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Managing Health-Related Worries

Why so many midlife women worry about declining health—and what to do about it.

Key points

  • Midlife women are bombarded with messages that aging is a decline.
  • Four out of five midlife women worry about the possibility that their health may decline.
  • People who treat declining health as inevitable are less likely to seek treatment for their health problems.

Here’s a rather worrisome statistic: The vast majority of midlife women are anxious about aging and about declining health in particular. According to sociologists Anne E. Barrett and Erica L. Toothman, who have studied women’s anxieties about aging, the thing midlife women worry about the most is declining health. Only one in five midlife women actually manage to steer clear of this particular worry.

It’s not surprising that so many of us are carrying this particular worry around. We receive so many cultural messages telling us that aging well is all about making good choices and that it’s our own personal responsibility to “age well,” which basically means not becoming a “burden” to anyone else. It’s a simplistic and wrong‑headed narrative—and one that causes a lot of unnecessary worry and even fear. As J. Brooks Bouson notes in Shame and the Aging Woman: Confronting and Resisting Ageism in Contemporary Women’s Writings,

“The chronically ill, disabled, and physically infirm elderly become receptacles of the projected social fears of dependency, vulnerability, and failure that lurk just below the surface of our competitive, success‑driven, and individualistic culture.”

This narrative not only fuels a lot of unnecessary anxiety but can actually increase the likelihood that we’ll end up in poorer health. There’s a solid body of research to show that people who treat declining health as inevitable and unstoppable are less likely to seek treatment for their health problems. And that, in turn, can actually lead to a shorter life. A 2002 study led by Yale University epidemiologist Becca R. Levy found that older adults who have negative views about old age tend to die seven‑and‑a‑half years sooner than their peers. In other words, this kind of toxic, life‑limiting thinking has a measurable impact. Ageism doesn’t just harm; it kills.

What we’re talking about here is basically ageism directed at the self, with a hefty side dish of ableism thrown in. It’s a toxic combination that erases the experiences of a lot of women and conveniently sidesteps the structural factors that are in play. A healthier approach would be to recognize disability as “an essential element of human diversity represented by at least 20 percent of the general population at any given point in time”—and even more of us as we grow older—and to acknowledge both the inequities that contribute to these differences and the supports and structural changes that might help to prevent or mitigate them, in the words of disability studies researchers Clara W. Berridge and Marty Martinson.

And as for managing all our anxiety about declining health, it can be helpful to acknowledge what’s at the root of these fears. For some people, it’s the mistaken belief that “it’s all downhill from here,” an oversimplistic narrative of decline that erases the fact that midlife and beyond are times of both losses and gains. And for others, it’s a fear of being dependent on other people.

Let’s start with the first worry: the idea that all you have to look forward to from now on is decline. It might be helpful to consider the changes that have been happening to your brain just as an example of how this narrative is anything but true. Sure, you may have lost a bit of processing speed over the years, but your older and wiser midlife brain can leave your younger brain in the dust when it comes to making connections, spotting patterns, and building bridges. And if you’re worried about that loss of processing speed, it’s worth remembering that what’s measurable in the laboratory doesn’t necessarily translate into a noticeable difference in day‑to‑day functioning. This nuanced reality is the same for your other organs and body systems.

Now, on to the next worry, the fear of being dependent on other people—of struggling to get your needs met in a culture that celebrates independence rather than dependence and punishes people for not measuring up to that anything but reasonable standard. The more you unpack this belief—the idea that we expect people to be completely autonomous in terms of their care needs as they age—the more ridiculous it seems. It’s not an expectation we carry over into other life stages. Do we insist that newborn babies be self‑sufficient from the moment they are born? No, we do not.

If we’re serious about reducing our anxiety about aging, we need to consistently and loudly challenge the narrative that says that aging well means aging on your own.

We need to insist on a very different narrative, one that celebrates interdependence, not independence.

Excerpt from Navigating the Messy Middle: A Fiercely Honest and Wildly Encouraging Guide for Midlife Women, by Ann Douglas©. Published 2022, by Douglas & McIntyre. Reprinted with permission of the publisher.


Barrett, A.E. and Toothman, E.L. Multiple “Old Ages”: The Influence of Social Context on Women’s Aging Anxiety. The Journals of Gerontology: Series B, 73(8), 154-164.

Berridge, C. W., & Martinson, M. (2017). Valuing Old Age Without Leveraging Ableism. Generations: Journal of the American Society on Aging, 41(4), 83–91.

Levy, B. R., Slade, M. D., Kunkel, S. R., & Kasl, S. V. (2002). Longevity Increased by Positive Self-Perceptions of Aging. Journal of Personality and Social Psychology, 83(2), 261–270.

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