Copyright 1991 by the American Psychological Association, Inc. 0882-7974/91/S3.00
Psychology and Aging 1991, Vol. 6. No. 1,100-108
Health, Stress, Psychological Resources, and Subjective Weil-Being Among Older Blacks Roosevelt Wright, Jr.
Thanh Y Tran
Graduate School of Social Work University of Texas at Arlington
Graduate School of Social Work Boston College
Linda Chatters
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
School of Public Health, Health Behavior/Health Education University of Michigan This study examines the structural relationships among sociodemographic characteristics, health status, stress, psychological resources, and subjective well-being (SWB) among the Black elderly. A structural equation model of SWB was evaluated with data from the 1979-1980 National Survey of Black Americans. The results revealed that poor subjective health status was predictive of lower levels of personal efficacy and SWB. Stressful life events tended to depress subjective assessments of health and had negative effects on self-esteem and SWB. Marital status and age had positive effects on SWB. Chronic health conditions and other demographic variables, however, had indirect effects on SWB.
This is true even though specific social conditions that characterize the Black elderly as a group (i.e., poor health status, disadvantaged life circumstances, and disproportionate likelihood of being in poverty) suggest that they may be at relatively greater risk for diminished quality of life and ultimately, lowered SWB (Herzog et al., 1982; Wright, Saleebey, Watts, & Lecca, 1983). The present study partly represents an attempt to examine some of the substantive concerns surrounding SWB among older Blacks. This study is an elaboration and expansion of a prior study of the causal relationships among health, stress, and SWB among a sample of older Black Americans (Chatters, 1988). As such, it builds on Chatters's (1988) investigation of SWB by including two important constructs (i.e., personal efficacy and self-esteem) that were not included in the original formulation of the SWB model. In particular, the current study (a) proposes a structural equation model incorporating psychological resources (i.e., personal efficacy and self-esteem) as variables that are intermediate to SWB and (b) involves the application of LISREL, which uses a maximum likelihood method of model estimation.
Researchers have increasingly turned their attention to the development of complex models of the relationships among health, stress, and subjective well-being (SWB) among older groups (House & Robbins, 1983). The development of these models has been guided by several considerations. First, there have been attempts to identify the role of social status and resources as antecedents to SWB (Fletcher & Lorenz, 1984; Herzog, Rodgers, & Woodworth, 1982). Social status and resources may exert direct effects on SWB or have their effects mediated by intervening factors and therefore function to shape life conditions that can jeopardize or enhance a sense of well-being. Second, several major studies have addressed the nature and significance of life circumstances and situations (e.g., health status and stress) as potential assets and liabilities for SWB (Herzog et al., 1982; Kessler & Cleary, 1980; Neighbors, 1986). Finally, some studies have been concerned with the possible mitigating or conditioning effects of social and psychological resources (e.g., social support and psychological traits and characteristics) on the relationships among health status, stress, and SWB (House & Robbins, 1983). With few exceptions (Chatters, 1988; Krause & Tran, 1989), previous research has not addressed these concerns among the Black elderly or more generally, among ethnic minority elderly.
Sociodemographic Characteristics Empirical studies on the effects of age on SWB indicate that older people, in general, are more positive in their evaluations of overall life quality (Ball, 1983; Campbell, 1981; Campbell, Converse, & Rodgers, 1976; Janson & Mueller, 1983; Veroff, Douvan, & Kulka, 1981) and of particular life events and transitions (House & Robbins, 1983) than are their younger counterparts. Although age demonstrates a consistent negative relationship with objective measures of health (Verbrugge, 1983), its relationship to subjective health is less clear. For example, findings of a negative relationship between age and subjective health (Herzog & Rodgers, 1981), as well as evidence for a positive relationship (Ferraro, 1980) and no relationship between age
The data used in this study came from the National Survey of Black Americans, 1979-1980, and were collected by James S. Jackson and Gerald Gurin and made available from the Inter-University Consortium for Political and Social Research. Neither the collectors of the original data nor the consortium is responsible for the analyses and interpretations presented in this article. Assistance from Jersey Liang and Neal Krause from the University of Michigan is very much appreciated. Correspondence concerning this article should be addressed to Thanh V Tran, Graduate School of Social Work, Boston College, Chestnut Hill, Massachusetts 02167.
