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How Do You Feel About...? Health Outcomes in Late Life and Self-Perceptions of Health and Well-Being

Correspondence: Address correspondence to Dan G. Blazer, MD, PhD, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.

Research has shown over the years that the self-perceptions of older adults about their health and well-being may be at least as important as objective data for predicting the course of their health over time. I review a series of studies that span 30 years in which I and my colleagues have asked older adults in the community about their self-rated health and well-being across a spectrum of parameters, including self-rated health, social support, and mood (both negative and positive), and about whether their basic needs are being met. The social environment shapes perceptions of health and well-being, as does the body. Feelings, such as feelings about health and well-being, are therefore a key (but not the only) psychological–behavioral bridge between the body (genome and physiology) and society (environmental stressors and social context). Following a review of these studies, I attempt to place these perceptions of health and well-being in a social context, a context critical to understanding the consistency and strength of these studies (and others performed over many years) documenting the association between answers to the question "How do you feel about...?" and health outcomes over time.

Key Words: Health • Self-perception • Well-being