jason
Schnittker, a professor of sociology at the University of Pennsylvania who has studied self-rated health. Resilience is also at play. As older adults adapt to illness and other physical changes, they tend to adjust their outlook. “I may be handicapped, but I can still walk,” one 86-year-old woman told Swiss researchers after being hospitalized due to a fall and forced to use a stick to get around. She considered herself fortunate and rated her health positively. “As long as you can get to church, as long as you can walk, you can say all’s well,” a man in his 80s declared after becoming severely disabled because of a slipped disc in his spine and an embolism. He, too, felt good about his health. Positivity: A Predictor of Longevity Lest you think older adults’ bias toward positivity is a sign of denial or a lack of objectivity, a large body of research shows it’s highly meaningful. “Self-rated health is very strongly predictive of longevity,” as well as other outcomes such as cognitive health and use of health care services, Schnittker noted. Idler and Yael Benyamini, a professor at Tel Aviv University’s Bob Shapell School of Social Work, were among the first scholars to highlight the association between self-rated health and mortality in a much-cited 1997 study that examined research reports from around the world. The link was consistent even when adjustments were made for respondents’ medical conditions, medication use, health care utilization, socioeconomic status and other factors.
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September 2019, Never Too Late | Page 11
Pima Council on Aging
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