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Purpose - This paper's aim is to explore factors underlying resilience to health adversity, where resilience is defined as better perceived health after adjusting for the presence of doctor diagnosed heart disease, stroke or diabetes (vascular disease). Design/methodology/approach - A population sample of 667 men and women aged 50 p years from South Wales was recruited to participate in an epidemiologic study and were consented and assessed online. Participation included health status, psychological and cognitive assessment. Structural equation modelling was used to model causal pathways. The analysis presents baseline data for this sample. Findings - After adjustment for vascular disease, self-esteem was associated with higher perceived health (β = 0.279, p < 0.001) whilst depression was associated with lower perceived health (β = -0.368, p < 0.001). Self-efficacy and anxiety were not associated with perceived health. Further analysis found self-esteem to buffer an effect of vascular disease on depression, reducing the impact of depression on perceived health. Practical implications - Cognitive and affective factors are involved in resilience, in relation to health these are specific to self-esteem and depression. Although more complex associations may be found with other adversities, in relation to health, interventions to improve self-esteem and ameliorate depression are likely to increase resilience. Originality/value - Resilience has been modelled as a process involving cognitive and affective response to adversity. In the context of health, the adverse effect of depression on health perception was mediated by self-esteem. These associations add to the understanding of the processes underlying resilience and suggest opportunities for interventions designed to increase resilience to health adversities. © Emerald Group Publishing Limited.

Original publication




Journal article


Quality in Ageing and Older Adults

Publication Date





197 - 204