Powerlessness, health and mortality: a longitudinal study of older men and mature women

National samples of older men (age 45-59 in 1966) and mature women (30-44 in 1967), surveyed periodically over more than a decade, establish the association over time between the sense of powerlessness and various indices of health status (chiefly, psychosocial symptoms and limits on physical activities). The results are basically coordinate for men and women, and they are replicated for initially healthy and initially impaired sub-samples. The results show that: (1) in each year, powerlessness is associated with greater activity limits and more psychosocial symptoms; (2) powerlessness also provides prospective prediction, since high initial powerlessness scores are associated with health problems observed five and ten years later, with initial health controlled; (3) increasing powerlessness accompanies deterioration in health (with stringent controls on prior health); and (4) for a sub-sample of men, mortality between 1976 and 1981 is also associated with initially high powerlessness scores (with prior health controlled). These results are discussed for their import in relation to the steadily growing interest in social psychological factors in health.