Dr. Eric S. Kim is currently an Assistant Professor in the Department of Psychology at the University of British Columbia (UBC). His program of research focuses on aging adults and aims to identify, understand, and intervene upon the dimensions of psychological well-being (e.g., sense of purpose) that reduce the risk of age-related conditions. This research also aims to understand the influence that the social environment has on the connection between psychological well-being and physical health. His research integrates perspectives from psychology (health, clinical, developmental, social, personality), gerontology, social epidemiology, biology, biostatistics, and translational science. Please visit our lab's website for more information: https://flourishing.psych.ubc.ca/
Little is known about early-life experiences that may lead to higher optimism levels in adulthood... more Little is known about early-life experiences that may lead to higher optimism levels in adulthood. Using data from 202,898 adults in 22 countries, we evaluated childhood candidate antecedents of optimism. We examined the associations between retrospectively reported childhood experiences and adult optimism levels in each country separately, and cross-nationally by pooling results across countries. Our pooled results suggest that higher adult optimism levels were associated with childhood experiences of having positive relationships with both parents, higher subjective financial status, better childhood self-rated health, frequent religious service attendance, an earlier year of birth, and being female. Conversely, lower adult optimism was associated with childhood experiences of parental divorce, abuse, financial hardship, and feeling like an outsider in the family. However, country-specific analyses showed substantial between-country variations in these associations, suggesting diverse societal influences. This study provides valuable insights into the association between early-life experiences and adult optimism levels across national contexts.
Prior research (mainly from Western industrialized countries) documents associations between grea... more Prior research (mainly from Western industrialized countries) documents associations between greater dispositional optimism (a generalized expectation that good things will happen) and improved health and well-being. However, less is known about whether and how levels of optimism differ across countries and across sociodemographic groups within different countries. This study presents a cross-national exploration of optimism, and its variations across sociodemographic groups. Using a sample of 202,898 adults from 22 diverse countries, we examined the relationships between optimism and key sociodemographic factors in each country separately, and cross-nationally by pooling results across countries using meta-analytic techniques. Our results suggest that mean optimism levels vary substantially across countries. Optimism also varies significantly across most of the sociodemographic factors included in our analyses. In the pooled results across countries, individuals who are older, female, married, employed, highly educated, attending religious services frequently, and native-born reported higher mean optimism levels. In the country-specific analyses, the sociodemographic variation in optimism differs across countries, indicating diverse societal influences. The findings of this study provide novel insights into the population distribution of optimism and disparities in optimism by sociodemographic groups across countries. This study provides a valuable foundation for future investigations into sociocultural influences that shape optimism.
An orientation to promote good (i.e., a disposition to take actions that contribute to the good o... more An orientation to promote good (i.e., a disposition to take actions that contribute to the good of oneself and others) has been associated with better health and well-being outcomes. However, less is known about how orientation to promote good differs across countries and across sociodemographic groups within different countries. Using a sample of 202,898 adults from 22 diverse countries, this study examined the distribution of orientation to promote good across key sociodemographic groups within each country separately, and cross-nationally by pooling estimates across countries. Our results suggest that population mean levels of promoting good vary substantially across countries. In the pooled results, the means of promoting good also vary across most of the sociodemographic factors that we examined. Specifically, individuals who are older, female, married, employed or retired, highly educated, attending religious services frequently, and native-born reported higher means of promoting good than those in other demographic groups. In country-specific analyses, the sociodemographic variation in promoting good also differs across countries, indicating diverse societal influences. This study provides novel insights into the social distribution of orientation to promote good, which paves the way for future investigations into sociocultural influences that may shape individuals' expression of character across different national contexts.
In this article, we describe the statistical and design methodology of the demographic variation ... more In this article, we describe the statistical and design methodology of the demographic variation analyses used as part of a coordinated set of manuscripts for wave 1 of the Global Flourishing Study (GFS). Aspects covered include the following: childhood predictors regression analyses, accounting for the complex sampling design, missing data and imputation, sensitivity analysis for unmeasured confounding and meta-analysis. We provide a brief illustrative example of the childhood predictor analyses using the sense of mastery construct indicator from the GFS survey and conclude by outlining some strengths and limitations of the methodology employed.
In this article, we describe the statistical and design methodology of the demographic variation ... more In this article, we describe the statistical and design methodology of the demographic variation analyses used as part of a coordinated set of manuscripts for wave 1 of the Global Flourishing Study (GFS). Aspects covered include the following: evaluating demographic variation, accounting for the complex sampling design, missing data and imputation, and meta-analysis. We provide a brief illustrative example of the demographic variation analyses using a measure of purpose in life from the GFS survey and conclude by outlining some strengths and limitations of the analytic and statistical methodology employed.
The Global Flourishing Study is a longitudinal panel study of over 200,000 participants in 22 geo... more The Global Flourishing Study is a longitudinal panel study of over 200,000 participants in 22 geographically and culturally diverse countries, spanning all six populated continents, with nationally representative sampling and intended annual survey data collection for 5 years to assess numerous aspects of flourishing and its possible determinants. The study is intended to expand our knowledge of the distribution and determinants of flourishing around the world. Relations between a composite flourishing index and numerous demographic characteristics are reported. Participants were also surveyed about their childhood experiences, which were analyzed to determine their associations with subsequent adult flourishing. Analyses are presented both across and within countries, and discussion is given as to how the demographic and childhood relationships vary by country and which patterns appear to be universal versus culturally specific. Brief comment is also given on the results of a whole series of papers in the Global Flourishing Study Special Collection, employing similar analyses, but with more-specific aspects of well-being. The Global Flourishing Study expands our knowledge of the distribution and determinants of well-being and provides foundational knowledge for the promotion of societal flourishing.
How might we cultivate a life imbued with purpose and meaning? Though common experience indicates... more How might we cultivate a life imbued with purpose and meaning? Though common experience indicates purpose and meaning are inherently important, empirical evidence confirms they are also linked to improved health/well-being. However, childhood antecedents of purpose and meaning in adulthood are understudied. We analyzed nationally representative data from 22 countries in the Global Flourishing Study (N = 202,898) and evaluated whether 11 aspects of a child’s upbringing correlate with purpose and meaning in adulthood, and if these associations vary by country. Some childhood factors were associated with increased purpose and meaning, including: good health, good relationship with parents, economic stability, regular religious service attendance, being female, and older birth cohorts. Childhood factors associated with decreased purpose and meaning included: abuse, feeling alienated, poor health, economic hardship, and loss of a parent. These findings may inform the development of programs designed to foster purpose and meaning that are globally adaptable and locally nuanced.
Objective: Volunteering has been repeatedly associated with reduced mortality in older adults, ye... more Objective: Volunteering has been repeatedly associated with reduced mortality in older adults, yet research examining the mechanisms explaining this association remains limited.We evaluated potentially modifiable mediators, and combinations of mediators, that may underlie the volunteering–mortality association. Method: We used prospective data from 9,962 participants in the Health and Retirement Study (2006– 2018), a national, diverse, and longitudinal cohort of U.S. adults aged .50. We evaluated associations between volunteering at baseline (2008/2010), mediators at Wave 2 (2010/2012), and mortality between Waves 3 and 4 (2010–2016 for Cohort A, 2012–2018 for Cohort B). Results: After adjusting for demographic confounders and mediators in the prebaselinewave (2006/2008),we observed evidence of mediation for those who volunteered ≥100 hr/year (vs. 0 hr/year) through combined physical health factors (proportion mediated [PM]= 49.56%, p =.004) and social factors (PM =90.76%, p= .017) as well as through increased contact with friends (PM =25.34%, p= .015) and helping friends/neighbors/relatives (PM= 25.12%, p=.018). However, there was less evidence of mediation through other proposed mediators. Conclusions: With further research, these results inform basic science, interventions, and policies by identifying potential mechanisms, which might become modifiable features of the volunteering experience, to promote longevity in our rapidly aging population.
