%0 Journal Article %J Psychosom Med %D 2014 %T Life satisfaction and frequency of doctor visits. %A Eric S Kim %A Nansook Park %A Jennifer K Sun %A Jacqui Smith %A Christopher Peterson %K Aged %K Female %K Health Behavior %K Humans %K Male %K Middle Aged %K Office Visits %K Personal Satisfaction %K Prospective Studies %K United States %X

OBJECTIVE: Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high-quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information about the association between life satisfaction and health care use is available. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors.

METHODS: Participants were 6379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults older than 50 years. Participants were tracked for 4 years. We analyzed the data using a generalized linear model with a gamma distribution and log link.

RESULTS: Higher life satisfaction was associated with fewer doctor visits. On a 6-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits--after adjusting for sociodemographic factors (relative risk = 0.89, 95% confidence interval = 0.86-0.93). The most satisfied respondents (n = 1121; 17.58%) made 44% fewer doctor visits than did the least satisfied (n = 182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (relative risk = 0.96, 95% confidence interval = 0.93-0.99).

CONCLUSIONS: Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs.

%B Psychosom Med %I 76 %V 76 %P 86-93 %8 2014 Jan %G eng %U http://www.psychosomaticmedicine.org/content/76/1/86.abstract %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/24336427?dopt=Abstract %4 Life Satisfaction/Life Satisfaction/Successful Aging/Health Care Use/Doctor Visit/Psychological Well-Being/Positive Psychology %$ 999999 %R 10.1097/PSY.0000000000000024 %0 Journal Article %J Social Science and Medicine %D 2013 %T Perceived neighborhood social cohesion and stroke %A Eric S Kim %A Nansook Park %A Christopher Peterson %K Demographics %K Health Conditions and Status %K Healthcare %K Public Policy %X Research in the last three decades has shown that negative neighborhood factors such as neighborhood violence, noise, traffic, litter, low neighborhood socioeconomic status, and poor air quality increase the risk of poor health. Fewer studies have examined the potential protective effect that neighborhood factors can have on health, particularly stroke. We examined whether higher perceived neighborhood social cohesion was associated with lower stroke incidence after adjusting for traditional risk and psychological factors that have been linked with stroke risk. Prospective data from the Health and Retirement Study-a nationally representative panel study of American adults over the age of 50-were used. Analyses were conducted on a subset of 6740 adults who were stroke-free at baseline. Analyses adjusted for chronic illnesses and relevant sociodemographic, behavioral, and psychosocial factors. Over a four-year follow-up, higher perceived neighborhood social cohesion was associated with a lower risk of stroke. Each standard deviation increase in perceived neighborhood social cohesion was associated with a multivariate-adjusted odds ratio (O.R.) of 0.85 for stroke incidence (95 Cl, 0.75-0.97, p 0.05). The effect of perceived neighborhood social cohesion remained significant after adjusting for a comprehensive set of risk factors. Therefore, perceived neighborhood social cohesion plays an important role in protecting against stroke. (C) 2013 Elsevier Ltd. All rights reserved. %B Social Science and Medicine %I 97 %V 97 %P 49-55 %G eng %4 Stroke/Epidemiology/Public Health/Neighborhood Social Cohesion/Health Psychology/Positive Psychology/Coronary Artery Disease/Myocardial Infarction/Socioeconomic Status/Heart Disease/Incident Stroke/Ischemic Stroke/Mortality %$ 999999 %R 10.1016/j.socscimed.2013.08.001 %0 Journal Article %J Journal of Psychosomatic Research %D 2013 %T Purpose in life and reduced incidence of stroke in older adults: 'The Health and Retirement Study' %A Eric S Kim %A Jennifer K Sun %A Nansook Park %A Christopher Peterson %K Demographics %K Health Conditions and Status %K Healthcare %X Objective: To determine whether purpose in life is associated with reduced stroke incidence among older adults after adjusting for relevant sociodemographic, behavioral, biological, and psychosocial factors. Methods: We used prospective data from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. 6739 adults who were stroke-free at baseline were examined. A multiple imputation technique was used to account for missing data. Purpose in life was measured using a validated adaptation of Ryff and Keyes' Scales of Psychological Well-Being. After controlling for a comprehensive list of covariates, we assessed the odds of stroke incidence over a four-year period. We used psychological and covariate data collected in 2006, along with occurrences of stroke reported in 2008, 2010, and during exit interviews. Covariates included sociodemographic factors (age, gender, race/ethnicity, marital status, education level, total wealth, functional status), health behaviors (smoking, exercise, alcohol use), biological factors (hypertension, diabetes, systolic blood pressure, diastolic blood pressure, BMI, heart disease), negative psychological factors (depression, anxiety, cynical hostility, negative affect), and positive psychological factors (optimism, positive affect, and social participation). Results: Greater baseline purpose in life was associated with a reduced likelihood of stroke during the four-year follow-up. In a model that adjusted for age, gender, race/ethnicity, marital status, education level, total wealth, and functional status, each standard deviation increase in purpose was associated with a multivariate-adjusted odds ratio of 0.78 for stroke (95 CI, 0.67-0.91, p =.002). Purpose remained significantly associated with a reduced likelihood of stroke after adjusting for several additional covariates including: health behaviors, biological factors, and psychological factors. Conclusion: Among older American adults, greater purpose in life is linked with a lower risk of stroke. %B Journal of Psychosomatic Research %I 74 %V 74 %P 427-432 %G eng %N 5 %4 Stroke/Purpose in life/Meaning in life/Healthy aging/Positive psychology/sociodemographic differences/sociodemographic differences/Socioeconomic Status %$ 69158 %R 10.1016/j.jpsychores.2013.01.013 %0 Journal Article %J Journal of Behavioral Medicine %D 2013 %T Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: a two-year follow-up %A Eric S Kim %A Jennifer K Sun %A Nansook Park %A Laura D Kubzansky %A Christopher Peterson %K Health Conditions and Status %K Healthcare %X This study examined whether purpose in life was associated with myocardial infarction among a sample of older adults with coronary heart disease after adjusting for relevant sociodemographic, behavioral, biological, and psychological factors. Prospective data from the Health and Retirement Study--a nationally representative panel study of American adults over the age of 50--were used. Analyses were conducted on the subset of 1,546 individuals who had coronary heart disease at baseline. Greater baseline purpose in life was associated with lower odds of having a myocardial infarction during the 2-year follow-up period. On a six-point purpose in life measure, each unit increase was associated with a multivariate-adjusted odds ratio of 0.73 for myocardial infarction (95 CI, 0.57-0.93, P = .01). The association remained significant after controlling for coronary heart disease severity, self-rated health, and a comprehensive set of possible confounds. Higher purpose in life may play an important role in protecting against myocardial infarction among older American adults with coronary heart disease. %B Journal of Behavioral Medicine %I 36 %V 36 %P 124-33 %G eng %U http://search.proquest.com.proxy.lib.umich.edu/docview/1318045524?accountid=14667 %N 2 %4 Psychology/Myocardial Infarction/CORONARY-HEART-DISEASE/Self assessed health/quality of Life %$ 68986 %R 10.1161/strokeaha.111.613448 10.1056/nejm199010183231606 http://dx.doi.org/10.1007/s10865-012-9406-4 %0 Journal Article %J Stroke %D 2011 %T Dispositional optimism protects older adults from stroke: the Health and Retirement Study. %A Eric S Kim %A Nansook Park %A Christopher Peterson %K Affect %K Aged %K Aged, 80 and over %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Middle Aged %K Personality %K Prospective Studies %K Risk Factors %K Stroke %X

