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Think Healthy, Be Healthy?

Perceived health may determine your actual well-being.

WebMD Feature

A first heart attack. Prostate cancer. A 50th birthday. At some point, every man gets a shocking reminder that he won't be young and healthy forever.

This realization brings up the Big Question: How much time do I have? For a good guess, you could subject yourself to a battery of medical tests, get a few parts probed, and fill out volumes of questionnaires. But for the most accurate forecast, you should ask the Even Bigger Question: How healthy do I feel?

Think carefully. No matter what all of those tests say, your future largely hinges on your answer.

The Prophecy Fulfilled

A number of recent studies have uncovered a startling fact: A man's opinion about his health is one of the most important keys to his longevity.

That's certainly what researchers at Duke University found when they asked almost 3,000 heart patients to rate their health as poor, fair, good, or very good. As reported in the December 1999 issue of Medical Care, those who chose "poor" were about three times more likely than those who chose "very good" to die within the next three and a half years. Even an answer of "good" instead of "very good" increased the risk of death by 70%.

At first, those numbers may not seem particularly shocking. After all, a man who thinks he's in poor shape is usually right. The astounding thing is that in this study and many others, researchers did their best to control for age, smoking, activity levels, socioeconomic class, weight, blood pressure, cholesterol, current diseases, and practically everything else that could affect a person's survival.

Even with all of these factors removed from the equation, a man's outlook on his health still stands out as a strong predictor of his survival. (The trend, while found in both men and women, is for unknown reasons significantly stronger in men.) Take a roomful of 55-year-old men with the same lifestyles and identical results from their last checkups, and a single question may tell you which ones are most likely to see 60.

More Hazardous Than Smoking or Heart Failure

The trend has held up again and again. A review of 19 recent studies, published in the May 1999 issue of Research on Aging, found that a pessimistic view of one's health -- regardless of other major risk factors -- roughly doubled the chances of dying during study periods, which ranged from one to 10 years.

In one of those studies, published in the February 25, 1998 issue of the Journal of the American Medical Association, a rating of "poor" in regard to one's health proved to be deadlier than congestive heart failure or smoking 50 or more packs of cigarettes per year.

A Matter of the Mind?

"Nobody knows why self-ratings of health are so important to mortality," says Ellen Idler, Ph.D., Professor at Rutgers University and a co-author of the review in Research on Aging. Idler speculates that a fatalistic attitude may encourage a person to slip into an unhealthy lifestyle. She says it's also possible that people are deeply tuned to their bodies and can sense impending trouble.

Looking on the Bright Side

"People with depressive personality traits, neuroticism, or anxiety seem to be at greater risk [for heart trouble and other diseases]," says Gunnar Engstrom, M.D., Ph.D., a professor at Lund University in Sweden who has studied health self-ratings extensively. "A positive attitude per se could be protective."

You don't even have to be particularly healthy to see the bright side. Idler once interviewed a wheelchair-bound man who claimed to be in excellent health. "His only complaint was that he recently strained his shoulder in a karate class," she says. "He never even mentioned the wheelchair."

Not everyone can match this man's indestructible optimism. But we can all take some control over the attitudes that might help steer our fate. As Idler puts it, "People should occasionally turn their attention away from risks to their health and focus on the resources they have to stay healthy."

And if anyone asks how you feel, try to find something good to say. And mean it.

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