100
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
OLDER BLACKS' WELL-BEING
and subjective health (Markides & Pappas, 1982), exist in the current literature. Findings regarding gender differences in the SWB of older Black adults are equivocal and indicate either no differences (Linn, Hunter, & Perry, 1979) or that men are more likely to characterize their life situations in a positive manner (Kessler, 1979). In addition, previous research has suggested that women tend to have lower self-esteem than men have (see Rosenfield, 1980). However, there is a lack of research on sex differences in self-esteem within the Black population. Studies regarding the relationships among income, educational status, and SWB among older Black adults have equivocal findings. For example, Ehrlich (1973) reported a positive effect for income on SWB, whereas other researchers found no significant relationship between the two (Jackson, Bacon, & Peterson, 1977; Jackson, Chatters, & Neighbors, 1986; Sauer, 1977). Jackson et al. (1977) reported a positive relationship between education and SWB, in contrast to other studies indicating no significant relationship (Ehrlich, 1973; Sauer, 1977). Finally, investigations of marital status differences in SWB among older Black adults indicate that people who are married tend to report higher levels of SWB than do those who are not married (Ehrlich, 1973; Jackson et al., 1977,1986). The use of sociodemographic characteristics as control variables in this study provides useful information to better understand the unique contributions of health status, stress, and psychological resources to SWB assessments. More specifically, we empirically examine structural relationships between chronic health conditions, stressful life events, subjective health, psychological resources, and SWB among older Black adults, after the effects of sociodemographic variables have been considered. Health Status Objective health status and subjective health assessment bear a positive relationship to each other (Ferraro, 1980; Palmore, Cleveland, Nowlin, Ramm, & Siegler, 1979), and both types of health measures have been found to be significantly related to SWB in studies of older individuals (Ball, 1983; Ehrlich, 1973; Larson, 1978; Markides & Martin, 1979; Okun, Stock, Haring, & Witter, 1984; Sauer, 1977). Previous work has found that good health is inversely related to psychological distress (Abrahams & Patterson, 1978; Lieberman, 1975) and positively related to psychological well-being (Hayes & Ross, 1986) and self-esteem (Antonucci & Jackson, 1983). Although health status is frequently viewed as an outcome variable, the causal model we propose suggests that both chronic health conditions and subjective health assessments represent personal resources or assets. Therefore, self-esteem, personal efficacy, and SWB are consequences of objective and subjective health status. Stress and Psychological Resources Previous work indicates that stress has a negative effect on evaluations of life quality (Kessler, Price, & Wortman, 1985; Tessler & Mechanic, 1978), although the magnitude of the effect is generally small. Conceptual models of the relationship between stress and SWB suggest that the effects of stress may
101
operate indirectly through psychological components that are important to the maintenance of a positive self-concept. In effect, stress compromises one's self-conceptions or sense of selfworth, which in turn negatively affects well-being. Self-esteem and personal efficacy, which have been associated with enhanced well-being (Bortner & Hultsch, 1970; Campbell et al., 1976; Jackson et al., 1977), represent two psychological resources that may mitigate the effects of stress on well-being (Pearlin & Schooler, 1978). In an attempt to model the complex relationships among health, stress, psychological resources, and well-being, we suggest that personal efficacy and self-esteem are intervening factors that mediate the effects of health and stress on SWB. In this study, we examine the general hypothesis that chronic health conditions and stressful life events directly affect an individual's level of satisfaction with his or her health status and therefore exert both direct and indirect effects on one's sense of personal efficacy, self-esteem, and SWB. Method Model Specification Structural relationships among SWB, psychological resources, subjective health, chronic health conditions, stressful life events, and sociodemographic characteristics are illustrated in a path model (see Figure 1). Analysis of linear structural relationships by the method of maximum likelihood or LISREL was adopted in this study. The notations of the variables and their structural relationships are in accordance with the LISREL conventions (Joreskog & Sorbom, 1986). In this study, the causal (path) model (see Figure 1) contains five exogenous variables: education, annual family income, sex, marital status, and age (£1 to {5). It is hypothesized that the exogenous variables would have direct effects on all endogenous variables. The six endogenous variables are chronic health conditions, stressful life events, subjective health, personal efficacy, self-esteem, and SWB fyjl to ?j6). It is also hypothesized that chronic health conditions and stressful life events would have direct effects on subjective health, psychological resources, and SWB. Finally, psychological resources are hypothesized to have direct effects on SWB. Among the six endogenous variables, efficacy (>j4), self-esteemfoS),and SWBfo6)are considered latent constructs (see Table 1 and Figure 1). These constructs are measured by the associated observable indicators, y4 to yl3 in Figure 1. The epsilons £s) are the measurement errors of observed indicators. The zetas (fs) are the residual variances of the structural equations. The gammas (ys) are the effects of exogenous on endogenous variables. The betas (0s) are the effects among endogenous variables.
