Health Attitude

Aging naturally entails changes in physical, cognitive, and social capacities. Many of these changes, such as declining strength, difficulty remembering, or bereavement from the death of friends and loved ones, are experienced as a kind of loss. Experiences of loss can affect one's health negatively, but some people maintain a positive health attitude despite these unwelcome events, which gives rise to a variety of positive health-related consequences. Like any attitude, which comprises a summary evaluation, favorable or unfavorable, of a concept, object, or situation, one's health attitude is the overall evaluation of one's own health as excellent, good, fair, or poor.

A positive health attitude typically reflects an objective health status that is also positive. Many large-scale surveys of population health, conducted in North America and Europe, have found that respondents' self-evaluations correspond well with more objective measures of their health, such as physician ratings, utilization of health services, diagnosed chronic conditions, or days of reduced activity due to health problems, and poor self-rated health has been shown to predict mortality (Mossey and Shapiro, 1982). A positive health attitude is also likely to be associated with consistent beliefs and behaviors. Someone with a positive health attitude might hold the consistent belief that he or she is not highly susceptible to disease, whereas someone with a negative health attitude might rarely or never engage in health-enhancing behaviors, such as exercise. These relationships are further understood to be bidirectional, that is, engaging in good health practices promotes a positive health attitude and vice versa. Past research has supported theories, such as the health belief model or theory of planned behavior, which describe beliefs as a cause, and behavior as a consequence, of health-related attitudes. Behavior can also be a cause of attitudes, according to research on cognitive dissonance and self-perception theory.

Aspects of an individual's personality, notably his or her optimism and perceived personal control over life events, can contribute to a positive health attitude as well. Highly optimistic people and those with high perceived control consistently view their health more positively, and cope more successfully with health problems, than do highly pessimistic people and those with low perceived control. Finally, the way people explain a health-related event can affect how positively they view their health. When negative events happen (e.g., a heart attack), people who attribute the event to a stable cause (e.g., genetic makeup) will view their health prospects more negatively than do people who attribute the event to an unstable cause (e.g., unhealthy lifestyle). Such characteristic attributions may account for the effects of dispositions such as optimism or perceived control on health attitudes. Moreover, according to research in achievement settings, these attributions may be subject to psychotherapeutic intervention, suggesting one way in which people can adopt a positive health attitude. It remains unclear, however, whether such induced attitudes convey the same protection as those that occur spontaneously.

Positive health attitudes have been associated with mostly desirable health-related consequences, as assessed at a later time. Other circumstances being equal, people who view their health positively live longer, on average, than people who view their health negatively. However, a positive health attitude can also serve a defensive function, leading to undesirable consequences. People may continue a health-damaging behavior, such as smoking, or fail to adopt a health-enhancing one, such as sunscreen use, because their positive health attitude shields them from recognizing the health threat that these choices may pose. Finally, one's health attitude can serve a symbolic function, by reaffirming the increasing value people place on their health as they age.