How Healthy Are We?: A National Study of Well-being at Midlife. Edited by O. G. Brim, C. D. Ryff and R. C. Kessler. (Pp. 687; $42.00; ISBN 0-226-07475-7.) University of Chicago Press: Chicago. 2003.

Mid-life has not been investigated as a fruitful stage for study across the life-cycle, in contrast to childhood, adolescence, and later life. We do find a few notable exceptions. Erik Erikson, in Childhood and Society, portrayed mid-life as a time when people attempted to leave a generative gift to the world (though he did not arrive at his conclusions from empirical study of representative samples of mid-lifers) (Erikson, 1963). Daniel Levenson (1978) explored ‘the seasons of a man’s life ’ in a small group of men he interviewed extensively. Gail Sheehy (1977) scooped and popularized Levenson’s studies (by including women among other means). Therefore, the establishment of the MacArthur Research Network on Successful Midlife Development in 1990 was a groundbreaking project. The mission of the network was to identify the major biomedical, psychological, and social factors that permit some, but not others, to flourish in the middle years (following the mission of the MacArthur Research Network on Successful Aging established a few years earlier). The key effort of the midlife network was fielding a national survey, the Midlife in the United States (MIDUS) study. The volume under review presents the findings from this study along with commentary. The MIDUS survey was administered to a national sample of over 7000 subjects aged between 25 and 74 years [to compare subjects in their operational definition of mid-life (40–60 years of age) with both younger and older subjects]. Although data was collected on underrepresented minorities, the samples of these groups were small. Each subject was administered a telephone questionnaire (response rate of 70%) and a self-administered questionnaire. The investigators collected data on demographics, living arrangements, childhood background (such as financial status of parents), occupational history, finances, spouse/partner, sexuality (such as number of sexual partners over past year), parents, parenting (such as difficulties with child care), psychological wellbeing, social networks and support, social participation (such as voluntary work), religion and spirituality, physical health, mental health (depression, anxiety, panic) and health-related beliefs. The investigators therefore acquired a mass of data on a very large (but perhaps not representative) group of mid-lifers. When epidemiologists seek a compendium of data on the frequency and correlates of psychiatric disorders, they often turn to Psychiatric Disorders in America (Regier & Robins, 1991), a summary of Epidemiologic Catchment Area survey results. In like manner, How Healthy Are We? may take its place as the definitive compendium on the health and well-being of midlifers in the United States, with, however, at least two caveats. First, the bias towards the white majority could be a major drawback. For example, how can the findings of this study reasonably be generalized to a 45-year-old African American living and working in the rural south? Secondly, the study was fielded during a period of dramatic economic prosperity. Many seemingly well-to-do mid-lifers were content with their prosperity and secure about the future. Yet I suspect a significant number of those sampled have either lost their jobs or have experienced dramatically increased job stress since the survey. Despite these drawbacks, the findings of this volume are interesting and informative. They include: mid-life mood is greatly influenced by context (mid-lifers are embedded in work and social/personal relationships and these social environments are more determinant of mood compared to young adults and the elderly) ; depression is more frequent among homemakers and the unemployed (not a surprise but worth bearing in mind) ; quality of life improves Psychological Medicine, 2005, 35, 295–298. f 2005 Cambridge University Press Printed in the United Kingdom