Health: Age 45–65

Health during middle age is typically good to excellent. In fact, American middle adults are quite healthy, especially those who are college‐educated, wealthier (with an annual income over $35,000), and white. The most common health problems experienced during middle age are arthritis, asthma, bronchitis, coronary heart disease, diabetes, genitourinary disorders, hypertension (high blood pressure), mental disorders, and strokes (cerebrovascular accidents). AIDS has also become an increasingly frequent health problem in this age group.

Stress, or the internal sense that one's resources to cope with demands will soon be depleted, is present in all age groups, although it seems to be unavoidable during middle age. Middle adults are faced with stressors, such as the challenges of raising a family, paying their mortgages, facing layoffs at the office, learning to use technology that is continually changing, or dealing with chronic health ailments.

All stressful events need not be negative (distressors), however. Psychiatrists Holmes and Rahe note that positive events (eustressors), such as marriage, vacations, holidays, and winning the lottery, can be just stressful as negative ones. They also indicated that the higher a person's stress levels, including the number of good or bad stresses being experienced, the more likely that person is to develop an illness within two years.

Resistance to stress, known as hardiness, varies from person to person. Hardiness is probably due to a combination of a person's cognitive appraisal, or interpretation, of the stresses, the degree to which he or she feels in control of the stresses, and his or her personality type and behavioral patterns. Some people, such as easygoing type B's, seem less bothered by stress and are thus better equipped physically to handle both negative and positive stresses than are other personality types, such as type A's, or more anxious people.

Most everyone considers death during middle age as being a premature occurrence. Even so, the death rate doubles during each decade after 35, and unlike death in adolescence and young adulthood, death during middle adulthood is more often the result of natural causes than accidents. Socioeconomic status and race also have an impact on health and death. Typically, less educated, urban, and poorer minorities have the worst health, frequently due to limited access to necessary medical care. The death rate for middle‐aged black Americans is nearly twice that of their white counterparts.

Perhaps the place where stress is most keenly felt during middle age is at work. Middle adults may feel that their competence is in question because of their age, or middle adults may feel pressured to compete with younger workers. Research indicates that age has less to do with predicting job success than do tests of physical and mental abilities.

The most common sources of stress in the workplace include forced career changes, lack of expected progress (including promotions and raises), lack of creative input into decision making, monotonous work, lack of challenging work, inadequate pay, feelings of being underutilized, unclear procedures and job descriptions, conflicts with the boss or supervisor, lack of quality vacation time, workaholism (addiction to work), and sexual harassment. Long‐term job stress can eventually result in burnout, a state of mental exhaustion characterized by feelings of helplessness and loss of control, as well as the inability to cope with or complete assigned work. Short of resigning, interventions to prevent burnout include using standard stress‐ reduction techniques, such as meditation or exercise, and taking longer breaks at work and longer vacations from work.

Most middle adults can be categorized as either successful in a stable career chosen during young adulthood or ready for a new career. Career changes are sometimes the result of reevaluation, or a midcareer reassessment, which can certainly be stressful. Such reexamination of one's vocation can come about for many reasons, such as feeling trapped in a career or even wanting to make more money. One recent trend, however, is for middle adults to leave high‐paying professions to take on more humanitarian roles, such as ministers, social workers, or counselors.

The greatest source of job stress is unemployment, especially when termination comes suddenly. Besides wrestling with issues of self‐esteem, unemployed workers must also deal with the financial hardship brought about by loss of income. As may be expected, unemployed persons who have alternative financial resources and who also cognitively reframe their situations tend to cope better than those who do not.