Does happiness itself directly affect mortality? The prospective UK Million Women Study

Abstract

SummaryBackgroundPoor health can cause unhappiness and poor health increases mortality. Previous reports of reduced mortality associated with happiness could be due to the increased mortality of people who are unhappy because of their poor health. Also, unhappiness might be associated with lifestyle factors that can affect mortality. We aimed to establish whether, after allowing for the poor health and lifestyle of people who are unhappy, any robust evidence remains that happiness or related subjective measures of wellbeing directly reduce mortality.MethodsThe Million Women Study is a prospective study of UK women recruited between 1996 and 2001 and followed electronically for cause-specific mortality. 3 years after recruitment, the baseline questionnaire for the present report asked women to self-rate their health, happiness, stress, feelings of control, and whether they felt relaxed. The main analyses were of mortality before Jan 1, 2012, from all causes, from ischaemic heart disease, and from cancer in women who did not have heart disease, stroke, chronic obstructive lung disease, or cancer at the time they answered this baseline questionnaire. We used Cox regression, adjusted for baseline self-rated health and lifestyle factors, to calculate mortality rate ratios (RRs) comparing mortality in women who reported being unhappy (ie, happy sometimes, rarely, or never) with those who reported being happy most of the time.FindingsOf 719 671 women in the main analyses (median age 59 years [IQR 55–63]), 39% (282 619) reported being happy most of the time, 44% (315 874) usually happy, and 17% (121 178) unhappy. During 10 years (SD 2) follow-up, 4% (31 531) of participants died. Self-rated poor health at baseline was strongly associated with unhappiness. But after adjustment for self-rated health, treatment for hypertension, diabetes, asthma, arthritis, depression, or anxiety, and several sociodemographic and lifestyle factors (including smoking, deprivation, and body-mass index), unhappiness was not associated with mortality from all causes (adjusted RR for unhappy vs happy most of the time 0·98, 95% CI 0·94–1·01), from ischaemic heart disease (0·97, 0·87–1·10), or from cancer (0·98, 0·93–1·02). Findings were similarly null for related measures such as stress or lack of control.InterpretationIn middle-aged women, poor health can cause unhappiness. After allowing for this association and adjusting for potential confounders, happiness and related measures of wellbeing do not appear to have any direct effect on mortality.FundingUK Medical Research Council, Cancer Research UK.

Depression in midlife women

“…Therefore interpretation of the data can be challenging. The Million Women Study, a prospective study of UK women recruited between 1996 and 2001, demonstrated that poor health can cause unhappiness in middle-aged women, but after adjustment for potential confounders, happiness and other measures of wellbeing did not appear to have any effect on mortality (71). There was some excess mortality when adjusting only for age, but when adjusted for other measures, there was no association for all-cause mortality, ischaemic heart disease, or cancer.…”

Unravelling the associations between social isolation, loneliness, and mortality

“…Although Elovainio and colleagues report that their findings were similar among those with no chronic illnesses self-reported at baseline, further restriction of the analysis to those who rated their health as good would have been important. 4 The substantial attenuation of the risk estimates associated with social isolation after adjusting for various factors suggest that such associations might be due to residual confounding. Socially isolated individuals differ from those not isolated in many important ways, including being more socioeconomically deprived, more likely to smoke, and less likely to partake in physical activity.…”

Association between Psychological Wellbeing and Antiretroviral Therapy Adherence in North-Central, Nigeria

“…This theory offered a holistic and value laden framework to understand the psychological wellbeing of individuals in the society. In understanding psychology of health outcomes, many studies have found association between psychological wellbeing and medication adherence in chronic illnesses [15,20,21,27]. For instance, Bravo, Edwards, Rollnick [10], Andersen, Magidson, O'Cleirigh, Remmert, Kagee et al, [5] and Elwyn, 2010) reported depression, mental illness, poor self-perception as psychological indicators of poor medication adherence in the treatment of cancer patients.…”