Purpose in life and use of preventive health care services
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Edited* by Bruce S. McEwen, The Rockefeller University, New York, NY, and approved September 30, 2014 (received for review August 2, 2014)

Significance
Less than 50% of people over the age of 65 are up-to-date with core preventive services. Identifying modifiable factors linked with preventive services are important targets for research and practice. Purpose in life, recently the focus of multiple intervention studies, has been linked with better health (mental and physical) as well as improved health behaviors. However, its association with health care use has been understudied. We found that higher purpose was linked with greater use of several preventive health care services and also fewer nights spent hospitalized. These results may facilitate the development of new strategies to increase use of preventive health care services and improve health, thereby offsetting the burden of rising health care costs in our aging society.
Abstract
Purpose in life has been linked with better health (mental and physical) and health behaviors, but its link with patterns of health care use are understudied. We hypothesized that people with higher purpose would be more proactive in taking care of their health, as indicated by a higher likelihood of using preventive health care services. We also hypothesized that people with higher purpose would spend fewer nights in the hospital. Participants (n = 7,168) were drawn from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50, and tracked for 6 y. After adjusting for sociodemographic factors, each unit increase in purpose (on a six-point scale) was associated with a higher likelihood that people would obtain a cholesterol test [odds ratio (OR) = 1.18, 95% confidence interval (CI) = 1.08–1.29] or colonoscopy (OR = 1.06, 95% CI = 0.99–1.14). Furthermore, females were more likely to receive a mammogram/X-ray (OR = 1.27, 95% CI = 1.16–1.39) or pap smear (OR = 1.16, 95% CI = 1.06–1.28), and males were more likely to receive a prostate examination (OR = 1.31, 95% CI = 1.18–1.45). Each unit increase in purpose was also associated with 17% fewer nights spent in the hospital (rate ratio = 0.83, 95% CI = 0.77–0.89). An increasing number of randomized controlled trials show that purpose in life can be raised. Therefore, with additional research, findings from this study may inform the development of new strategies that increase the use of preventive health care services, offset the burden of rising health care costs, and enhance the quality of life among people moving into the ranks of our aging society.
Footnotes
- ↵1To whom correspondence should be addressed. Email: kimeric{at}umich.edu.
Author contributions: E.S.K., V.J.S., and C.D.R. designed research; E.S.K. performed research; E.S.K. analyzed data; and E.S.K., V.J.S., and C.D.R. wrote the paper.
The authors declare no conflict of interest.
↵*This Direct Submission article had a Prearranged Editor.
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1414826111/-/DCSupplemental.
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