Health Behavior and Personal Autonomy: A Longitudinal Study of the Sense of Control in Illness

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Abstract
This study documents the wide-ranging significance for health of the person's sense of control, i.e., the sense of mastery vs. fate-orientation. Health behavior is examined in three domains: (1) preventive care; (2) health knowledge and perspectives; and (3) physical status, e.g., acute and chronic illness. A representative metropolitan sample was interviewed at the beginning (1976) and at the close (1977) of a year-long investigation that included telephone call-backs at six-week intervals to trace health-related incidents. A sense of low control is shown to be significantly associated with (1) less self-initiated preventive care; (2) less optimism concerning the efficacy of early treatment; (3) poorer self-rated health; and (4) more illness episodes, more bed confinement, and greater dependence upon the physician. These relationships are also shown to be discriminating, e.g., meaningfully different for men and women, and hence are unlikely to be instrument-generated effects. The results are interpreted in the light of the recent congruence in psychology and sociology on the importance of the sense of control.

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