Majority of US adults have some health problems

November 22, 2002

The total package of good physical and mental health is elusive for most American adults, according to new research. Two-thirds of U.S. adults participating in a 1995 survey reported some degree of physical or mental infirmity that kept them from being completely healthy.

The remaining third of the survey group was split into nearly equal percentages of completely healthy and completely unhealthy individuals, say study authors Corey L.M. Keyes, Ph.D., of Emory University and Joseph G. Grzywacz, Ph.D., of Wake Forest University School of Medicine. Keyes and Grzywacz published their findings in the November/December issue of the American Journal of Health Promotion.

The researchers conclude that "an alarmingly small portion of the American adult population between the ages of 25 and 74 as of 1995 was healthy."

"America is a society that defines itself in part by the ideal that we can have it all," Keyes says. "When it comes to health, very few Americans are achieving this ideal."

Complete health is a measure of an individual's physical, mental and social well being, including any actual physical and mental infirmities and personal perceptions of physical and mental health. Although it's an important concept for health promotion practitioners, who look for ways to improve overall health rather than simply prevent disease, complete health is rarely defined and measured in actual populations.

Keyes and Grzywacz surveyed 3,032 adults across the continental United States, chosen at random for a telephone interview and a follow-up self-administered questionnaire. To build a picture of complete health for each individual surveyed, the researchers collected information on chronic physical conditions like high blood pressure and limits on daily activities like carrying groceries. They also looked at mental illnesses like depression, generalized anxiety, and panic disorder, and personal evaluations of overall physical health, energy levels and emotional, social and psychological well being.

Based on these data, participants in the survey were then classified as completely healthy, (with high levels of physical and mental health and low levels of illness), completely unhealthy (with low levels of health and high levels of illness) or incompletely healthy. Incompletely healthy individuals were physically healthy and mentally unhealthy, or mentally healthy and physically unhealthy.

Nineteen percent of the 3,032 people surveyed were classified as completely healthy, 18.8 percent were classified as completely unhealthy, and 62.2 percent of the individuals were classified as incompletely healthy. In most cases, incompletely healthy persons suffered from poor physical health rather than poor mental health.

The researchers also compared measures of complete health by gender, age, marital status, education and income. Compared to completely unhealthy individuals, completely healthy individuals tended to be male, either young (25 to 34 years old) or old (55 years or older), married and college-educated with higher household incomes.

Although this profile of the "completely healthy" person is generally consistent with previous studies of complete health, the authors did uncover a few surprises regarding race, age and gender.

Despite many previous studies showing consistent health disparities between blacks and whites, Keyes and Grzywacz found racial differences only within the larger group of incompletely healthy individuals. Blacks in the study were more likely than whites to be "resilient" -- mentally healthy while in poor physical health -- as opposed to completely unhealthy.

The researchers also noted surprising percentages of younger adults (aged 35 to 44) and women classified as completely unhealthy.

The survey results may help practitioners identify the types of interventions necessary for improving public health, and serves as a reminder that the absence of illness or infirmity doesn't necessarily mean that a population is completely healthy, say the authors.

This research was supported by the John D. and Catherine T. MacArthur Foundation through membership in its research network on successful midlife development. The data are from the "Midlife in the United States" representative national survey of adults between the ages of 25 and 74 years old.
Health Behavior News Service: (202) 387-2829 or
Interviews: Contact Corey Keyes at (404) 727-7894 or or Nancy Seideman at (404) 727-064 or
American Journal of Health Promotion: Call (248) 682-0707 or visit


Center for Advancing Health

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