Data and Sample The data used in this study are from the 1979-1980 National Survey of Black Americans (NSBA). The NSBA is a multistage area probability sample that of 2,107 Black Americans aged 18 and older. This study used data from the 581 Black respondents who were 55 years of age and older. With respect to sex and marital status, 63.2% were women, and 38.8% were married. The mean age of persons in the sample was 66.98 years (SD = 8.343). Most respondents had fewer than 12 years of education (74.2%). Forty-seven percent of respondents had family incomes below $5,000, and approximately 10% had annual family incomes above $20,000. After the listwise deletion of cases with missing data, the effective sample size for this study was 407 respondents. Taylor's (1986) comparison of the NSBA sample with U.S. Census Bureau data on the Black population identified several minor differences with re-
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
102
T. TRAN, R. WRIGHT, JR., AND L. CHATTERS
Figure 1. The trimmed path model of health, stress, psychological resources, and subjective well-being.
gard to sociodemographic indicators. The NSBA sample is slightly older, has a higher percentage of women, has fewer never-married persons and more persons who are widowed, and has higher family incomes.
Measurements Congeneric measurement model. A confirmatory factor analysis (Joreskog & Sorbom, 1986) was performed to evaluate a three-factor congeneric measurement model of personal efficacy, self-esteem, and SWB. Table 1 shows the factor loadings of the observed indicators on their latent variables, measurement errors, reliability scores, and measures of goodness of fit. The results revealed that the observed indicators had acceptable factor loadings and reliability scores. The measures of fit also indicated that the congeneric measurement model of these three latent variables was supported relatively well by the data. In the following sections, we present and discuss the three latent variables and other variables used in this analysis. SWB. SWB was measured with three items relating to evaluations of life satisfaction, happiness, and goal attainment. The data on which this study is based relied on single-item measures and did not include scales of SWB such as the Life Satisfaction Index A (LSIA), the Affect Balance Scale, or the Philadelphia Geriatric Center (PGC) Morale Scale. The NSBA was a survey of the adult Black population aged 18 years and older, and the inclusion of the LSIA and the PGC Morale Scale, in particular, was not viewed as appropriate for this population group. Furthermore, a selective administration of these scales to older respondents was not a feasible option. The individual SWB items used in this analysis (i.e., life satisfaction,
happiness, and goal attainment) have face validity with reference to the content of their meanings. In line with conceptualizations of SWB suggested by Stock, Okun, and Benin (1986) and others (Bradburn, 1969), each item requires that respondents arrive at a SWB evaluation through a process in which positive and negative affects are aggregated. Furthermore, these items involve global or overall (vs. domain specific) evaluations of life quality and vary with regard to their temporal frame of reference (i.e., temporal present vs. prior to the immediate past; Stock et al., 1986). The item on life satisfaction is worded as follows: "In general, how satisfied are you with your life as a whole these days? Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied" The focus is on events prior to the immediate past (residual affect), with a greater relative emphasis on cognitive as opposed to affective elements. The happiness item (Gurin, Veroff, & Feld, 1960), "Taking all things together, how would you say things are these days—would you say that you're very happy, pretty happy, or not too happy these days?" focuses on events occurring in the temporal present and emphasizes affective elements over cognitive. Finally, the goal attainment item states, "Up to now, have you gotten mostly what you hoped for out of life or have you gotten less than you hoped for?" This item focuses on events that are prior to the immediate past and, in emphasizing an explicit comparison between respondents' goals and attainments, incorporates a high degree of cognitive activity. Furthermore, the comparison of goals and attainments suggests that this item taps the notion of congruence that underlies general conceptualizations of SWB (George, 1979; Liang, 1984). In sum, these items represent, in varying degrees, the affective and cognitive dimensions of SWB (see Andrews & McKennell, 1980; Liang, 1984) and tap different components in relation to temporal (i.e.,
103
OLDER BLACKS' WELL-BEING
Table 1 Three-Factor Congeneric Measurement Model of Personal Efficacy, Self-Esteem, and Subjective Well-Being
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Measure Personal efficacy Better to plan Plans work out Feel life would work out Run own life Self-esteem Cannot do anything Life is not useful Not proud Subjective well-being Life satisfaction Happiness Got what hoped for Goodness of fit X2 (32, N = 407)
GFI AGFI Bentler and Bonett (Al) Bollen (A2)
Factor loading/GFI
Measurement error
Reliability score
0.350 0.490 0.630 0.511
.877 .759 .604 .739
.123 .241 .396 .261
0.455 0.750 0.720
.793 .437 .481
.207 .563 .519
0.591 0.601 0.508
.651 .639 .742
.349 .361 .258
63.270 1.970 0.970 0.949 0.890 0.940
Note. GFI = Goodness-of-Fit Index; AGFI = Adjusted Goodness-of-Fit Index.
