In Sickness but Not in Health: Self-ratings, Identity, and Mortality

Journal of Health and Social Behavior - Tập 45 Số 3 - Trang 336-356 - 2004
Ellen Idler1, Howard Leventhal2, Julie McLaughlin3, Elaine A. Leventhal4
1Ellen L. Idler is Professor and Chair of the Department of Sociology and a member of the Institute for Health, Health Care Policy, and Aging Research at Rutgers University. Her research interests stem from the impact of psychosocial factors on health, particularly in aging populations. Specific interests include religion and health, the self-reporting and perception of health status, and end of life experiences. Her current projects include a study of outcomes of coronary artery bypass surgery, an analysis of quality of life in the last year of life, and depression in geriatric clinical populations.
2Howard Leventhal is Board of Governors Professor of Health Psychology at Rutgers University, a member of the Institute for Health, Health Care Policy, and Aging Research, and a member of the Department of Psychology. His research is focused on common-sense models of illness and treatment, the interaction of these models with beliefs about the self and the social context, and the effects of these processes on the management of chronic illness and quality of care.
3Julie McLaughlin is Assistant Professor in the Department of Sociology at the University of North Carolina at Charlotte. Her current research examines the relationship between the temporal composition of family transitions and psychological well-being.
4Elaine Leventhal is Professor of Medicine and Director of the Gerontological Institute at the Robert Wood Johnson School of Medicine of the University of Medicine and Dentistry of New Jersey, and a Fellow of the American College of Physicians. Her research, stimulated by her geriatric patients, is focused on how the biology of illness affects subjective experience and shapes patients' implicit models of their bodies and illnesses. Her current interest is on the practitioner's ability to detect and make explicit use of patients' implicit models of illness in establishing mutually agreed upon treatments. She chairs the Aging Committee of New Brunswick Tomorrow, a community organization for improving health care and quality of life, and she is involved in the introduction of a life span, behavioral perspective into the medical curriculum.

Tóm tắt

Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study (NHEFS) data for respondents with circulatory system disease (N = 3,709) and respondents with no diagnosable disorders (N = 1,127) at baseline, we test the idea that individuals with experience of chronic disease of the circulatory system will have more predictive self-ratings of health than healthy individuals. Poor or fair self-rated health increased the adjusted hazard of all-cause mortality for respondents with circulatory system disease, but not for respondents who were healthy. Additional analyses confirm that poor or fair self-rated health is particularly predictive for respondents with self-reported history of circulatory system diagnoses and perception of symptoms, but not for respondents without symptoms or diagnoses prior to the NHANES physical exam.

Từ khóa


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Thông tin xuất bản

Journal of Health and Social Behavior

Tập 45 Số 3

336-356

Thông tin tác giả