Objectives: This study examined whether changes in optimism in older adulthood are associated wit... more Objectives: This study examined whether changes in optimism in older adulthood are associated with subsequent health and wellbeing outcomes. Method: Longitudinal data are from the Health and Retirement Study, a nationally representative sample of U.S. older adults (N = 12,998, 2006/2008 to 2014/2016 waves). To evaluate changes in optimism, we examined optimism assessed in 2010/2012 and adjusted for optimism assessed 4 years earlier in 2006/2008 in regression models, which, under the specified statistical models, is equivalent to assessing changes in optimism during the 4-year interval. We examined 35 outcomes assessed in 2014/2016, including: indicators of physical health, health behaviors, psychological distress, psychological wellbeing, and social factors. Results: Increases in optimism (e.g. from the lowest to highest quartile) were favorably associated with several physical health outcomes such as a reduced risk of mortality (relative risk [RR] = 0.76; 95% confidence interval [CI]: 0.62, 0.94) and better self-rated health, but were not associated with specific disease outcomes (e.g. diabetes, stroke) or health behaviors. Increased optimism was also inversely associated with all psychological distress indicators and positively associated with multiple aspects of psychosocial wellbeing. Conclusion: An optimistic mindset may be desirable in its own right. Increased optimism may also enhance health and wellbeing among older adults.
Purpose: Intergovernmental organizations, such as the World Health Organization, policymakers, sc... more Purpose: Intergovernmental organizations, such as the World Health Organization, policymakers, scientists, and the public alike are recognizing the importance of loneliness for health/well-being outcomes. However, it remains unclear if loneliness in adolescence shapes health/well-being in adulthood. We examined if an increase in loneliness during adolescence was associated with worse health/well-being in adulthood, across 41 outcomes.
Methods: We conducted a longitudinal study using data from Add Health, a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if an increase in loneliness over 1 year (between Wave I, 1994–1995 and Wave II, 1996) was associated with worse health/well-being outcomes 11.37 years later (in Wave IV, 2008; N = 11,040) or 20.64 years later (in Wave V, 2016–2018; N = 9,003). Participants were aged 15.28 years at study onset and aged 28.17 or 37.20 years during the final assessment.
Results: Participants with the highest (vs. lowest) loneliness had worse outcomes on 4 (of 7) mental health outcomes (e.g., higher likelihood of depression (relative risk = 1.25, confidence interval [CI] = 1.06, 1.49, p = .010)), 3 (of 4) psychological well-being outcomes (e.g., lower optimism [b = −0.12, 95% CI = −0.23, −0.01, p = .030]), 2 (of 7) social outcomes (e.g., lower romantic relationship quality (b = −0.10, 95% CI = −0.19, 0.00, p = .043)), one (of 13) physical health outcomes (e.g., higher likelihood of asthma (relative risk = 1.24, 95% CI = 1.01, 1.53, p = .041)), and 0 (of 9) health behavior outcomes and 0 (of 2) civic/prosocial outcomes.
Discussion: These findings suggest the promise of testing scalable loneliness interventions and policies during adolescence to better determine their impact on various outcomes.
Many middle-aged to older adults do not engage in regular exercise at all, despite its importance... more Many middle-aged to older adults do not engage in regular exercise at all, despite its importance for healthy aging. Extensive research grounded in behavioral and social science theories has identified numerous determinants of exercise. However, few studies used an exposure-wide approach, a data-driven exploratory method particularly useful for identifying novel determinants.
Methods: We used data from 13 771 participants in the Health and Retirement Study, a diverse, national panel study of adults aged >50 years in the United States, to evaluate 62 candidate determinants of exercise participation. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. We used Poisson regression with robust error variance to individually regress exercise in the outcome wave (t2: 2014/2016) on baseline candidate predictors (at t1: 2010/2012) controlling for all covariates in the previous wave (t0: 2006/2008).
Results: Some physical health conditions (eg, physical functioning limitations and lung disease), psychological factors (eg, health mastery, purpose in life, and positive affect), and social factors (eg, helping others, religious service attendance, and volunteering) were robustly associated with increased subsequent exercise. Among factors related to psychological distress, perceived constraints stood out as a factor in reducing exercise.
Conclusions: We identified potentially novel exercise determinants, such as helping friends/neighbors/relatives, religious attendance, and volunteering, that have not been captured using a theory-driven approach. Future studies validating these findings experimentally in midlife and older adults are needed.
Accumulating studies have documented strong associations between a higher sense of control and im... more Accumulating studies have documented strong associations between a higher sense of control and improved health and well-being outcomes. However, less is known about the determinants of increased sense of control. Our analysis used data from 13,771 older adults in the Health and Retirement Study (HRS)—a diverse, longitudinal, and national study of adults aged >50 in the United States. Using generalized linear regression models, with a lagged exposure-wide approach, we evaluated how changes in 59 predictors (i.e., physical health, health behavior, and psychosocial factors) over a 4-year period (between t0;2006/2008 and t1;2010/2012) might lead to changes in sense of control another 4 years later (t2;2014/2016). After adjusting for a rich set of baseline covariates, changes in some health behaviors (e.g., sleep problems), physical health conditions (e.g., physical functioning limitations, eyesight), and psychosocial factors (e.g., positive affect, purpose in life) were associated with changes in sense of control four years later. However, there was little evidence that other factors were associated with a subsequent sense of control. A key challenge in advancing intervention development is the identification of antecedents that predict a sense of control. Our results identified several novel targets for interventions and policies aimed at increasing a sense of control.
In the present study, we examined the prospective associations of both spousal support and spousa... more In the present study, we examined the prospective associations of both spousal support and spousal strain with a wide range of health and well-being outcomes in married older adults. Applying the analytic template for outcome-wide designs, three waves of longitudinal data from the Health and Retirement Study (n = 7788, Mage = 64.2 years) were analyzed using linear regression, logistic regression, and generalized linear models. A set of models was performed for spousal support and another set of models for spousal strain (2010/2012, t1). Outcomes included 35 different aspects of physical health, health behaviors, psychological well-being, psychological distress, and social factors (2014/2016, t2). All models adjusted for pre-baseline levels of sociodemographic covariates and all outcomes (2006/2008, t0). Spousal support evidenced positive associations with five psychological well-being outcomes, as well as negative associations with five psychological distress outcomes and loneliness. Conversely, spousal strain evidenced negative associations with three psychological well-being outcomes, in addition to positive associations with three psychological distress outcomes and loneliness. The magnitude of these associations was generally small, although some effect estimates were somewhat larger. Associations of both spousal support and strain with other social and health-related outcomes were more negligible. Both support and strain within a marital relationship have the potential to impact various aspects of psychological well-being, psychological distress, and loneliness in the aging population.
Using longitudinal data from the Health and Retirement Study, we examined the association between... more Using longitudinal data from the Health and Retirement Study, we examined the association between optimism/ pessimism before the pandemic and adaptation during the COVID-19 pandemic. Overall, optimism was associated with behaviors that reduce COVID-19 transmission and higher psychological well-being (βs>|.196|) through changes in social contacts (indirect effect βs> |.004|) and/or increases in physical activity (βs=|.01|). Separating optimism and pessimism, we found that only pessimism was associated with behaviors that reduce risk, but both optimism and pessimism were associated with psychological well-being. By investigating them in the context of new public health challenges, we found that while the presence of optimism and absence of pessimism may both be resources for well-being, the absence of pessimism may be particularly important for health-relevant behaviors.