events occurring in the temporal present vs. those prior to the immediate past) frames of reference (Stock et al., 1986). These SWB items have been used widely in previous research (Okun et al., 1984). When used as a summative index, its scores ranged from 3 to 9 (M = 7.44, SD = 1.40), with higher scores reflecting greater levels of SWB. The SWB index had a Cronbach's alpha of .56. In this analysis, SWB was viewed as a latent variable (see Table 1 and Figure 1). Personal efficacy. Personal efficacy was measured by four items encompassing a person's feelings of taking control of life by making and executing plans and running one's own life. This measure of personal efficacy has been used successfully in previous research with older Blacks and the general population (Krause & Tran, 1989; Veroff et al., 1981). When used as a summative index, its scores ranged from 4 to 8, with higher scores referring to a higher sense of personal efficacy (M= 6.04, SD = 1.33). This index had a Cronbach's alpha of .58. Personal efficacy was also viewed as a latent variable in this analysis (Table I and Figure 1). Self-esteem. Self-esteem was measured by three items that are somewhat similar to Rosenberg's (1965) negative items of self-esteem. The items comprising this scale were coded in such a way that a higher score refers to a higher sense of self-esteem. The scores on this scale ranged from 3 to 12 (M = 10.57, SD = 1.90), and Cronbach's alpha was .66. This scale has been subjected to validation (see Krause & Tran, 1989) and was viewed in this study as a latent variable (Table 1 and Figure 1). Chronic health conditions and subjective health. In this analysis, chronic health conditions were assessed by an index that consisted of I 1 health conditions, including arthritis, ulcers, cancer, high blood pressure, diabetes, liver problem, kidney problem, stroke, nervous conditions, blood circulation problem, and sickle cell anemia. The maximum number of chronic health conditions experienced by respondents was 7 (M= 2.084, SD = 1.530). Subjective health status was measured by the following question: "In general, how satisfied are you with your health? Would you say you are very satisfied (I), somewhat satisfied (2), somewhat dissatisfied (3), or very dissatisfied (4)?" Higher scores on this item indicate poorer health (M = 1.75, SD = .83).
Stressful life events. This index consisted of 10 stressful life situations, including problems with health, money, job, family or marriage, people outside the family, children, crime, police, love life, and racism. The maximum number of stressful situations experienced by respondents was 8 (M = 1.00, SD = 1.17). Sociodemographic variables. Education was measured as the actual number of years of formal school completed (M= 8.21, SD = 3.90). Annual family income was coded 1 for $0.000 to 17 for $30,000 and over (M= 8.03, SD = 4.28). Sex was coded 1 for male and 0 for female. Marital status was coded 1 for married and 0 for other categories. Finally, age was measured by respondents' actual age, ranging from 55 to 101 years (M = 66.98, SD = 8.34). Tables 2 and 3 present the correlation matrix and descriptive statistics for the variables used in the analysis. Three endogenous variables, chronic health conditions, stressful life events, and subjective health, were measured by single indicators. It is not realistic to assume, however, that these single indicators were measured without errors. Subsequently, we applied the method suggested by Anderson and Gerbing (1988) to adjust for the measurement errors of these indicators. They suggested that in the absence of reliability estimates for single indicators, one may set the lambda equal to .95 and the theta delta equal to the square root of 1 minus .90, that is, 1 minus the assumed reliability score (also, see Sorbom & J6reskog, 1982).
Results Theory Trimming We began our analysis with the evaluation of a fully recursive model. In that model, we hypothesized that all independent variables had significant direct effects on their dependent variables. Subsequently, we used the theory-trimming approach to delete path coefficients that had / ratios smaller than 2 (JOreskog & Sorbom, 1986). Although the theory-trimming approach has
104
T. TRAN, R. WRIGHT, JR., AND L. CHATTERS its shortcomings, it can be used to develop an exploratory model (Pedhazur, 1982). We deleted insignificant paths simultaneously from a fully recursive model and analyzed a trimmed model, shown in Figure 1. Five predicted paths among endogenous variables were not statistically significant and are not shown in Figure 1. These paths are (a) the path between subjective health and self-esteem, (b) the path between stressful life events and personal efficacy, (c) the path between chronic conditions and SWB, (d) the path between chronic conditions and self-esteem, and (e) the path between chronic conditions and personal efficacy (Table 4).
g
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Goodness-of-Fit Measures The findings revealed that 55% of the variance in SWB was explained by the variables included in the model. With respect to the goodness of fit, the trimmed model had a x2 of 205.31 with 123 dfand a sample size of 407 (p < .001), indicating a poor fit. However, the \2 is very sensitive to sample size and violation of multivariate normality. The ratio of the x2 to its degrees of freedom was 1.69, indicating a good fit. The Goodness-of-Fit Index (GFI) and the Adjusted Goodness-of-Fit Index (AGFI) had values of .92 and .94, respectively, also indicating a good fit. In addition, we used the Rentier and Bonett (1980) normed index (Al) and Bollen's (1989) modification of the incremental fit index (A2). The Bentler and Bonett normed index was .83, suggesting a moderate fit, and Bollen's modification of the incremental fit index was .92, suggesting an acceptable fit. Thus, most of these goodness-of-fit indices indicate that the trimmed path model of SWB was supported fairly well by the data.
