Betty Ford, the outspoken and much-admired wife of PresidentGerald R. Ford who overcame alcoholism and an addiction to pills and helped found one of the best-known rehabilitation centers in the nation, died Friday in Rancho Mirage, Calif. She was 93.

Her death was confirmed by Chris Chase, Mrs. Ford’s biographer.

The news of her death at Eisenhower Medical Center brought statements of condolence from President Obama, former Presidents George Bush, George W. Bush and Jimmy Carter, and Nancy Reagan, the former first lady.

“She was Jerry Ford’s strength through some very difficult days in our country’s history,” Mrs. Reagan said, “and I admired her courage in facing and sharing her personal struggles with all of us.”

Few first ladies have been as popular as Betty Ford, and it was her frankness and lack of pretense that made her so. She spoke often in support of the Equal Rights Amendment, endorsed legalized abortion, discussed premarital sex and revealed that she intended to share a bed with her husband in the White House.

When her husband’s voice failed him the morning after he was defeated by Jimmy Carter in 1976, it was she who read the official concession statement with smiling grace. And when Mr. Ford died in December 2006, it was Mrs. Ford who announced his death. The six days of national mourning returned her to a spotlight she had tried to avoid in her later years, living in Rancho Mirage, Calif., a golf community southeast of Palm Springs, and tending to her clinic there, the Betty Ford Center.

The country’s affection for Betty Ford transcended party lines. It began in earnest slightly more than two months after Gerald Ford became president in August 1974, following President Richard M. Nixon’s resignation over Watergate. Mr. Ford had been vice president for less than 10 months, named by Nixon to succeed Spiro T. Agnew, who had resigned in disgrace over accusations of bribery and tax evasion. On Sept. 28, 1974, Mrs. Ford had a radical mastectomy after doctors discovered cancer in her right breast.

Courage Against Cancer

Within days, 10,000 letters, more than 500 telephone calls, more than 200 telegrams and scores of floral arrangements poured into the White House and into her suite at Bethesda Naval Hospital. In the months that followed, tens of thousands of American women, inspired by Mrs. Ford’s forthrightness and courage in facing her illness, crowded into doctors’ offices and clinics for breast-cancer examinations.

After leaving the hospital, Mrs. Ford underwent chemotherapy treatment for two years. In November 1976, her physician announced that she had made a complete recovery.

Mrs. Ford was once asked if she felt sorry for herself during the trauma of losing her breast.

“No! Oh, no — heavens, no,” she replied. “I’ve heard women say they’d rather lose their right arm, and I can’t imagine it. It’s so stupid. I can even wear my evening clothes.”

She advised women facing such an operation to “go as quickly as possible and get it done.”

“Once it’s done,” she said, “put it behind you and go on with your life.”

Breast cancer was only one of the medical battles Mrs. Ford won.

Confronting Addiction

Her dependency on pills began in 1964 with a medical prescription to relieve constant pain from a neck injury and a pinched nerve. Her drinking, which became troublesome as she was faced with her husband’s frequent absences on political business, grew increasingly serious as Mr. Ford’s Congressional career advanced. Her loneliness was compounded by low self-esteem and a debilitating self-consciousness about things like her lack of a college degree.

“Now I know that some of the pain I was trying to wipe out was emotional,” she recalled in “Betty: A Glad Awakening” (1987), the second volume of her autobiography written with Ms. Chase. Going back to the days when her husband was a Michigan congressman and minority leader in the House of Representatives, she remembered that “on one hand, I loved being ‘the wife of’; on the other hand, I was convinced that the more important Jerry became, the less important I became.”

In 1978, the year after leaving the White House, her husband, children, doctors and several friends confronted her about her drinking and her abuse of pills. She refused to acknowledge that a problem existed, calling her family “a bunch of monsters,” but she eventually entered the Long Beach Naval Hospital in California for treatment.

The Betty Ford Center, dedicated on Oct. 3, 1982, was a direct result of Mrs. Ford’s victory over her alcoholism and addiction. Set on 14 acres on the campus of the Eisenhower Medical Center 11 miles southeast of Palm Springs, the center was a nonprofit venture spearheaded by Mrs. Ford and Leonard K. Firestone, an industrialist and former ambassador to Belgium who raised a major part of the money.

