Abstract
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. Comparisons were made between optimists and poor-health realists, both of whom have serious health problems, to discover the ways in which these groups develop their disparate self-ratings of health. When asked about the meanings they attach to health, respondents variously referred to topics including family history, social comparisons, subjective age, and life expectancy to form their ratings. These results begin to clarify the ways in which different people view similar states of health, building on recent research showing that health pessimists are at an elevated risk of mortality, while health optimists reduce their mortality risk.
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