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Psychology and Aging 1991, Vol. 6. No. 1,100-108
Health, Stress, Psychological Resources, and Subjective Weil-Being Among Older Blacks Roosevelt Wright, Jr.
Thanh Y Tran
Graduate School of Social Work University of Texas at Arlington
Graduate School of Social Work Boston College
Linda Chatters
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
School of Public Health, Health Behavior/Health Education University of Michigan This study examines the structural relationships among sociodemographic characteristics, health status, stress, psychological resources, and subjective well-being (SWB) among the Black elderly. A structural equation model of SWB was evaluated with data from the 1979-1980 National Survey of Black Americans. The results revealed that poor subjective health status was predictive of lower levels of personal efficacy and SWB. Stressful life events tended to depress subjective assessments of health and had negative effects on self-esteem and SWB. Marital status and age had positive effects on SWB. Chronic health conditions and other demographic variables, however, had indirect effects on SWB.
This is true even though specific social conditions that characterize the Black elderly as a group (i.e., poor health status, disadvantaged life circumstances, and disproportionate likelihood of being in poverty) suggest that they may be at relatively greater risk for diminished quality of life and ultimately, lowered SWB (Herzog et al., 1982; Wright, Saleebey, Watts, & Lecca, 1983). The present study partly represents an attempt to examine some of the substantive concerns surrounding SWB among older Blacks. This study is an elaboration and expansion of a prior study of the causal relationships among health, stress, and SWB among a sample of older Black Americans (Chatters, 1988). As such, it builds on Chatters's (1988) investigation of SWB by including two important constructs (i.e., personal efficacy and self-esteem) that were not included in the original formulation of the SWB model. In particular, the current study (a) proposes a structural equation model incorporating psychological resources (i.e., personal efficacy and self-esteem) as variables that are intermediate to SWB and (b) involves the application of LISREL, which uses a maximum likelihood method of model estimation.
Researchers have increasingly turned their attention to the development of complex models of the relationships among health, stress, and subjective well-being (SWB) among older groups (House & Robbins, 1983). The development of these models has been guided by several considerations. First, there have been attempts to identify the role of social status and resources as antecedents to SWB (Fletcher & Lorenz, 1984; Herzog, Rodgers, & Woodworth, 1982). Social status and resources may exert direct effects on SWB or have their effects mediated by intervening factors and therefore function to shape life conditions that can jeopardize or enhance a sense of well-being. Second, several major studies have addressed the nature and significance of life circumstances and situations (e.g., health status and stress) as potential assets and liabilities for SWB (Herzog et al., 1982; Kessler & Cleary, 1980; Neighbors, 1986). Finally, some studies have been concerned with the possible mitigating or conditioning effects of social and psychological resources (e.g., social support and psychological traits and characteristics) on the relationships among health status, stress, and SWB (House & Robbins, 1983). With few exceptions (Chatters, 1988; Krause & Tran, 1989), previous research has not addressed these concerns among the Black elderly or more generally, among ethnic minority elderly.
Sociodemographic Characteristics Empirical studies on the effects of age on SWB indicate that older people, in general, are more positive in their evaluations of overall life quality (Ball, 1983; Campbell, 1981; Campbell, Converse, & Rodgers, 1976; Janson & Mueller, 1983; Veroff, Douvan, & Kulka, 1981) and of particular life events and transitions (House & Robbins, 1983) than are their younger counterparts. Although age demonstrates a consistent negative relationship with objective measures of health (Verbrugge, 1983), its relationship to subjective health is less clear. For example, findings of a negative relationship between age and subjective health (Herzog & Rodgers, 1981), as well as evidence for a positive relationship (Ferraro, 1980) and no relationship between age
The data used in this study came from the National Survey of Black Americans, 1979-1980, and were collected by James S. Jackson and Gerald Gurin and made available from the Inter-University Consortium for Political and Social Research. Neither the collectors of the original data nor the consortium is responsible for the analyses and interpretations presented in this article. Assistance from Jersey Liang and Neal Krause from the University of Michigan is very much appreciated. Correspondence concerning this article should be addressed to Thanh V Tran, Graduate School of Social Work, Boston College, Chestnut Hill, Massachusetts 02167.
