Socioeconomic Disparities in Optimism and Pessimism

  • Kathryn A. RobbEmail author
  • Alice E. Simon
  • Jane Wardle



Socioeconomic status (SES) exhibits a graded relationship with health. Dispositional optimism represents a potential mediator and has been strongly linked to health, but few studies have assessed its association with SES.


To assess the relationship between SES and trait optimism and pessimism in a representative community sample of older British adults.


Community samples of adults (55–64 years) from Scotland (N = 10,650) and England (N = 5,099) registered with Primary Care Practices were mailed self-report questionnaires. Optimism was measured by the Life Orientation Test (LOT), which generates a total score and positive (optimism) and negative (pessimism) subscale scores. SES was assessed with an individual-level index of socioeconomic deprivation based on education, housing tenure, and car ownership.


In both samples, there was a strong SES gradient in the total LOT score, with higher SES being associated with higher scores. However, when pessimism and optimism subscales were analyzed separately, the gradient was strong for pessimism, but minimal for optimism.


The results suggest that lower SES is associated with viewing the future as containing more negative events, but there was little SES difference for positive events. It will be important to distinguish the roles of pessimism and optimism in other determinants of health.


Socioeconomic status SES Dispositional optimism Pessimism Psychosocial 



This research was supported by Cancer Research UK, the Medical Research Council and the Centers for Disease Control and Prevention.


