A qualitative approach to studying health optimism, realism, and pessimism

To determine why older people are optimistic, realistic, or pessimistic on self-rated health relative to standard medical health measures, 48 persons older than age 65 were interviewed in an in-depth, semistructured format. C omparisons were made between optimists and poor-health realists, both of wh om have serious health problems, to discover the ways in which these groups develop their disparate self-ratings of health. When asked about the meani ngs they attach to health, respondents variously referred to topics includi ng family history, social comparisons, subjective age, and life expectancy to form their ratings. These results begin to clarify the ways in which dif ferent people view similar states of health, building on recent research sh owing that health pessimists are at an elevated risk of mortality, while he alth optimists reduce their mortality risk.