Staying healthy: the salience and meaning of health maintenance behaviors among rural older adults in North Carolina

Beliefs about what constitutes health promoting behaviors vary by culture a nd class, and knowing how an older adult interprets a specific health behav ior can improve health education and medical compliance. Ethnomedical appro aches have investigated how people define disease and the therapies used to return to a state of health. However, little research has addressed how in dividuals define health, or the behaviors they use to maintain health. We a nalyze the behaviors elders state are needed to stay healthy, and their mea nings for these behaviors. Narratives collected through in-depth interviews with 145 male and female rural North Carolina residents aged 70 and older, including African Americans, Native Americans and European Americans are a nalyzed using systematic text analysis. The participants' narratives includ e seven salient health maintenance domains: (1) Eating Right, (2) Drinking Water, (3) "Taking" Exercise, (4) Staying Busy, (5) Being with People, (6) Trusting in God and Participating in Church, and (7) Taking Care of Yoursel f. Several of these domains are multi-dimensional in the meanings the elder s ascribe to them. There is also overlap in the content of some of the doma ins; they are not discrete in the minds of the elders and a specific health behavior can reflect more than one domain. Four themes cross-cut the domai ns: "balance and moderation", "the holistic view of health", "social integr ation", and "personal responsibility". Elders in these rural communities ho ld a definition of health that overlaps with, but is not synonymous with a biomedical model. These elders' concept of health seamlessly integrates phy sical, mental, spiritual, and social aspects of health, reflecting how heal th is embedded in the everyday experience of these elders. Staying healthy is maintaining the ability to function in a community. These results indica te that providers cannot assume that older patients will share their interp retation of general health promotion advice. (C) 2001 Elsevier Science Ltd. All rights reserved.