  1. Adler NE, Boyce T, Chesney MA, Cohen S, Folkman S, Kahn RL, et al. Socioeconomic status and health. The challenge of the gradient. Am Psychol 1994;49:15–24.CrossRefPubMedGoogle Scholar
  2. Atkin W, Edwards R, Wardle J, Northover J, Sutton S, Hart A, et al. Design of a multicentre randomised trial to evaluate flexible sigmoidoscopy in colorectal cancer screening. J Med Screen 2001;8:137–44.CrossRefPubMedGoogle Scholar
  3. Bartley M. Health inequality: an introduction to theories, concepts and methods. Cambridge: Polity; 2004.Google Scholar
  4. Baum A, Garofalo JP, Yali AM. Socioeconomic status and chronic stress: does stress account for SES effects on health? Ann NY Acad Sci 1999;896:131–44.CrossRefPubMedGoogle Scholar
  5. Brody GH, Murry VM, Kim S, Brown AC. Longitudinal pathways to competence and psychological adjustment among African American children living in rural single-parent households. Child Dev 2002;73:1505–16.CrossRefPubMedGoogle Scholar
  6. Carver CS, Pozo C, Harris SD, Noriega V, Scheier MF, Robinson DS, et al. How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. J Pers Soc Psychol 1993;65:375–90.CrossRefPubMedGoogle Scholar
  7. Ek E, Remes J, Sovio U. Social and developmental predictors of optimism from infancy to early adulthood. Soc Indic Res 2004;69:219–42.CrossRefGoogle Scholar
  8. Epping-Jordan JE, Compas BE, Osowiecki DM, Oppedisano G, Gerhardt C, Primo K, et al. Psychological adjustment in breast cancer: processes of emotional distress. Health Psychol 1999;18:315–26.CrossRefPubMedGoogle Scholar
  9. Gallo LC, Matthews KA. Understanding the association between socioeconomic status and physical health: do negative emotions play a role? Psychol Bull 2003;129:10–51.CrossRefPubMedGoogle Scholar
  10. Giltay EJ, Geleijnse JM, Zitman FG, Hoekstra T, Schouten EG. Dispositional optimism and all-cause and cardiovascular mortality in a prospective cohort of elderly Dutch men and women. Arch Gen Psychiatry 2004;61:1126–35.CrossRefPubMedGoogle Scholar
  11. Greater Glasgow Health Board. Indicators of deprivation. Glasgow: Health Information Unit; 1995.Google Scholar
  12. Griffin JM, Fuhrer R, Stansfeld SA, Marmot M. The importance of low control at work and home on depression and anxiety: do these effects vary by gender and social class? Soc Sci Med 2002;54:783–8.CrossRefPubMedGoogle Scholar
  13. Grundy E, Holt G. The socioeconomic status of older adults: how should we measure it in studies of health inequalities? J Epidemiol Community Health 2001;55:895–904.CrossRefPubMedGoogle Scholar
  14. Heinonen K, Raikkonen K, Matthews KA, Scheier MF, Raitakari OT, et al. Socioeconomic status in childhood and adulthood: associations with dispositional optimism and pessimism over a 21-year follow-up. J Pers 2006;74:1111–26.CrossRefPubMedGoogle Scholar
  15. Herzberg PY, Glaesmer H, Hoyer J. Separating optimism and pessimism: a robust psychometric analysis of the revised life orientation test (LOT-R). Psychol Assess 2006;18:433–8.CrossRefPubMedGoogle Scholar
  16. Howell DC. Statistical methods for psychology. 4th ed. Belmont: Wadsworth; 1997.Google Scholar
  17. Ironson G, Balbin E, Stuetzle R, Fletcher MA, O’Cleirigh C, Laurenceau JP, et al. Dispositional optimism and the mechanisms by which it predicts slower disease progression in HIV: proactive behavior, avoidant coping, and depression. Int J Behav Med 2005;12:86–97.CrossRefPubMedGoogle Scholar
  18. Krieger N, Chen JT, Waterman PD, Rehkopf DH, Subramanian SV. Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: the Public Health Disparities Geocoding Project. Am J Public Health 2005;95:312–23.CrossRefPubMedGoogle Scholar
  19. Lawlor DA, Smith GD, Ebrahim S. Association between childhood socioeconomic status and coronary heart disease risk among postmenopausal women: findings from the British Women’s Heart and Health Study. Am J Public Health 2004;94:1386–92.CrossRefPubMedGoogle Scholar
  20. Lobel M, DeVincent CJ, Kaminer A, Meyer BA. The impact of prenatal maternal stress and optimistic disposition on birth outcomes in medically high-risk women. Health Psychol 2000;19:544–53.CrossRefPubMedGoogle Scholar
  21. Lynch JW, Kaplan GA, Shema SJ. Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. N Engl J Med 1997;337:1889–95.CrossRefPubMedGoogle Scholar
  22. Marmot M. Status syndrome—how your social standing directly affects your health and life expectancy.London: Bloomsbury & Henry Holt New York; 2004.Google Scholar
  23. Marmot MG, Bosma H, Hemingway H, Brunner E, Stansfeld S. Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet 1997;350:235–9.CrossRefPubMedGoogle Scholar