Meaning, a fundamental component of human well-being, can be categorized into seven interrelated ... more Meaning, a fundamental component of human well-being, can be categorized into seven interrelated subdomains, as our study provides evidence for. These categories nest within a previously established tripartite classification of meaning in life (e.g. coherence, significance, and direction/purpose). We present the psychological and philosophical distinctions that led to the development of the Comprehensive Measure of Meaning (CMM). We provide empirical evidence for the reliability of scores and validity of the CMM using a longitudinal sample of college students (N = 4058) and a large, diverse sample from a Latin American financial institution (N = 8794). The measurement of individuals’ perception of their meaning in life is internally consistent, and we present results based on an innovative method to explore conceptual distinctions. Finally, we provide recommendations on using the CMM as a measure of individuals’ perceptions of their meaning in life and avenues for potentially beneficial modifications researchers might consider based on their intended uses.
Objective: Positive affect may influence health by promoting physical activity, but evidence eval... more Objective: Positive affect may influence health by promoting physical activity, but evidence evaluating this association is mostly cross-sectional and cannot discern directionality. This study used a counterfactual-based framework to estimate the causal effect of positive affect on physical activity patterns over 25 years, accounting for potential reverse associations. Method: Data were from 3,352 participants in the Coronary Artery Risk Development in Young Adults study. Repeated assessments of positive affect and physical activity were collected from 1990 to 2016. Longitudinal associations were evaluated in two ways: (a) using baseline positive affect in traditional linear mixed models that accounted for reverse causal associations by adjusting for baseline physical activity, and (b) using marginal structural models that treated positive affect as a time-varying exposure, thus accounting for dynamic reverse causal associations due to bidirectional relationships. Results: Fully adjusted traditional models found no association with physical activity at the first follow-up assessment, but positive affect was related to a slower decline in physical activity over time. Marginal structural models similarly found that positive affect was unrelated to physical activity at the first follow-up assessment but robustly associated with a slower decline in activity levels (5-year change: β = −3.33, 95% confidence interval [CI] = −5.80, −0.86; difference in 5-year change per 1 − SD positive affect: β = 4.99, 95% CI = 2.52, 7.46). Conclusions: Positive affect may play a causal role in slowing the decline in physical activity adults generally experience during through midlife. Efforts to enhance positive affect at the population level may be a promising new approach to help individuals stay active as they age. Public Significance Statement This study examined the impact of positive affect on physical activity trajectories from young adulthood through midlife using existing data from a large-scale cohort study. Results found a relationship with slower declines in activity levels over time, suggesting positive affect may be a viable future target for population-based efforts to help adults stay active during the transition to midlife.
Does higher perceived neighborhood social cohesion in adolescence lead to better health and well‐... more Does higher perceived neighborhood social cohesion in adolescence lead to better health and well‐being 10–12 years later? We evaluated this question using data from a large, prospective, and nationally representative sample of US adolescents (Add Health; N = 10,963), and an outcome‐wide approach. Across 38 outcomes, perceived neighborhood social cohesion was associated with some: mental health outcomes (i.e., depressive symptoms, suicidal ideation, perceived stress), psychological well‐being outcomes (i.e., happiness, optimism), social outcomes (i.e., loneliness, romantic relationship quality, satisfaction with parenting), and civic/prosocial outcomes (i.e., volunteering). However, it was not associated with health behaviors nor physical health outcomes. These results were maintained after robust control for a wide range of potential confounders.
IMPORTANCE
Supporting healthy aging is a US public health priority, and gratitude is a potential... more IMPORTANCE
Supporting healthy aging is a US public health priority, and gratitude is a potentially modifiable psychological factor that may enhance health and well-being in older adults. However, the association between gratitude and mortality has not been studied.
OBJECTIVE
To examine the association of gratitude with all-cause and cause-specific mortality in later life.
DESIGN, SETTING, AND PARTICIPANTS
This population-based prospective cohort study used data from self-reported questionnaires and medical records of 49,275 US older female registered nurses who participated in the Nurses’ Health Study (2016 questionnaire wave to December 2019). Cox proportional hazards regression models estimated the hazard ratio (HR) of deaths by self-reported levels of gratitude at baseline. These models adjusted for baseline sociodemographic characteristics, social participation, physical health, lifestyle factors, cognitive function, and mental health. Data analysis was conducted from December 2022 to April 2024.
EXPOSURE
Gratitude was assessed with the 6-item Gratitude Questionnaire, a validated and widely used measure of one’s tendency to experience grateful affect.
MAIN OUTCOMES AND MEASURES
Deaths were identified from the National Death Index, state statistics records, reports by next of kin, and the postal system. Causes of death were ascertained by physicians through reviewing death certificates and medical records.
RESULTS
Among the 49,275 participants (all female; mean [SD] age at baseline, 79 [6.16] years), 4,608 incident deaths were identified over 151,496 person-years of follow-up. Greater gratitude at baseline was associated with a lower hazard of mortality in a monotonic fashion. For instance, the highest tertile of gratitude, compared with the lowest tertile, was associated with a lower hazard of all-cause deaths (HR, 0.91; 95% CI, 0.84-0.99) after adjusting for baseline sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function, and mental health. When considering cause-specific deaths, death from cardiovascular disease was inversely associated with gratitude (HR, 0.85; 95% CI, 0.73-0.995).
CONCLUSIONS AND RELEVANCE
This study provides the first empirical evidence suggesting that experiencing grateful affect is associated with increased longevity among older adults. The findings will need to be replicated in future studies with more representative samples.
Background
Several intergovernmental organizations, including the World Health Organization and U... more Background Several intergovernmental organizations, including the World Health Organization and United Nations, are urging countries to use well-being indicators for policymaking. This trend, coupled with increasing recognition that positive affect is beneficial for health/well-being, opens new avenues for intervening on positive affect to improve outcomes. However, it remains unclear if positive affect in adolescence shapes health/well-being in adulthood. We examined if increases in positive affect during adolescence were associated with better health/well-being in adulthood across 41 outcomes.
Methods and findings We conducted a longitudinal cohort study using data from Add Health—a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if increases in positive affect over 1 year (between Wave I; 1994 to 1995 and Wave II; 1995 to 1996) were associated with better health/well-being 11.37 years later (in Wave IV; 2008; N = 11,040) or 20.64 years later (in Wave V; 2016 to 2018; N = 9,003). Participants were aged 15.28 years at study onset, and aged 28.17 or 37.20 years—during the final assessment. Participants with the highest (versus lowest) positive affect had better outcomes on 3 (of 13) physical health outcomes (e.g., higher cognition (β = 0·12, 95% CI = 0·05, 0·19, p = 0.002)), 3 (of 9) health behavior outcomes (e.g., lower physical inactivity (RR = 0·80, CI = 0·66, 0·98, p = 0.029)), 6 (of 7) mental health outcomes (e.g., lower anxiety (RR = 0·81, CI = 0·71, 0·93, p = 0.003)), 2 (of 3) psychological well-being (e.g., higher optimism (β = 0·20, 95% CI = 0·12, 0·28, p < 0.001)), 4 (of 7) social outcomes (e.g., lower loneliness (β = −0·09, 95% CI = −0·16, −0·02, p = 0.015)), and 1 (of 2) civic/prosocial outcomes (e.g., more voting (RR = 1·25, 95% CI = 1·16, 1·36, p < 0.001)). Study limitations include potential unmeasured confounding and reverse causality.
Conclusions Enhanced positive affect during adolescence is linked with a range of improved health/well-being outcomes in adulthood. These findings suggest the promise of testing scalable positive affect interventions and policies to more definitively assess their impact on outcomes.
Background. A large and accumulating body of evidence shows that loneliness is detrimental for va... more Background. A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness. Methods. We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t 0 ;2006/2008 to t 1 ;2010/2012) were associated with subsequent loneliness 4 years later (t 2 ;2014/2016). Results. Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness. Conclusions. Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.