100
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
OLDER BLACKS' WELL-BEING
and subjective health (Markides & Pappas, 1982), exist in the current literature. Findings regarding gender differences in the SWB of older Black adults are equivocal and indicate either no differences (Linn, Hunter, & Perry, 1979) or that men are more likely to characterize their life situations in a positive manner (Kessler, 1979). In addition, previous research has suggested that women tend to have lower self-esteem than men have (see Rosenfield, 1980). However, there is a lack of research on sex differences in self-esteem within the Black population. Studies regarding the relationships among income, educational status, and SWB among older Black adults have equivocal findings. For example, Ehrlich (1973) reported a positive effect for income on SWB, whereas other researchers found no significant relationship between the two (Jackson, Bacon, & Peterson, 1977; Jackson, Chatters, & Neighbors, 1986; Sauer, 1977). Jackson et al. (1977) reported a positive relationship between education and SWB, in contrast to other studies indicating no significant relationship (Ehrlich, 1973; Sauer, 1977). Finally, investigations of marital status differences in SWB among older Black adults indicate that people who are married tend to report higher levels of SWB than do those who are not married (Ehrlich, 1973; Jackson et al., 1977,1986). The use of sociodemographic characteristics as control variables in this study provides useful information to better understand the unique contributions of health status, stress, and psychological resources to SWB assessments. More specifically, we empirically examine structural relationships between chronic health conditions, stressful life events, subjective health, psychological resources, and SWB among older Black adults, after the effects of sociodemographic variables have been considered. Health Status Objective health status and subjective health assessment bear a positive relationship to each other (Ferraro, 1980; Palmore, Cleveland, Nowlin, Ramm, & Siegler, 1979), and both types of health measures have been found to be significantly related to SWB in studies of older individuals (Ball, 1983; Ehrlich, 1973; Larson, 1978; Markides & Martin, 1979; Okun, Stock, Haring, & Witter, 1984; Sauer, 1977). Previous work has found that good health is inversely related to psychological distress (Abrahams & Patterson, 1978; Lieberman, 1975) and positively related to psychological well-being (Hayes & Ross, 1986) and self-esteem (Antonucci & Jackson, 1983). Although health status is frequently viewed as an outcome variable, the causal model we propose suggests that both chronic health conditions and subjective health assessments represent personal resources or assets. Therefore, self-esteem, personal efficacy, and SWB are consequences of objective and subjective health status. Stress and Psychological Resources Previous work indicates that stress has a negative effect on evaluations of life quality (Kessler, Price, & Wortman, 1985; Tessler & Mechanic, 1978), although the magnitude of the effect is generally small. Conceptual models of the relationship between stress and SWB suggest that the effects of stress may
101
operate indirectly through psychological components that are important to the maintenance of a positive self-concept. In effect, stress compromises one's self-conceptions or sense of selfworth, which in turn negatively affects well-being. Self-esteem and personal efficacy, which have been associated with enhanced well-being (Bortner & Hultsch, 1970; Campbell et al., 1976; Jackson et al., 1977), represent two psychological resources that may mitigate the effects of stress on well-being (Pearlin & Schooler, 1978). In an attempt to model the complex relationships among health, stress, psychological resources, and well-being, we suggest that personal efficacy and self-esteem are intervening factors that mediate the effects of health and stress on SWB. In this study, we examine the general hypothesis that chronic health conditions and stressful life events directly affect an individual's level of satisfaction with his or her health status and therefore exert both direct and indirect effects on one's sense of personal efficacy, self-esteem, and SWB. Method Model Specification Structural relationships among SWB, psychological resources, subjective health, chronic health conditions, stressful life events, and sociodemographic characteristics are illustrated in a path model (see Figure 1). Analysis of linear structural relationships by the method of maximum likelihood or LISREL was adopted in this study. The notations of the variables and their structural relationships are in accordance with the LISREL conventions (Joreskog & Sorbom, 1986). In this study, the causal (path) model (see Figure 1) contains five exogenous variables: education, annual family income, sex, marital status, and age (£1 to {5). It is hypothesized that the exogenous variables would have direct effects on all endogenous variables. The six endogenous variables are chronic health conditions, stressful life events, subjective health, personal efficacy, self-esteem, and SWB fyjl to ?j6). It is also hypothesized that chronic health conditions and stressful life events would have direct effects on subjective health, psychological resources, and SWB. Finally, psychological resources are hypothesized to have direct effects on SWB. Among the six endogenous variables, efficacy (>j4), self-esteemfoS),and SWBfo6)are considered latent constructs (see Table 1 and Figure 1). These constructs are measured by the associated observable indicators, y4 to yl3 in Figure 1. The epsilons £s) are the measurement errors of observed indicators. The zetas (fs) are the residual variances of the structural equations. The gammas (ys) are the effects of exogenous on endogenous variables. The betas (0s) are the effects among endogenous variables.
