Mental Health
Optimism and Preventive Healthcare Use Hayami Koga* Hayami Koga Koichiro Shiba Tyler J VanderWeele Laura Kubzansky
Objective: Identifying factors that promote preventive healthcare use is important for aging societies. Optimism has been linked to healthier behaviors and better physical health. However, less is known about the association between optimism and preventive healthcare use. We evaluated if optimism is associated with increased use of flu shots, cholesterol tests, mammograms, Pap smears, and prostate exams.
Methods: Participants were adults over age 50 from the Health and Retirement Study. Optimism was assessed using the Life Orientation Test Revised in 2006/2008, 2010/2012, 2014/2016, and 2018/2020. Preventive healthcare use was assessed in 2008, 2012, 2016, and 2020. We examined the association between optimism at baseline and subsequent service use using Generalized Estimating Equations. We also assessed the extent to which optimism measured over time is associated with preventive service use in 2020 using Marginal structural models (MSM).
Results: The final analytic sample included 13,805 adults (mean [] age, 69 [10] years). After adjusting for sociodemographic factors, health conditions, and pre-baseline healthcare use, a 1-SD increase in optimism was associated with higher odds of receiving subsequent cholesterol tests (OR=1.06; 95%CI,106-.14), mammograms (OR=1.05; 95%CI, 1.02-1.09), and prostate exams (OR=1.11; 95%CI, 1.06-1.16). For Pap smears, associations were observed only when adjusting for sociodemographic factors. MSM analyses showed that consistently high versus low optimism levels over time was associated with higher odds of receiving cholesterol tests (OR=1.49; 95%CI, 1.17-1.90) and prostate exams (OR=1.59; 95%CI, 1.15-2.19).
Conclusion: Higher levels of optimism at baseline and over time were associated with increased subsequent use of preventive healthcare for some but not all services. Optimism may be a promising target of intervention to increase the uptake of preventive healthcare.