Abstract
Rowe and Kahn's (1987) seminal piece in the journal Science, and the work driven by the MacArthur Foundation that followed (Rowe & Kahn, 1997, 1998), arguably signaled a paradigm shift in how we think about aging and health. Rather than a purely biomedical view of aging and health, Rowe and Kahn postulated a broader perspective suggesting that in addition to the avoidance of disease and disability (and risk factors that predispose one to such consequences), “successful” aging also entails maintaining a high level of function, and being actively engaged with life through social connectedness and productive activity. Healthy aging, therefore, is best viewed contextually, involving an interplay of personal (including behavioral and attitudinal as well as genetic), environmental, social, and cultural factors (House, 2002; Sallis, Owen, & Fisher, 2008; Vaillant, 2002; Vaillant & Mukamal, 2001).
Investigations such as the Nun Study (Snowdon, 2001) and the Landmark Harvard Study of Adult Development (Vaillant, 2002) demonstrated that healthy aging is an outcome of a convergence of multiple influences over one's lifetime. It is, hence, a life course issue, potentially subject to the challenges associated with altered circumstances out of the individual's control (such as spousal loss), or one's deliberate attempt to effect a change within some aspect of his or her own life. Quitting smoking, for instance, not only entails a significant change from an unhealthy behavior to a healthy one, but also precipitates a transformation in one's identity from a lifelong smoker to a nonsmoker. What influences do life transitions have on an individual's journey as they evolve and develop into their “aging self”? To what extent can they age successfully and by what criteria—how they subjectively perceive it based on their own assessment or according to more objective standards akin to Rowe and Kahn's (1997, 1998) aforementioned dimensions (Pruchno, Wilson-Genderson, & Cartwright, 2010; Strawbridge, Wallhagen, & Cohen, 2002)? What distinguishes those experiencing negative versus positive—even resilient—outcomes? And knowing that, how should prevention and intervention efforts be targeted? The following articles in this special issue represent a combined effort to begin to address these questions.
In addition to comparing those who ever smoked with those who did not, Pruchno et al. examine the complex relationships that exist as individuals transition from being a smoker to a nonsmoker, factoring in the age at which one quits. Their findings emphasize that while broadly focused prevention and cessation efforts have value, special efforts need to be targeted to those early points in the life course when smoking behaviors are adopted. They also present some sobering conclusions pertaining to quitting in later life, which, while it should not be discounted, does not easily predict one would age successfully by both objective as well as subjective criteria. This only reinforces the importance of not smoking at any point within the life course.
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