Little is known about early-life experiences that may lead to higher optimism levels in adulthood... more Little is known about early-life experiences that may lead to higher optimism levels in adulthood. Using data from 202,898 adults in 22 countries, we evaluated childhood candidate antecedents of optimism. We examined the associations between retrospectively reported childhood experiences and adult optimism levels in each country separately, and cross-nationally by pooling results across countries. Our pooled results suggest that higher adult optimism levels were associated with childhood experiences of having positive relationships with both parents, higher subjective financial status, better childhood self-rated health, frequent religious service attendance, an earlier year of birth, and being female. Conversely, lower adult optimism was associated with childhood experiences of parental divorce, abuse, financial hardship, and feeling like an outsider in the family. However, country-specific analyses showed substantial between-country variations in these associations, suggesting diverse societal influences. This study provides valuable insights into the association between early-life experiences and adult optimism levels across national contexts.
Prior research (mainly from Western industrialized countries) documents associations between grea... more Prior research (mainly from Western industrialized countries) documents associations between greater dispositional optimism (a generalized expectation that good things will happen) and improved health and well-being. However, less is known about whether and how levels of optimism differ across countries and across sociodemographic groups within different countries. This study presents a cross-national exploration of optimism, and its variations across sociodemographic groups. Using a sample of 202,898 adults from 22 diverse countries, we examined the relationships between optimism and key sociodemographic factors in each country separately, and cross-nationally by pooling results across countries using meta-analytic techniques. Our results suggest that mean optimism levels vary substantially across countries. Optimism also varies significantly across most of the sociodemographic factors included in our analyses. In the pooled results across countries, individuals who are older, female, married, employed, highly educated, attending religious services frequently, and native-born reported higher mean optimism levels. In the country-specific analyses, the sociodemographic variation in optimism differs across countries, indicating diverse societal influences. The findings of this study provide novel insights into the population distribution of optimism and disparities in optimism by sociodemographic groups across countries. This study provides a valuable foundation for future investigations into sociocultural influences that shape optimism.
An orientation to promote good (i.e., a disposition to take actions that contribute to the good o... more An orientation to promote good (i.e., a disposition to take actions that contribute to the good of oneself and others) has been associated with better health and well-being outcomes. However, less is known about how orientation to promote good differs across countries and across sociodemographic groups within different countries. Using a sample of 202,898 adults from 22 diverse countries, this study examined the distribution of orientation to promote good across key sociodemographic groups within each country separately, and cross-nationally by pooling estimates across countries. Our results suggest that population mean levels of promoting good vary substantially across countries. In the pooled results, the means of promoting good also vary across most of the sociodemographic factors that we examined. Specifically, individuals who are older, female, married, employed or retired, highly educated, attending religious services frequently, and native-born reported higher means of promoting good than those in other demographic groups. In country-specific analyses, the sociodemographic variation in promoting good also differs across countries, indicating diverse societal influences. This study provides novel insights into the social distribution of orientation to promote good, which paves the way for future investigations into sociocultural influences that may shape individuals' expression of character across different national contexts.
In this article, we describe the statistical and design methodology of the demographic variation ... more In this article, we describe the statistical and design methodology of the demographic variation analyses used as part of a coordinated set of manuscripts for wave 1 of the Global Flourishing Study (GFS). Aspects covered include the following: childhood predictors regression analyses, accounting for the complex sampling design, missing data and imputation, sensitivity analysis for unmeasured confounding and meta-analysis. We provide a brief illustrative example of the childhood predictor analyses using the sense of mastery construct indicator from the GFS survey and conclude by outlining some strengths and limitations of the methodology employed.
In this article, we describe the statistical and design methodology of the demographic variation ... more In this article, we describe the statistical and design methodology of the demographic variation analyses used as part of a coordinated set of manuscripts for wave 1 of the Global Flourishing Study (GFS). Aspects covered include the following: evaluating demographic variation, accounting for the complex sampling design, missing data and imputation, and meta-analysis. We provide a brief illustrative example of the demographic variation analyses using a measure of purpose in life from the GFS survey and conclude by outlining some strengths and limitations of the analytic and statistical methodology employed.
The Global Flourishing Study is a longitudinal panel study of over 200,000 participants in 22 geo... more The Global Flourishing Study is a longitudinal panel study of over 200,000 participants in 22 geographically and culturally diverse countries, spanning all six populated continents, with nationally representative sampling and intended annual survey data collection for 5 years to assess numerous aspects of flourishing and its possible determinants. The study is intended to expand our knowledge of the distribution and determinants of flourishing around the world. Relations between a composite flourishing index and numerous demographic characteristics are reported. Participants were also surveyed about their childhood experiences, which were analyzed to determine their associations with subsequent adult flourishing. Analyses are presented both across and within countries, and discussion is given as to how the demographic and childhood relationships vary by country and which patterns appear to be universal versus culturally specific. Brief comment is also given on the results of a whole series of papers in the Global Flourishing Study Special Collection, employing similar analyses, but with more-specific aspects of well-being. The Global Flourishing Study expands our knowledge of the distribution and determinants of well-being and provides foundational knowledge for the promotion of societal flourishing.
How might we cultivate a life imbued with purpose and meaning? Though common experience indicates... more How might we cultivate a life imbued with purpose and meaning? Though common experience indicates purpose and meaning are inherently important, empirical evidence confirms they are also linked to improved health/well-being. However, childhood antecedents of purpose and meaning in adulthood are understudied. We analyzed nationally representative data from 22 countries in the Global Flourishing Study (N = 202,898) and evaluated whether 11 aspects of a child’s upbringing correlate with purpose and meaning in adulthood, and if these associations vary by country. Some childhood factors were associated with increased purpose and meaning, including: good health, good relationship with parents, economic stability, regular religious service attendance, being female, and older birth cohorts. Childhood factors associated with decreased purpose and meaning included: abuse, feeling alienated, poor health, economic hardship, and loss of a parent. These findings may inform the development of programs designed to foster purpose and meaning that are globally adaptable and locally nuanced.
Objective: Volunteering has been repeatedly associated with reduced mortality in older adults, ye... more Objective: Volunteering has been repeatedly associated with reduced mortality in older adults, yet research examining the mechanisms explaining this association remains limited.We evaluated potentially modifiable mediators, and combinations of mediators, that may underlie the volunteering–mortality association. Method: We used prospective data from 9,962 participants in the Health and Retirement Study (2006– 2018), a national, diverse, and longitudinal cohort of U.S. adults aged .50. We evaluated associations between volunteering at baseline (2008/2010), mediators at Wave 2 (2010/2012), and mortality between Waves 3 and 4 (2010–2016 for Cohort A, 2012–2018 for Cohort B). Results: After adjusting for demographic confounders and mediators in the prebaselinewave (2006/2008),we observed evidence of mediation for those who volunteered ≥100 hr/year (vs. 0 hr/year) through combined physical health factors (proportion mediated [PM]= 49.56%, p =.004) and social factors (PM =90.76%, p= .017) as well as through increased contact with friends (PM =25.34%, p= .015) and helping friends/neighbors/relatives (PM= 25.12%, p=.018). However, there was less evidence of mediation through other proposed mediators. Conclusions: With further research, these results inform basic science, interventions, and policies by identifying potential mechanisms, which might become modifiable features of the volunteering experience, to promote longevity in our rapidly aging population.
