Introduction

Mental illness has always been a problem, but never serious enough to be considered a public health issue until 1996, when the World Health Organization published the results of the first Global Burden of Disease (GBD) study (Murray & Lopez, 1996). The GBD study estimated the total contribution of 107 acute and chronic medical conditions and illnesses by including disability in the equation to calculate disability-adjusted life years (DALY). The DALY reflects the total number of years in a population that were either lived with disability or abbreviated prematurely due to death that is attributable to specific physical or mental conditions. Depression was the fourth leading cause of disease burden, accounting for 3.7 percent of DALY in 1990, 4.4 percent in 2000, and projected to be 15 percent of DALY by 2020 (Üstün, 1999; Üstün, Ayuso-Mateos, Chatterji, Mathers, & Murray, 2004).

The debate is no longer about whether mental illness, and depression in particular, are a public health issue. Rather, the next debate is what can be done to reduce the number of cases of mental illness and those suffering from it.

This volume addresses the topic of “new frontiers in resilient aging,” which is of ever-increasing significance in current gerontological and geriatric discourse and research. The topic is not only very complex, but has enormous scope and breadth, encompassing a number of psychosocial and biological models of aging, theoretical formulations, definitions, and dimensions of resilience, and the core determinants of resilience that lay the foundations for discourse and research. Resilience as a psychological construct emerged from the study of children and youth at risk, and discourse on resilience, adaptation, and healthy longevity has focused mainly on younger adults, perhaps because of a misconception that resilience capacities diminish rapidly and perhaps irreversibly after young adulthood. Currently, increased life-expectancy without the compression of morbidity and vulnerability, together with the rising costs of healthcare, has highlighted the need for greater attention to the capacity for resilience throughout adulthood and in late life.

More recently, factors that influence resilience in later life are being studied more extensively. Within the last few years the theme of resilience in an aging society has been featured prominently in a number of national and international conferences and is the subject of intensive study in institutes of health sciences, mental health, and gerontology. This confluence of events suggests that the time is ripe to highlight some of the more recent and important research and writing on the topic of resilience in later life, and to bring the strands of this rapidly emerging scholarship together to showcase the movement toward promoting healthier aging.

Women's health research has historically centered on the topic of reproductive health. Until recently, research focused almost exclusively on biological and anatomical systems and their differences distinguishing men and women. Today, social and behavioral research on gender differences in health employs multiple disciplinary frameworks and multiple methodologies. Moreover, researchers are now seeking to better understand the causes and mechanisms that explain the higher rates of physical diseases and mental disorders in women and men.

Symptoms of depression and the diagnosis of depression are more prevalent in women. The evidence is now overwhelming that nondepressed individuals function better and are more productive than depressed individuals. Moreover, depression is prevalent, is often comorbid with other psychiatric disorders, recurs throughout the lifespan, is costly to treat, and generates substantial indirect costs to society in terms of lost productivity. Depression, then, has serious consequences whether it affects men or women. However, the fact that it is two to three times more likely to happen to women has become historically troubling because a greater percentage of women today than ever before are participating in the paid labor force in addition to their more traditional roles of raising children and tending to their families. When depression strikes women, it is disabling a central lynchpin in the structure of society.