BACKGROUND AND PURPOSE: Although higher optimism has been linked to an array of positive health outcomes, the association between optimism and incidence of stroke remains unclear, especially among older adults. We examined whether higher optimism was associated with a lower incidence of stroke.

METHOD: Prospective data from the Health and Retirement Study--a nationally representative panel study of American adults aged>50 years--were used. Analyses were conducted for a 2-year follow-up on the subset of 6044 adults (2542 men, 3502 women) who were stroke-free at baseline. Analyses adjusted for chronic illnesses, self-rated health, and relevant sociodemographic, behavioral, biological, and psychological factors.

RESULTS: Higher optimism was associated with a lower risk of stroke. On an optimism measure ranging from 3 to 18, each unit increase in optimism was associated with an age-adjusted OR of 0.90 for stroke (95% CI, 0.84 to 0.97; P<0.01). The effect of optimism remained significant even after fully adjusting for a comprehensive set of sociodemographic, behavioral, biological, and psychological stroke risk factors.

CONCLUSIONS: Optimism may play an important role in protecting against stroke among older adults.

%B Stroke %I 42 %V 42 %P 2855-9 %8 2011 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/21778446?dopt=Abstract %3 21778446 %4 health outcomes/optimism/optimism/Chronic Disease/Self assessed health/sociodemographic factors/sociodemographic factors/risk Factors %$ 62732 %R 10.1161/STROKEAHA.111.613448