Objectives: This study examined whether changes in optimism in older adulthood are associated wit... more Objectives: This study examined whether changes in optimism in older adulthood are associated with subsequent health and wellbeing outcomes. Method: Longitudinal data are from the Health and Retirement Study, a nationally representative sample of U.S. older adults (N = 12,998, 2006/2008 to 2014/2016 waves). To evaluate changes in optimism, we examined optimism assessed in 2010/2012 and adjusted for optimism assessed 4 years earlier in 2006/2008 in regression models, which, under the specified statistical models, is equivalent to assessing changes in optimism during the 4-year interval. We examined 35 outcomes assessed in 2014/2016, including: indicators of physical health, health behaviors, psychological distress, psychological wellbeing, and social factors. Results: Increases in optimism (e.g. from the lowest to highest quartile) were favorably associated with several physical health outcomes such as a reduced risk of mortality (relative risk [RR] = 0.76; 95% confidence interval [CI]: 0.62, 0.94) and better self-rated health, but were not associated with specific disease outcomes (e.g. diabetes, stroke) or health behaviors. Increased optimism was also inversely associated with all psychological distress indicators and positively associated with multiple aspects of psychosocial wellbeing. Conclusion: An optimistic mindset may be desirable in its own right. Increased optimism may also enhance health and wellbeing among older adults.
Purpose: Intergovernmental organizations, such as the World Health Organization, policymakers, sc... more Purpose: Intergovernmental organizations, such as the World Health Organization, policymakers, scientists, and the public alike are recognizing the importance of loneliness for health/well-being outcomes. However, it remains unclear if loneliness in adolescence shapes health/well-being in adulthood. We examined if an increase in loneliness during adolescence was associated with worse health/well-being in adulthood, across 41 outcomes.
Methods: We conducted a longitudinal study using data from Add Health, a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if an increase in loneliness over 1 year (between Wave I, 1994–1995 and Wave II, 1996) was associated with worse health/well-being outcomes 11.37 years later (in Wave IV, 2008; N = 11,040) or 20.64 years later (in Wave V, 2016–2018; N = 9,003). Participants were aged 15.28 years at study onset and aged 28.17 or 37.20 years during the final assessment.
Results: Participants with the highest (vs. lowest) loneliness had worse outcomes on 4 (of 7) mental health outcomes (e.g., higher likelihood of depression (relative risk = 1.25, confidence interval [CI] = 1.06, 1.49, p = .010)), 3 (of 4) psychological well-being outcomes (e.g., lower optimism [b = −0.12, 95% CI = −0.23, −0.01, p = .030]), 2 (of 7) social outcomes (e.g., lower romantic relationship quality (b = −0.10, 95% CI = −0.19, 0.00, p = .043)), one (of 13) physical health outcomes (e.g., higher likelihood of asthma (relative risk = 1.24, 95% CI = 1.01, 1.53, p = .041)), and 0 (of 9) health behavior outcomes and 0 (of 2) civic/prosocial outcomes.
Discussion: These findings suggest the promise of testing scalable loneliness interventions and policies during adolescence to better determine their impact on various outcomes.
Many middle-aged to older adults do not engage in regular exercise at all, despite its importance... more Many middle-aged to older adults do not engage in regular exercise at all, despite its importance for healthy aging. Extensive research grounded in behavioral and social science theories has identified numerous determinants of exercise. However, few studies used an exposure-wide approach, a data-driven exploratory method particularly useful for identifying novel determinants.
Methods: We used data from 13 771 participants in the Health and Retirement Study, a diverse, national panel study of adults aged >50 years in the United States, to evaluate 62 candidate determinants of exercise participation. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. We used Poisson regression with robust error variance to individually regress exercise in the outcome wave (t2: 2014/2016) on baseline candidate predictors (at t1: 2010/2012) controlling for all covariates in the previous wave (t0: 2006/2008).
Results: Some physical health conditions (eg, physical functioning limitations and lung disease), psychological factors (eg, health mastery, purpose in life, and positive affect), and social factors (eg, helping others, religious service attendance, and volunteering) were robustly associated with increased subsequent exercise. Among factors related to psychological distress, perceived constraints stood out as a factor in reducing exercise.
Conclusions: We identified potentially novel exercise determinants, such as helping friends/neighbors/relatives, religious attendance, and volunteering, that have not been captured using a theory-driven approach. Future studies validating these findings experimentally in midlife and older adults are needed.
Accumulating studies have documented strong associations between a higher sense of control and im... more Accumulating studies have documented strong associations between a higher sense of control and improved health and well-being outcomes. However, less is known about the determinants of increased sense of control. Our analysis used data from 13,771 older adults in the Health and Retirement Study (HRS)—a diverse, longitudinal, and national study of adults aged >50 in the United States. Using generalized linear regression models, with a lagged exposure-wide approach, we evaluated how changes in 59 predictors (i.e., physical health, health behavior, and psychosocial factors) over a 4-year period (between t0;2006/2008 and t1;2010/2012) might lead to changes in sense of control another 4 years later (t2;2014/2016). After adjusting for a rich set of baseline covariates, changes in some health behaviors (e.g., sleep problems), physical health conditions (e.g., physical functioning limitations, eyesight), and psychosocial factors (e.g., positive affect, purpose in life) were associated with changes in sense of control four years later. However, there was little evidence that other factors were associated with a subsequent sense of control. A key challenge in advancing intervention development is the identification of antecedents that predict a sense of control. Our results identified several novel targets for interventions and policies aimed at increasing a sense of control.
In the present study, we examined the prospective associations of both spousal support and spousa... more In the present study, we examined the prospective associations of both spousal support and spousal strain with a wide range of health and well-being outcomes in married older adults. Applying the analytic template for outcome-wide designs, three waves of longitudinal data from the Health and Retirement Study (n = 7788, Mage = 64.2 years) were analyzed using linear regression, logistic regression, and generalized linear models. A set of models was performed for spousal support and another set of models for spousal strain (2010/2012, t1). Outcomes included 35 different aspects of physical health, health behaviors, psychological well-being, psychological distress, and social factors (2014/2016, t2). All models adjusted for pre-baseline levels of sociodemographic covariates and all outcomes (2006/2008, t0). Spousal support evidenced positive associations with five psychological well-being outcomes, as well as negative associations with five psychological distress outcomes and loneliness. Conversely, spousal strain evidenced negative associations with three psychological well-being outcomes, in addition to positive associations with three psychological distress outcomes and loneliness. The magnitude of these associations was generally small, although some effect estimates were somewhat larger. Associations of both spousal support and strain with other social and health-related outcomes were more negligible. Both support and strain within a marital relationship have the potential to impact various aspects of psychological well-being, psychological distress, and loneliness in the aging population.
Using longitudinal data from the Health and Retirement Study, we examined the association between... more Using longitudinal data from the Health and Retirement Study, we examined the association between optimism/ pessimism before the pandemic and adaptation during the COVID-19 pandemic. Overall, optimism was associated with behaviors that reduce COVID-19 transmission and higher psychological well-being (βs>|.196|) through changes in social contacts (indirect effect βs> |.004|) and/or increases in physical activity (βs=|.01|). Separating optimism and pessimism, we found that only pessimism was associated with behaviors that reduce risk, but both optimism and pessimism were associated with psychological well-being. By investigating them in the context of new public health challenges, we found that while the presence of optimism and absence of pessimism may both be resources for well-being, the absence of pessimism may be particularly important for health-relevant behaviors.
Meaning, a fundamental component of human well-being, can be categorized into seven interrelated ... more Meaning, a fundamental component of human well-being, can be categorized into seven interrelated subdomains, as our study provides evidence for. These categories nest within a previously established tripartite classification of meaning in life (e.g. coherence, significance, and direction/purpose). We present the psychological and philosophical distinctions that led to the development of the Comprehensive Measure of Meaning (CMM). We provide empirical evidence for the reliability of scores and validity of the CMM using a longitudinal sample of college students (N = 4058) and a large, diverse sample from a Latin American financial institution (N = 8794). The measurement of individuals’ perception of their meaning in life is internally consistent, and we present results based on an innovative method to explore conceptual distinctions. Finally, we provide recommendations on using the CMM as a measure of individuals’ perceptions of their meaning in life and avenues for potentially beneficial modifications researchers might consider based on their intended uses.
