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Ann Behav Med. 2019 Mar 20;53(4):321-332. doi: 10.1093/abm/kay041.

Americans' Health Mindsets: Content, Cultural Patterning, and Associations With Physical and Mental Health.

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Department of Psychology, Stanford University, Stanford, CA, USA.



Health mindsets are mental frameworks that help people recognize, organize, interpret, and respond to health-relevant information. Although mindsets shape health behaviors and outcomes, no study has examined the health mindsets of ethnically and socioeconomically diverse Americans.


We explored the content, cultural patterning, and health correlates of diverse Americans' health mindsets.


Two studies surveyed approximately equal numbers of African American, Asian American, European American, and Latinx American men and women of lower and higher socioeconomic status (SES). Study 1 (N = 334) used open-ended questions to elicit participants' mindsets about the definitions, causes, and benefits of health. Study 2 (N = 320) used Study 1's results to develop a closed-ended instrument.


In Study 1, open-ended questioning revealed six overarching mindset themes: behavioral, medical, physical, psychological, social, and spiritual. The most prevalent mindsets were psychological definitions, behavioral causes, and psychological benefits. Participants mentioned more cause themes than definition or benefit themes, and mindset theme mentions correlated with worse health. Older participants mentioned more themes than younger, women mentioned more definition themes than men, and low-SES participants mentioned more cause themes than high-SES participants. In Study 2, closed-ended scales uncovered more complex and positive health mindsets. Psychological and spiritual benefit mindsets correlated with good mental health. African Americans and women endorsed the widest array of mindsets, and the spiritual benefit mindset partially explained the superior mental health of African Americans.


Many Americans hold simplistic, illness-focused health mindsets. Cultivating more complex, benefit-focused, and culturally appropriate health mindsets could support health.


Health disparities; Lay theories; Mental health; Mindset; Race paradox


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