Data and Sample The data used in this study are from the 1979-1980 National Survey of Black Americans (NSBA). The NSBA is a multistage area probability sample that of 2,107 Black Americans aged 18 and older. This study used data from the 581 Black respondents who were 55 years of age and older. With respect to sex and marital status, 63.2% were women, and 38.8% were married. The mean age of persons in the sample was 66.98 years (SD = 8.343). Most respondents had fewer than 12 years of education (74.2%). Forty-seven percent of respondents had family incomes below $5,000, and approximately 10% had annual family incomes above $20,000. After the listwise deletion of cases with missing data, the effective sample size for this study was 407 respondents. Taylor's (1986) comparison of the NSBA sample with U.S. Census Bureau data on the Black population identified several minor differences with re-
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
102
T. TRAN, R. WRIGHT, JR., AND L. CHATTERS
Figure 1. The trimmed path model of health, stress, psychological resources, and subjective well-being.
gard to sociodemographic indicators. The NSBA sample is slightly older, has a higher percentage of women, has fewer never-married persons and more persons who are widowed, and has higher family incomes.
Measurements Congeneric measurement model. A confirmatory factor analysis (Joreskog & Sorbom, 1986) was performed to evaluate a three-factor congeneric measurement model of personal efficacy, self-esteem, and SWB. Table 1 shows the factor loadings of the observed indicators on their latent variables, measurement errors, reliability scores, and measures of goodness of fit. The results revealed that the observed indicators had acceptable factor loadings and reliability scores. The measures of fit also indicated that the congeneric measurement model of these three latent variables was supported relatively well by the data. In the following sections, we present and discuss the three latent variables and other variables used in this analysis. SWB. SWB was measured with three items relating to evaluations of life satisfaction, happiness, and goal attainment. The data on which this study is based relied on single-item measures and did not include scales of SWB such as the Life Satisfaction Index A (LSIA), the Affect Balance Scale, or the Philadelphia Geriatric Center (PGC) Morale Scale. The NSBA was a survey of the adult Black population aged 18 years and older, and the inclusion of the LSIA and the PGC Morale Scale, in particular, was not viewed as appropriate for this population group. Furthermore, a selective administration of these scales to older respondents was not a feasible option. The individual SWB items used in this analysis (i.e., life satisfaction,
happiness, and goal attainment) have face validity with reference to the content of their meanings. In line with conceptualizations of SWB suggested by Stock, Okun, and Benin (1986) and others (Bradburn, 1969), each item requires that respondents arrive at a SWB evaluation through a process in which positive and negative affects are aggregated. Furthermore, these items involve global or overall (vs. domain specific) evaluations of life quality and vary with regard to their temporal frame of reference (i.e., temporal present vs. prior to the immediate past; Stock et al., 1986). The item on life satisfaction is worded as follows: "In general, how satisfied are you with your life as a whole these days? Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied" The focus is on events prior to the immediate past (residual affect), with a greater relative emphasis on cognitive as opposed to affective elements. The happiness item (Gurin, Veroff, & Feld, 1960), "Taking all things together, how would you say things are these days—would you say that you're very happy, pretty happy, or not too happy these days?" focuses on events occurring in the temporal present and emphasizes affective elements over cognitive. Finally, the goal attainment item states, "Up to now, have you gotten mostly what you hoped for out of life or have you gotten less than you hoped for?" This item focuses on events that are prior to the immediate past and, in emphasizing an explicit comparison between respondents' goals and attainments, incorporates a high degree of cognitive activity. Furthermore, the comparison of goals and attainments suggests that this item taps the notion of congruence that underlies general conceptualizations of SWB (George, 1979; Liang, 1984). In sum, these items represent, in varying degrees, the affective and cognitive dimensions of SWB (see Andrews & McKennell, 1980; Liang, 1984) and tap different components in relation to temporal (i.e.,
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OLDER BLACKS' WELL-BEING
Table 1 Three-Factor Congeneric Measurement Model of Personal Efficacy, Self-Esteem, and Subjective Well-Being
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Measure Personal efficacy Better to plan Plans work out Feel life would work out Run own life Self-esteem Cannot do anything Life is not useful Not proud Subjective well-being Life satisfaction Happiness Got what hoped for Goodness of fit X2 (32, N = 407)
GFI AGFI Bentler and Bonett (Al) Bollen (A2)
Factor loading/GFI
Measurement error
Reliability score
0.350 0.490 0.630 0.511
.877 .759 .604 .739
.123 .241 .396 .261
0.455 0.750 0.720
.793 .437 .481
.207 .563 .519
0.591 0.601 0.508
.651 .639 .742
.349 .361 .258
63.270 1.970 0.970 0.949 0.890 0.940
Note. GFI = Goodness-of-Fit Index; AGFI = Adjusted Goodness-of-Fit Index.