Objective: Positive affect may influence health by promoting physical activity, but evidence eval... more Objective: Positive affect may influence health by promoting physical activity, but evidence evaluating this association is mostly cross-sectional and cannot discern directionality. This study used a counterfactual-based framework to estimate the causal effect of positive affect on physical activity patterns over 25 years, accounting for potential reverse associations. Method: Data were from 3,352 participants in the Coronary Artery Risk Development in Young Adults study. Repeated assessments of positive affect and physical activity were collected from 1990 to 2016. Longitudinal associations were evaluated in two ways: (a) using baseline positive affect in traditional linear mixed models that accounted for reverse causal associations by adjusting for baseline physical activity, and (b) using marginal structural models that treated positive affect as a time-varying exposure, thus accounting for dynamic reverse causal associations due to bidirectional relationships. Results: Fully adjusted traditional models found no association with physical activity at the first follow-up assessment, but positive affect was related to a slower decline in physical activity over time. Marginal structural models similarly found that positive affect was unrelated to physical activity at the first follow-up assessment but robustly associated with a slower decline in activity levels (5-year change: β = −3.33, 95% confidence interval [CI] = −5.80, −0.86; difference in 5-year change per 1 − SD positive affect: β = 4.99, 95% CI = 2.52, 7.46). Conclusions: Positive affect may play a causal role in slowing the decline in physical activity adults generally experience during through midlife. Efforts to enhance positive affect at the population level may be a promising new approach to help individuals stay active as they age. Public Significance Statement This study examined the impact of positive affect on physical activity trajectories from young adulthood through midlife using existing data from a large-scale cohort study. Results found a relationship with slower declines in activity levels over time, suggesting positive affect may be a viable future target for population-based efforts to help adults stay active during the transition to midlife.
Does higher perceived neighborhood social cohesion in adolescence lead to better health and well‐... more Does higher perceived neighborhood social cohesion in adolescence lead to better health and well‐being 10–12 years later? We evaluated this question using data from a large, prospective, and nationally representative sample of US adolescents (Add Health; N = 10,963), and an outcome‐wide approach. Across 38 outcomes, perceived neighborhood social cohesion was associated with some: mental health outcomes (i.e., depressive symptoms, suicidal ideation, perceived stress), psychological well‐being outcomes (i.e., happiness, optimism), social outcomes (i.e., loneliness, romantic relationship quality, satisfaction with parenting), and civic/prosocial outcomes (i.e., volunteering). However, it was not associated with health behaviors nor physical health outcomes. These results were maintained after robust control for a wide range of potential confounders.
IMPORTANCE
Supporting healthy aging is a US public health priority, and gratitude is a potential... more IMPORTANCE
Supporting healthy aging is a US public health priority, and gratitude is a potentially modifiable psychological factor that may enhance health and well-being in older adults. However, the association between gratitude and mortality has not been studied.
OBJECTIVE
To examine the association of gratitude with all-cause and cause-specific mortality in later life.
DESIGN, SETTING, AND PARTICIPANTS
This population-based prospective cohort study used data from self-reported questionnaires and medical records of 49,275 US older female registered nurses who participated in the Nurses’ Health Study (2016 questionnaire wave to December 2019). Cox proportional hazards regression models estimated the hazard ratio (HR) of deaths by self-reported levels of gratitude at baseline. These models adjusted for baseline sociodemographic characteristics, social participation, physical health, lifestyle factors, cognitive function, and mental health. Data analysis was conducted from December 2022 to April 2024.
EXPOSURE
Gratitude was assessed with the 6-item Gratitude Questionnaire, a validated and widely used measure of one’s tendency to experience grateful affect.
MAIN OUTCOMES AND MEASURES
Deaths were identified from the National Death Index, state statistics records, reports by next of kin, and the postal system. Causes of death were ascertained by physicians through reviewing death certificates and medical records.
RESULTS
Among the 49,275 participants (all female; mean [SD] age at baseline, 79 [6.16] years), 4,608 incident deaths were identified over 151,496 person-years of follow-up. Greater gratitude at baseline was associated with a lower hazard of mortality in a monotonic fashion. For instance, the highest tertile of gratitude, compared with the lowest tertile, was associated with a lower hazard of all-cause deaths (HR, 0.91; 95% CI, 0.84-0.99) after adjusting for baseline sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function, and mental health. When considering cause-specific deaths, death from cardiovascular disease was inversely associated with gratitude (HR, 0.85; 95% CI, 0.73-0.995).
CONCLUSIONS AND RELEVANCE
This study provides the first empirical evidence suggesting that experiencing grateful affect is associated with increased longevity among older adults. The findings will need to be replicated in future studies with more representative samples.
Background
Several intergovernmental organizations, including the World Health Organization and U... more Background Several intergovernmental organizations, including the World Health Organization and United Nations, are urging countries to use well-being indicators for policymaking. This trend, coupled with increasing recognition that positive affect is beneficial for health/well-being, opens new avenues for intervening on positive affect to improve outcomes. However, it remains unclear if positive affect in adolescence shapes health/well-being in adulthood. We examined if increases in positive affect during adolescence were associated with better health/well-being in adulthood across 41 outcomes.
Methods and findings We conducted a longitudinal cohort study using data from Add Health—a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if increases in positive affect over 1 year (between Wave I; 1994 to 1995 and Wave II; 1995 to 1996) were associated with better health/well-being 11.37 years later (in Wave IV; 2008; N = 11,040) or 20.64 years later (in Wave V; 2016 to 2018; N = 9,003). Participants were aged 15.28 years at study onset, and aged 28.17 or 37.20 years—during the final assessment. Participants with the highest (versus lowest) positive affect had better outcomes on 3 (of 13) physical health outcomes (e.g., higher cognition (β = 0·12, 95% CI = 0·05, 0·19, p = 0.002)), 3 (of 9) health behavior outcomes (e.g., lower physical inactivity (RR = 0·80, CI = 0·66, 0·98, p = 0.029)), 6 (of 7) mental health outcomes (e.g., lower anxiety (RR = 0·81, CI = 0·71, 0·93, p = 0.003)), 2 (of 3) psychological well-being (e.g., higher optimism (β = 0·20, 95% CI = 0·12, 0·28, p < 0.001)), 4 (of 7) social outcomes (e.g., lower loneliness (β = −0·09, 95% CI = −0·16, −0·02, p = 0.015)), and 1 (of 2) civic/prosocial outcomes (e.g., more voting (RR = 1·25, 95% CI = 1·16, 1·36, p < 0.001)). Study limitations include potential unmeasured confounding and reverse causality.
Conclusions Enhanced positive affect during adolescence is linked with a range of improved health/well-being outcomes in adulthood. These findings suggest the promise of testing scalable positive affect interventions and policies to more definitively assess their impact on outcomes.
Background. A large and accumulating body of evidence shows that loneliness is detrimental for va... more Background. A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness. Methods. We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t 0 ;2006/2008 to t 1 ;2010/2012) were associated with subsequent loneliness 4 years later (t 2 ;2014/2016). Results. Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness. Conclusions. Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.
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Papers by Eric S . Kim (UBC)
examining the mechanisms explaining this association remains limited.We evaluated potentially modifiable
mediators, and combinations of mediators, that may underlie the volunteering–mortality association.
