Culture, the Meaning of Personal Control and Health

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In order to understand the factors that contribute to health and well-being of older people in our increasingly diverse population, we need to identify constructs that help explain variations in health. Considerable evidence has accumulated over the past several decades regarding the importance of individuals' sense of control for their mental and physical health. In general, this influence may operate through the ways in which people appraise health situations, how much influence they feel they can have on their health, and on the specific behaviors they engage in to protect or improve their health. Further, sense of control has been proposed as a major mediating variable that may help explain the link between social structure and health. As with most of our personality constructs, however, measures of control have been established based on European American beliefs about control, and measured with instruments developed on European American samples. To ascertain whether sense of control has the same meaning across diverse ethnic groups, qualitative interviews will be conducted with African Americans, Latinos, and European Americans, age 65 and older. As a working hypothesis, the proposed study assumes that personal control is a multi-dimensional construct and that similarities and differences across groups may exist within each of the dimensions. Specifically, it is anticipated that culture will influence the meaning and interpretation of the following: 1) the controllability of life in general and of health specifically; 2) the agents of control: whether individualistic or collective; 3) the means of control, i.e., the ways one goes about controlling aspects of one's life; and 4) the targets of control. The goals of these analyses are threefold: 1) to shed light on the cultural appropriateness of currently used constructs and measures of sense of control; 2) to aid in interpreting the information we now collect regarding sense of control and its relationship to health across diverse groups; and 3) potentially, to lead to modification of existing measures or development of new, more culturally sensitive measures that better represent the variations in meaning and manifestations of sense of control. The knowledge gained from these analyses is expected to lead directly to a study of control and health in an ethnically diverse sample of older adults with chronic illnesses.