The center’s philosophy, drawn from the 12-step program of Alcoholics Anonymous, is based on peer interaction and learning to identify and express feelings. Many celebrities, including Elizabeth Taylor, Liza Minnelli, Mary Tyler Moore, Mickey Mantle and Darryl Strawberry, spent time there.

“It’s hard to make anyone understand what it’s like to have your name on something, to be given credit for things you haven’t done,” Mrs. Ford wrote. “I’ve been at meetings where someone turned and thanked me, and I hugged the person and said, ‘Don’t thank me, thank yourself, you’re the one who did it, with God’s help.’ From the beginning, we have wanted every patient at the center to feel, ‘I’m important here, I have some dignity.’ ”

Betty Ford was good at doing the things that every first lady does: accompanying her husband on tours and public ceremonies and holding dinners and parties. Her parties usually lasted past midnight as she danced from one partner to another.

But unlike many other wives of presidents, Mrs. Ford rarely hesitated to make public her views on touchy subjects. She held a White House news conference announcing her support of the Equal Rights Amendment; the mail response ran three to one against her. In 1975, appearing on “60 Minutes,” she said she “wouldn’t be surprised” if her daughter, Susan, had a premarital affair; the mail was four to one against her. Her husband jokingly told her later that the comment had cost him 20 million votes in the 1976 election, she said.

A decade later, reminiscing with Margaret Truman for Ms. Truman’s book “First Ladies,” she voiced regret over that television appearance. Later that year, despite her advocacy for abortion rights, she reined herself in. She said nothing about the Republican platform that called for a constitutional amendment to ban abortion.

She also told Ms. Truman that she had warned her husband not to pardon Nixon, a more definitive statement than one she made in “The Times of My Life” (1978), the first volume of Mrs. Ford’s autobiography. In that book she said she had known that a pardon would be unpopular but that she had supported it anyway.

“I think it had to be done,” she wrote. Nevertheless, she said, she believed it cost her husband the election.

Mrs. Ford said she had been influential in President Ford’s appointments of Carla Hills as secretary of housing and urban development and Anne Armstrong as ambassador to Britain. She was unsuccessful, however, in urging him to appoint a woman to the Supreme Court.

She was, in her own words, “more of a hawk” than her children on the war in Vietnam. Although she said she believed men and women should give two years of service to the country, she confessed she was “very relieved” when her sons drew high draft-lottery numbers.

A Relaxed White House

Mrs. Ford brought a relaxed touch to the White House within days of moving in. She asked why the staff never returned a greeting and was told that President Nixon and the first lady, Pat Nixon, had preferred them to be as silent and invisible as possible. An immediate change went into effect, to the degree that during family meals the president and the butler compared golf scores. And when Mrs. Ford returned from her mastectomy, the staff lined up with signs reading, “We love you, Betty.”

She disliked other manifestations of Mrs. Nixon’s formal tastes, particularly the choice of stiff furniture, which had replaced the more comfortable Kennedy ambience from the early ’60s. Although she left the décor as it was, she could not resist a bit of deviltry. A ceramic bowl in the Yellow Oval Room was supported by two Greek goddesses, one of them with her hands out. “Every time I went through,” Mrs. Ford said, “I used to put a cigarette between her fingers.” Her mischievous side also surfaced after her husband complained that she was too thin. Borrowing a skeleton from a hospital, she dressed it in her hat and coat and sat it in a bedroom chair to welcome him.

Later, when she was no longer first lady, she was criticized in some circles for having a facelift almost immediately after overcoming her addictions. She wanted, she said, a fresh new face for her new life. She later thought that some of the resentment stemmed from the fact that she could no longer be perceived as a victim — of cancer, drugs and drink. “It was easier to be sorry for me, to feel superior to me, and therefore to root for me,” she said. “We all like to cheer an underdog. But I’d stopped being an underdog; I’d gotten myself in hand.”