Method: We used prospective data from 9,962 participants in the Health and Retirement Study (2006–
2018), a national, diverse, and longitudinal cohort of U.S. adults aged .50. We evaluated associations
between volunteering at baseline (2008/2010), mediators at Wave 2 (2010/2012), and mortality between
Waves 3 and 4 (2010–2016 for Cohort A, 2012–2018 for Cohort B). Results: After adjusting for demographic
confounders and mediators in the prebaselinewave (2006/2008),we observed evidence of mediation
for those who volunteered ≥100 hr/year (vs. 0 hr/year) through combined physical health factors (proportion
mediated [PM]= 49.56%, p =.004) and social factors (PM =90.76%, p= .017) as well as through
increased contact with friends (PM =25.34%, p= .015) and helping friends/neighbors/relatives (PM=
25.12%, p=.018). However, there was less evidence of mediation through other proposed mediators.
Conclusions: With further research, these results inform basic science, interventions, and policies by identifying
potential mechanisms, which might become modifiable features of the volunteering experience, to
promote longevity in our rapidly aging population.
Methods: We conducted a longitudinal study using data from Add Health, a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if an increase in loneliness over 1 year (between Wave I, 1994–1995 and Wave II, 1996) was associated with worse health/well-being outcomes 11.37 years later (in Wave IV, 2008; N = 11,040) or 20.64 years later (in Wave V, 2016–2018; N = 9,003). Participants were aged 15.28 years at study onset and aged 28.17 or 37.20 years during the final assessment.
Results: Participants with the highest (vs. lowest) loneliness had worse outcomes on 4 (of 7) mental health outcomes (e.g., higher likelihood of depression (relative risk = 1.25, confidence interval [CI] = 1.06, 1.49, p = .010)), 3 (of 4) psychological well-being outcomes (e.g., lower optimism [b = −0.12, 95% CI = −0.23, −0.01, p = .030]), 2 (of 7) social outcomes (e.g., lower romantic relationship quality (b = −0.10, 95% CI = −0.19, 0.00, p = .043)), one (of 13) physical health outcomes (e.g., higher likelihood of asthma (relative risk = 1.24, 95% CI = 1.01, 1.53, p = .041)), and 0 (of 9) health behavior outcomes and 0 (of 2) civic/prosocial outcomes.
Discussion: These findings suggest the promise of testing scalable loneliness interventions and policies during adolescence to better determine their impact on various outcomes.
Methods: We used data from 13 771 participants in the Health and Retirement Study, a diverse, national panel study of adults aged >50 years in the United States, to evaluate 62 candidate determinants of exercise participation. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. We used Poisson regression with robust error variance to individually regress exercise in the outcome wave (t2: 2014/2016) on baseline candidate predictors (at t1: 2010/2012) controlling for all covariates in the previous wave (t0: 2006/2008).
Results: Some physical health conditions (eg, physical functioning limitations and lung disease), psychological factors (eg, health mastery, purpose in life, and positive affect), and social factors (eg, helping others, religious service attendance, and volunteering) were robustly associated with increased subsequent exercise. Among factors related to psychological distress, perceived constraints stood out as a factor in reducing exercise.
Conclusions: We identified potentially novel exercise determinants, such as helping friends/neighbors/relatives, religious attendance, and volunteering, that have not been captured using a theory-driven approach. Future studies validating these findings experimentally in midlife and older adults are needed.
an outcome‐wide approach. Across 38 outcomes, perceived neighborhood social cohesion was associated with some: mental health outcomes (i.e., depressive symptoms, suicidal ideation, perceived stress), psychological
well‐being outcomes (i.e., happiness, optimism), social outcomes (i.e., loneliness, romantic relationship quality, satisfaction with parenting), and civic/prosocial outcomes (i.e., volunteering). However, it was not associated with health behaviors nor physical health outcomes.
These results were maintained after robust control for a wide range of potential confounders.
Supporting healthy aging is a US public health priority, and gratitude is a potentially modifiable psychological factor that may enhance health and well-being in older adults. However, the association between gratitude and mortality has not been studied.
OBJECTIVE
To examine the association of gratitude with all-cause and cause-specific mortality in later life.
DESIGN, SETTING, AND PARTICIPANTS
This population-based prospective cohort study used data from self-reported questionnaires and medical records of 49,275 US older female registered nurses who participated in the Nurses’ Health Study (2016 questionnaire wave to December 2019). Cox proportional hazards regression models estimated the hazard ratio (HR) of deaths by self-reported levels of gratitude at baseline. These models adjusted for baseline sociodemographic characteristics, social participation, physical health, lifestyle factors, cognitive function, and mental health. Data analysis was conducted from December 2022 to April 2024.
EXPOSURE
Gratitude was assessed with the 6-item Gratitude Questionnaire, a validated and widely used measure of one’s tendency to experience grateful affect.
MAIN OUTCOMES AND MEASURES
Deaths were identified from the National Death Index, state statistics records, reports by next of kin, and the postal system. Causes of death were ascertained by physicians through reviewing death certificates and medical records.
RESULTS
Among the 49,275 participants (all female; mean [SD] age at baseline, 79 [6.16] years), 4,608 incident deaths were identified over 151,496 person-years of follow-up. Greater gratitude at baseline was associated with a lower hazard of mortality in a monotonic fashion. For instance, the highest tertile of gratitude, compared with the lowest tertile, was associated with a lower hazard of all-cause deaths (HR, 0.91; 95% CI, 0.84-0.99) after adjusting for baseline sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function, and mental health. When considering cause-specific deaths, death from cardiovascular disease was inversely associated with gratitude (HR, 0.85; 95% CI, 0.73-0.995).
CONCLUSIONS AND RELEVANCE
This study provides the first empirical evidence suggesting that experiencing grateful affect is associated with increased longevity among older adults. The findings will need to be replicated in future studies with more representative samples.
Several intergovernmental organizations, including the World Health Organization and United Nations, are urging countries to use well-being indicators for policymaking. This trend, coupled with increasing recognition that positive affect is beneficial for health/well-being, opens new avenues for intervening on positive affect to improve outcomes. However, it remains unclear if positive affect in adolescence shapes health/well-being in adulthood. We examined if increases in positive affect during adolescence were associated with better health/well-being in adulthood across 41 outcomes.
Methods and findings
We conducted a longitudinal cohort study using data from Add Health—a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if increases in positive affect over 1 year (between Wave I; 1994 to 1995 and Wave II; 1995 to 1996) were associated with better health/well-being 11.37 years later (in Wave IV; 2008; N = 11,040) or 20.64 years later (in Wave V; 2016 to 2018; N = 9,003). Participants were aged 15.28 years at study onset, and aged 28.17 or 37.20 years—during the final assessment. Participants with the highest (versus lowest) positive affect had better outcomes on 3 (of 13) physical health outcomes (e.g., higher cognition (β = 0·12, 95% CI = 0·05, 0·19, p = 0.002)), 3 (of 9) health behavior outcomes (e.g., lower physical inactivity (RR = 0·80, CI = 0·66, 0·98, p = 0.029)), 6 (of 7) mental health outcomes (e.g., lower anxiety (RR = 0·81, CI = 0·71, 0·93, p = 0.003)), 2 (of 3) psychological well-being (e.g., higher optimism (β = 0·20, 95% CI = 0·12, 0·28, p < 0.001)), 4 (of 7) social outcomes (e.g., lower loneliness (β = −0·09, 95% CI = −0·16, −0·02, p = 0.015)), and 1 (of 2) civic/prosocial outcomes (e.g., more voting (RR = 1·25, 95% CI = 1·16, 1·36, p < 0.001)). Study limitations include potential unmeasured confounding and reverse causality.
Conclusions
Enhanced positive affect during adolescence is linked with a range of improved health/well-being outcomes in adulthood. These findings suggest the promise of testing scalable positive affect interventions and policies to more definitively assess their impact on outcomes.
examining the mechanisms explaining this association remains limited.We evaluated potentially modifiable
mediators, and combinations of mediators, that may underlie the volunteering–mortality association.