events occurring in the temporal present vs. those prior to the immediate past) frames of reference (Stock et al., 1986). These SWB items have been used widely in previous research (Okun et al., 1984). When used as a summative index, its scores ranged from 3 to 9 (M = 7.44, SD = 1.40), with higher scores reflecting greater levels of SWB. The SWB index had a Cronbach's alpha of .56. In this analysis, SWB was viewed as a latent variable (see Table 1 and Figure 1). Personal efficacy. Personal efficacy was measured by four items encompassing a person's feelings of taking control of life by making and executing plans and running one's own life. This measure of personal efficacy has been used successfully in previous research with older Blacks and the general population (Krause & Tran, 1989; Veroff et al., 1981). When used as a summative index, its scores ranged from 4 to 8, with higher scores referring to a higher sense of personal efficacy (M= 6.04, SD = 1.33). This index had a Cronbach's alpha of .58. Personal efficacy was also viewed as a latent variable in this analysis (Table I and Figure 1). Self-esteem. Self-esteem was measured by three items that are somewhat similar to Rosenberg's (1965) negative items of self-esteem. The items comprising this scale were coded in such a way that a higher score refers to a higher sense of self-esteem. The scores on this scale ranged from 3 to 12 (M = 10.57, SD = 1.90), and Cronbach's alpha was .66. This scale has been subjected to validation (see Krause & Tran, 1989) and was viewed in this study as a latent variable (Table 1 and Figure 1). Chronic health conditions and subjective health. In this analysis, chronic health conditions were assessed by an index that consisted of I 1 health conditions, including arthritis, ulcers, cancer, high blood pressure, diabetes, liver problem, kidney problem, stroke, nervous conditions, blood circulation problem, and sickle cell anemia. The maximum number of chronic health conditions experienced by respondents was 7 (M= 2.084, SD = 1.530). Subjective health status was measured by the following question: "In general, how satisfied are you with your health? Would you say you are very satisfied (I), somewhat satisfied (2), somewhat dissatisfied (3), or very dissatisfied (4)?" Higher scores on this item indicate poorer health (M = 1.75, SD = .83).
Stressful life events. This index consisted of 10 stressful life situations, including problems with health, money, job, family or marriage, people outside the family, children, crime, police, love life, and racism. The maximum number of stressful situations experienced by respondents was 8 (M = 1.00, SD = 1.17). Sociodemographic variables. Education was measured as the actual number of years of formal school completed (M= 8.21, SD = 3.90). Annual family income was coded 1 for $0.000 to 17 for $30,000 and over (M= 8.03, SD = 4.28). Sex was coded 1 for male and 0 for female. Marital status was coded 1 for married and 0 for other categories. Finally, age was measured by respondents' actual age, ranging from 55 to 101 years (M = 66.98, SD = 8.34). Tables 2 and 3 present the correlation matrix and descriptive statistics for the variables used in the analysis. Three endogenous variables, chronic health conditions, stressful life events, and subjective health, were measured by single indicators. It is not realistic to assume, however, that these single indicators were measured without errors. Subsequently, we applied the method suggested by Anderson and Gerbing (1988) to adjust for the measurement errors of these indicators. They suggested that in the absence of reliability estimates for single indicators, one may set the lambda equal to .95 and the theta delta equal to the square root of 1 minus .90, that is, 1 minus the assumed reliability score (also, see Sorbom & J6reskog, 1982).
Results Theory Trimming We began our analysis with the evaluation of a fully recursive model. In that model, we hypothesized that all independent variables had significant direct effects on their dependent variables. Subsequently, we used the theory-trimming approach to delete path coefficients that had / ratios smaller than 2 (JOreskog & Sorbom, 1986). Although the theory-trimming approach has
104
T. TRAN, R. WRIGHT, JR., AND L. CHATTERS its shortcomings, it can be used to develop an exploratory model (Pedhazur, 1982). We deleted insignificant paths simultaneously from a fully recursive model and analyzed a trimmed model, shown in Figure 1. Five predicted paths among endogenous variables were not statistically significant and are not shown in Figure 1. These paths are (a) the path between subjective health and self-esteem, (b) the path between stressful life events and personal efficacy, (c) the path between chronic conditions and SWB, (d) the path between chronic conditions and self-esteem, and (e) the path between chronic conditions and personal efficacy (Table 4).
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Goodness-of-Fit Measures The findings revealed that 55% of the variance in SWB was explained by the variables included in the model. With respect to the goodness of fit, the trimmed model had a x2 of 205.31 with 123 dfand a sample size of 407 (p < .001), indicating a poor fit. However, the \2 is very sensitive to sample size and violation of multivariate normality. The ratio of the x2 to its degrees of freedom was 1.69, indicating a good fit. The Goodness-of-Fit Index (GFI) and the Adjusted Goodness-of-Fit Index (AGFI) had values of .92 and .94, respectively, also indicating a good fit. In addition, we used the Rentier and Bonett (1980) normed index (Al) and Bollen's (1989) modification of the incremental fit index (A2). The Bentler and Bonett normed index was .83, suggesting a moderate fit, and Bollen's modification of the incremental fit index was .92, suggesting an acceptable fit. Thus, most of these goodness-of-fit indices indicate that the trimmed path model of SWB was supported fairly well by the data.
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