  24. Marmot MG, Shipley MJ, Rose G. Inequalities in death-specific explanations of a general pattern? Lancet 1984;1:1003–6.CrossRefPubMedGoogle Scholar
  25. Marmot MG, Smith GD, Stansfeld S, Patel C, North F, Head J, et al. Health inequalities among British civil servants: the Whitehall II Study. Lancet 1991;337:1387–93.CrossRefPubMedGoogle Scholar
  26. McCaffery K, Wardle J, Nadel M, Atkin W. Socioeconomic variation in participation in colorectal cancer screening. J Med Screen 2002;9:104–8.CrossRefPubMedGoogle Scholar
  27. Mickelson KD, Kubzansky LD. Social distribution of social support: the mediating role of life events. Am J Community Psychol 2003;32:265–81.CrossRefPubMedGoogle Scholar
  28. Mirowsky J, Ross CE. Education, social status, and health. New York: Aldine de Gruyter; 2003.Google Scholar
  29. Peterson C, Bossio LM. Optimism and physical well-being. In: Chang EC, editor. Optimism & pessimism: implications for theory, research, and practice. Washington: American Psychological Association; 2001. p. 127–45.CrossRefGoogle Scholar
  30. Robbins AS, Spence JT, Clark H. Psychological determinants of health and performance: the tangled web of desirable and undesirable characteristics. J Pers Soc Psychol 1991;61:755–65.CrossRefPubMedGoogle Scholar
  31. Robinson-Whelen S, Kim C, MacCallum RC, Kiecolt-Glaser JK. Distinguishing optimism from pessimism in older adults: is it more important to be optimistic or not to be pessimistic? J Pers Soc Psychol 1997;73:1345–53.CrossRefPubMedGoogle Scholar
  32. Scheier MF, Carver CS. Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychol 1985;4:219–47.CrossRefPubMedGoogle Scholar
  33. Scheier MF, Weintraub JK, Carver CS. Coping with stress: divergent strategies of optimists and pessimists. J Pers Soc Psychol 1986;51:1257–64.CrossRefPubMedGoogle Scholar
  34. Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a re-evaluation of the Life Orientation Test. J Pers Soc Psychol 1994;67:1063–78.CrossRefPubMedGoogle Scholar
  35. Schou I, Ekeberg O, Ruland CM, Sandvik L, Karesen R. Pessimism as a predictor of emotional morbidity one year following breast cancer surgery. Psychooncology 2004;13:309–20.CrossRefPubMedGoogle Scholar
  36. Schulz R, Bookwala J, Knapp JE, Scheier M, Williamson GM. Pessimism, age, and cancer mortality. Psychol Aging 1996;11:304–9.CrossRefPubMedGoogle Scholar
  37. Schutte JW, Valerio JK, Carrillo V. Optimism and socioeconomic status: a cross-cultural study. Soc Behav Pers 1996;24:9–18.CrossRefGoogle Scholar
  38. Stansfeld S, Marmot M. Deriving a survey measure of social support: the reliability and validity of the Close Persons Questionnaire. Soc Sci Med 1992;35:1027–35.CrossRefPubMedGoogle Scholar
  39. Stansfeld SA, Head J, Fuhrer R, Wardle J, Cattell V. Social inequalities in depressive symptoms and physical functioning in the Whitehall II Study: exploring a common cause explanation. J Epidemiol Community Health 2003;57:361–7.CrossRefPubMedGoogle Scholar
  40. Stanton AL, Snider PR. Coping with a breast cancer diagnosis: a prospective study. Health Psychol 1993;12:16–23.CrossRefPubMedGoogle Scholar
  41. Steptoe A, Wardle J, Vinck J, Tuomisto M, Holte A, Wichstrom L. Personality and attitudinal correlates of healthy and unhealthy lifestyles in young adults. Psychol Health 1994;9:331–3.CrossRefGoogle Scholar
  42. Taylor SE, Seeman TE. Psychosocial resources and the SES–health relationship. Ann NY Acad Sci 1999;896:210–25.CrossRefPubMedGoogle Scholar
  43. The Royal College of General Practitioners. Profile of UK Practices. Accessed 16 September 2008; May 2006.
  44. Townsend P, Phillimore P, Beattie A. Health and deprivation: inequality and the north. Kent: Croom Helm; 1988.Google Scholar
  45. Turner RJ, Marino F. Social support and social structure: a descriptive epidemiology. J Health Soc Behav 1994;35:193–212.CrossRefPubMedGoogle Scholar
  46. UK Flexible Sigmoidoscopy Screening Trial Investigators. Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial, Lancet 2002;359:1291–300.CrossRefGoogle Scholar
  47. Walsh K. Evaluation of the use of general practice age-sex registers in epidemiological research. Br J Gen Pract 1994;44:118–22.PubMedGoogle Scholar
  48. Wardle J, McCaffery K, Nadel M, Atkin W. Socioeconomic differences in cancer screening participation: comparing cognitive and psychosocial explanations. Soc Sci Med 2004;59:249–61.CrossRefPubMedGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2009

Authors and Affiliations

  • Kathryn A. Robb
    • 1
    Email author
  • Alice E. Simon
    • 1
  • Jane Wardle
    • 1
  1. 1.Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUniversity College LondonLondonUK

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