Method: We used prospective data from 9,962 participants in the Health and Retirement Study (2006–
2018), a national, diverse, and longitudinal cohort of U.S. adults aged .50. We evaluated associations
between volunteering at baseline (2008/2010), mediators at Wave 2 (2010/2012), and mortality between
Waves 3 and 4 (2010–2016 for Cohort A, 2012–2018 for Cohort B). Results: After adjusting for demographic
confounders and mediators in the prebaselinewave (2006/2008),we observed evidence of mediation
for those who volunteered ≥100 hr/year (vs. 0 hr/year) through combined physical health factors (proportion
mediated [PM]= 49.56%, p =.004) and social factors (PM =90.76%, p= .017) as well as through
increased contact with friends (PM =25.34%, p= .015) and helping friends/neighbors/relatives (PM=
25.12%, p=.018). However, there was less evidence of mediation through other proposed mediators.
Conclusions: With further research, these results inform basic science, interventions, and policies by identifying
potential mechanisms, which might become modifiable features of the volunteering experience, to
promote longevity in our rapidly aging population.
Methods: We conducted a longitudinal study using data from Add Health, a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if an increase in loneliness over 1 year (between Wave I, 1994–1995 and Wave II, 1996) was associated with worse health/well-being outcomes 11.37 years later (in Wave IV, 2008; N = 11,040) or 20.64 years later (in Wave V, 2016–2018; N = 9,003). Participants were aged 15.28 years at study onset and aged 28.17 or 37.20 years during the final assessment.
Results: Participants with the highest (vs. lowest) loneliness had worse outcomes on 4 (of 7) mental health outcomes (e.g., higher likelihood of depression (relative risk = 1.25, confidence interval [CI] = 1.06, 1.49, p = .010)), 3 (of 4) psychological well-being outcomes (e.g., lower optimism [b = −0.12, 95% CI = −0.23, −0.01, p = .030]), 2 (of 7) social outcomes (e.g., lower romantic relationship quality (b = −0.10, 95% CI = −0.19, 0.00, p = .043)), one (of 13) physical health outcomes (e.g., higher likelihood of asthma (relative risk = 1.24, 95% CI = 1.01, 1.53, p = .041)), and 0 (of 9) health behavior outcomes and 0 (of 2) civic/prosocial outcomes.
Discussion: These findings suggest the promise of testing scalable loneliness interventions and policies during adolescence to better determine their impact on various outcomes.
Methods: We used data from 13 771 participants in the Health and Retirement Study, a diverse, national panel study of adults aged >50 years in the United States, to evaluate 62 candidate determinants of exercise participation. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. We used Poisson regression with robust error variance to individually regress exercise in the outcome wave (t2: 2014/2016) on baseline candidate predictors (at t1: 2010/2012) controlling for all covariates in the previous wave (t0: 2006/2008).
Results: Some physical health conditions (eg, physical functioning limitations and lung disease), psychological factors (eg, health mastery, purpose in life, and positive affect), and social factors (eg, helping others, religious service attendance, and volunteering) were robustly associated with increased subsequent exercise. Among factors related to psychological distress, perceived constraints stood out as a factor in reducing exercise.
Conclusions: We identified potentially novel exercise determinants, such as helping friends/neighbors/relatives, religious attendance, and volunteering, that have not been captured using a theory-driven approach. Future studies validating these findings experimentally in midlife and older adults are needed.
an outcome‐wide approach. Across 38 outcomes, perceived neighborhood social cohesion was associated with some: mental health outcomes (i.e., depressive symptoms, suicidal ideation, perceived stress), psychological
well‐being outcomes (i.e., happiness, optimism), social outcomes (i.e., loneliness, romantic relationship quality, satisfaction with parenting), and civic/prosocial outcomes (i.e., volunteering). However, it was not associated with health behaviors nor physical health outcomes.
These results were maintained after robust control for a wide range of potential confounders.
Supporting healthy aging is a US public health priority, and gratitude is a potentially modifiable psychological factor that may enhance health and well-being in older adults. However, the association between gratitude and mortality has not been studied.
OBJECTIVE
To examine the association of gratitude with all-cause and cause-specific mortality in later life.
DESIGN, SETTING, AND PARTICIPANTS
This population-based prospective cohort study used data from self-reported questionnaires and medical records of 49,275 US older female registered nurses who participated in the Nurses’ Health Study (2016 questionnaire wave to December 2019). Cox proportional hazards regression models estimated the hazard ratio (HR) of deaths by self-reported levels of gratitude at baseline. These models adjusted for baseline sociodemographic characteristics, social participation, physical health, lifestyle factors, cognitive function, and mental health. Data analysis was conducted from December 2022 to April 2024.
EXPOSURE
Gratitude was assessed with the 6-item Gratitude Questionnaire, a validated and widely used measure of one’s tendency to experience grateful affect.
MAIN OUTCOMES AND MEASURES
Deaths were identified from the National Death Index, state statistics records, reports by next of kin, and the postal system. Causes of death were ascertained by physicians through reviewing death certificates and medical records.
RESULTS
Among the 49,275 participants (all female; mean [SD] age at baseline, 79 [6.16] years), 4,608 incident deaths were identified over 151,496 person-years of follow-up. Greater gratitude at baseline was associated with a lower hazard of mortality in a monotonic fashion. For instance, the highest tertile of gratitude, compared with the lowest tertile, was associated with a lower hazard of all-cause deaths (HR, 0.91; 95% CI, 0.84-0.99) after adjusting for baseline sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function, and mental health. When considering cause-specific deaths, death from cardiovascular disease was inversely associated with gratitude (HR, 0.85; 95% CI, 0.73-0.995).
CONCLUSIONS AND RELEVANCE
This study provides the first empirical evidence suggesting that experiencing grateful affect is associated with increased longevity among older adults. The findings will need to be replicated in future studies with more representative samples.
Several intergovernmental organizations, including the World Health Organization and United Nations, are urging countries to use well-being indicators for policymaking. This trend, coupled with increasing recognition that positive affect is beneficial for health/well-being, opens new avenues for intervening on positive affect to improve outcomes. However, it remains unclear if positive affect in adolescence shapes health/well-being in adulthood. We examined if increases in positive affect during adolescence were associated with better health/well-being in adulthood across 41 outcomes.
Methods and findings
We conducted a longitudinal cohort study using data from Add Health—a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if increases in positive affect over 1 year (between Wave I; 1994 to 1995 and Wave II; 1995 to 1996) were associated with better health/well-being 11.37 years later (in Wave IV; 2008; N = 11,040) or 20.64 years later (in Wave V; 2016 to 2018; N = 9,003). Participants were aged 15.28 years at study onset, and aged 28.17 or 37.20 years—during the final assessment. Participants with the highest (versus lowest) positive affect had better outcomes on 3 (of 13) physical health outcomes (e.g., higher cognition (β = 0·12, 95% CI = 0·05, 0·19, p = 0.002)), 3 (of 9) health behavior outcomes (e.g., lower physical inactivity (RR = 0·80, CI = 0·66, 0·98, p = 0.029)), 6 (of 7) mental health outcomes (e.g., lower anxiety (RR = 0·81, CI = 0·71, 0·93, p = 0.003)), 2 (of 3) psychological well-being (e.g., higher optimism (β = 0·20, 95% CI = 0·12, 0·28, p < 0.001)), 4 (of 7) social outcomes (e.g., lower loneliness (β = −0·09, 95% CI = −0·16, −0·02, p = 0.015)), and 1 (of 2) civic/prosocial outcomes (e.g., more voting (RR = 1·25, 95% CI = 1·16, 1·36, p < 0.001)). Study limitations include potential unmeasured confounding and reverse causality.
Conclusions
Enhanced positive affect during adolescence is linked with a range of improved health/well-being outcomes in adulthood. These findings suggest the promise of testing scalable positive affect interventions and policies to more definitively assess their impact on outcomes.