Sense of Control and Self-Reported Health in a Population-Based Sample of Older Americans: Assessment of Potential Confounding by Affect, Personality, and Social Support.

Background: Sense of control has been linked to improved health outcomes, but it is unclear if this association is independent of other psychosocial factors. Purpose: The aim of this study is to test the strength of association between sense of control and self-reported health after adjustment for positive and negative affect, 'Big 5' personality factors, and social support. Method: Data on sense of control (measured by personal mastery, perceived constraints, and a health-specific rating of control), affect, personality, social support, and two measures of self-reported health (global rating of fair or poor health and presence of functional limitations) were obtained on 6,891 participants in the Health and Retirement Study, a population-based survey of older Americans. The cross-sectional association between sense of control measures and each measure of self-reported health was tested in hierarchical logistic regression models, before and after adjustment for affect, personality, and social support. Results: Participants with higher personal mastery were less likely to report fair/poor health (odds ratio 0.76 per 1-point increase) while those with higher perceived constraints were more likely to report fair/poor health (odds ratio 1.37 per 1-point increase). Associations remained after adjustment for affect, but adjustment for affect attenuated the association of personal mastery by 37% and of perceived constraints by 67%. Further adjustment for personality and social support did not alter the strength of association. Findings were similar for the health-specific rating of control, and for associations with functional limitations. Conclusion: Sense of control is associated with self-reported health in older Americans, but this association is partly confounded by affect. [ABSTRACT FROM AUTHOR]