Elizabeth Anne Bloomer was born on April 8, 1918, in Chicago to William S. Bloomer and the former Hortense Neahr. She always wanted to be called Elizabeth but ended up with Betty, Bet or Bets. She was the youngest child and the only girl in a family of three children. Her father was a traveling salesman in conveyor belts for factories. The family moved to Grand Rapids, Mich., when she was 2.

The Bloomers were financially comfortable, lived in a fashionable area and spent summers at Whitefish Lake. She began dancing lessons when she was 8, and for two summers after graduation from high school she attended Bennington School of the Dance at Bennington College in Vermont. At 14, she was confirmed as an Episcopalian (her mother’s religion; her father was a Christian Scientist) and began working on Saturdays, for $3, as a model for Herpolsheimer’s department store.

At 20, she was in New York, living on the fringes of Greenwich Village and attending dance classes with Martha Graham. She also joined her troupe.

Dance was always a major interest, and Mrs. Ford said many times that she was disappointed that she had never been quite good enough to be a first-rate dancer. When she went to China with her husband in 1975, however, she enchanted the Chinese by kicking off her shoes and dancing in her stocking feet at a Beijing school.

Her mother persuaded her to return to Grand Rapids in 1941, but not before she had modeled on Seventh Avenue and for the John Robert Powers modeling agency. Back home, she became a fashion coordinator for the store in which she had been a teenage model. In her spare time, she taught dance to underprivileged and disabled children.

The following year, she married William C. Warren, a furniture dealer. The marriage ended in divorce in 1947, and she did not ask for alimony. When Mr. Ford became vice president and his wife’s first marriage was disclosed, Mrs. Ford was asked why she had kept it a secret. She hadn’t, she said: “No one ever bothered to ask.”

Some months after her divorce, she began dating Gerald R. Ford, a lawyer with political ambitions and a man she described as “probably the most eligible bachelor in Grand Rapids.” He proposed in February 1948. “He’s a very shy man and he really didn’t tell me he loved me,” she wrote. “He just told me he’d like to marry me — I took him up on it immediately.”

They were married on Oct. 15, 1948, while he was running his first race for a seat in the House. The ceremony took place on a Friday so that Mr. Ford’s plans to go to a Northwestern-Michigan football game the following day would not be disrupted. (He had played center for Michigan.) The groom was 35; the bride, 30. They spent their two-day honeymoon at Republican Party rallies.

Mr. Ford won the election. “We came to Washington for 2 years and stayed for 28,” Mrs. Ford said. Their first son, Michael, was born in 1950 while the Fords lived in an apartment in Georgetown. By 1952, when John, known as Jack, was born, they had moved to an apartment in suburban Northern Virginia. Steven was born in 1956, a year after the Fords’ split-level house in Alexandria, Va., was completed. Susan, their only daughter, came along the next year.

“From the outside, our life looked like a Norman Rockwell illustration,” Mrs. Ford said at one point. Nevertheless, by 1962, she was seeing a psychiatrist twice a week because, as she put it, “I’d lost my feeling of self-worth.”

“I think a lot of women go through this,” she said. “Their husbands have fascinating jobs, their children start to turn into independent people and the women begin to feel useless, empty.”

Later, when she accompanied her husband on campaign trips more frequently, she acknowledged that that, too, was not all fun. At one point, she recalled, she was in an airport and “through clenched teeth said: ‘I don’t want anyone to come over and talk to me. I just want to sit here all alone and finish this cigarette.’ ”

Shortly after leaving the White House, the Fords built a 15-room house bordering the 13th fairway of the Thunderbird Country Club in Rancho Mirage. The couple also acquired a second home, an elaborate ski lodge in Vail, Colo. Mrs. Ford remained active in the Betty Ford Center and in feminist causes.

In addition to her four children, she is also survived by seven grandchildren and several great-grandchildren.

“I am an ordinary woman who was called onstage at an extraordinary time,” she wrote in the prologue to her first autobiography. “I was no different once I became first lady than I had been before. But through an accident of history, I had become interesting to people.”

Elizabeth B Ford