A paradigm shift in public health and medicine has broadened the field from a singular focus on the ill effects of negative states and psychopathology to an expanded view that examines protective psychological assets that may promote improved physical health and longevity. We summarize recent evidence of the link between psychological well-being (including positive affect, optimism, life meaning and purpose, and life satisfaction) and physical health, with particular attention to outcomes of mortality and chronic disease incidence and progression. Within this evolving discipline there remain controversies and lessons to be learned. We discuss measurement-related challenges, concerns about the quality of the evidence, and other shortcomings in the field, along with a brief discussion of hypothesized biobehavioral mechanisms involved. Finally, we suggest next steps to move the field forward.

Given the well-documented deleterious health effects, poor sleep has become a serious public health concern and increasing efforts are directed towards understanding underlying pathways. One potential mechanism may be stress and its biological correlates; however, studies investigating the effects of poor sleep on a body’s capacity to deal with challenges are lacking. The current study thus aimed at testing the effects of sleep quality and sleep quantity on cortisol responses to acute psychosocial stress. A total of 73 college-aged adults (44 females) were investigated. Self-reported sleep behavior was assessed via the Pittsburgh Sleep Quality Index and salivary cortisol responses to the Trier Social Stress Test (TSST) were measured. In terms of sleep quality, we found a significant three-way interaction, such that relative to bad sleep quality, men who reported fairly good or very good sleep quality showed blunted or exaggerated cortisol responses, respectively, while women’s stress responses were less dependent on their self-reported sleep quality. Contrarily, average sleep duration did not appear to impact cortisol stress responses. Lastly, participants who reported daytime dysfunctions (i.e., having trouble staying awake or keeping up enthusiasm) also showed a trend to blunted cortisol stress responses compared to participants who did not experience these types of daytime dysfunctions. Overall, the current study suggests gender-specific stress reactivity dysfunctions as one mechanism linking poor sleep with detrimental physical health outcomes. Furthermore, the observed differential sleep effects may indicate that while the body may be unable to maintain normal HPA functioning in an acute psychosocial stress situation after falling prey to low sleep quality, it may retain capacities to deal with challenges during extended times of sleep deprivation.

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The following study assessed whether future orientation and self-esteem mediated the relationship between family stress and mental health problems among African American youth. Data from this study included 638 African American adolescents purposively sampled from predominantly lowincome neighborhoods. Major variables assessed were family stress, self-esteem, future orientation, mental health, and covariates (i.e., gender, sexual orientation, and socioeconomic proxy). Structural equation modeling computed direct and indirect (meditational) relationships between family stress and youth mental health. The average age of participants was 15.83 years old, slightly half of whom were female. The path model detected a significant relationship between family stress and mental health problems. Self-esteem and future orientation had a significant mediation effect on the relationship between family stress and mental health problems. Overall findings underscore the importance of strengthening resilience factors for African American youth, especially those who live in low-income communities. Public Policy Relevance StatementYouth from low resourced communities are confronted by structural disadvantage often resulting in them residing in households where there are high rates of adult substance use, incarceration, and mental health problems. While African American youth are overrepresented in many of these stressful households, the majority of research targeting these youth have adopted a deficit versus resiliency-based paradigm. This study findings document in even in the presence of contextual and family stressors protective factors can correlate with better behavioral and mental health. Policymakers are, therefore, required to direct resources and promote programs that support the development of self-esteem and future orientation especially in the presence of harsh social contexts. When adults face significant life stressors, their adolescent children are at greater risk of poor mental health (

Objectives: Age is the most common predictor of hearing loss; however, many older adults are not screened. Hearing screening could improve healthcare access, participation, and outcomes. Establishing whether hearing screening in older adults is cost-effective could improve the availability and utilization of screening. Methods: We searched nine databases in January 2020. Studies with populations aged 50+ and provided data on the cost-effectiveness of hearing screening were included in the review. Results: Five studies met the inclusion criteria and all found hearing screening programs to be cost-effective compared to no hearing screening, regardless of screening method (i.e., instrument or strategy). The maximum number of repeated screenings, coupled with younger ages, was most cost-effective. Discussion: This review suggests that hearing screening in older adults is cost-effective, however, the evidence is limited. There is pressing need for research focused on economic impacts of hearing healthcare in older adults to inform research, policy and practice.