Prospective associations between strengths of moral character and health: longitudinal evidence from survey and insurance claims data

Abstract

Purpose Excellent character, reflected in adherence to high standards of moral behavior, has been argued to contribute to well-being. The study goes beyond this claim and provides insights into the role of strengths of moral character (SMC) for physical and mental health. Methods This study used longitudinal observational data merged with medical insurance claims data collected from 1209 working adults of a large services organization in the US. Self-reported physical and mental health as well as diagnostic information on depression, anxiety, and cardiovascular disease were used as outcomes. The prospective associations between SMC (7 indicators and a composite measure) and physical and mental health outcomes were examined using lagged linear and logistic regression models. A series of sensitivity analyses provided evidence for the robustness of results. Results The results suggest that persons who live their life according to high moral standards have substantially lower odds of depression (by 21–51%). The results were also indicative of positive associations between SMC and self-reports of mental health (β = 0.048–0.118) and physical health (β = 0.048–0.096). Weaker indications were found for a protective role of SMC in mitigating anxiety (OR = 0.797 for the indicator of delayed gratification) and cardiovascular disease (OR = 0.389 for the indicator of use of SMC for helping others). Conclusions SMC may be considered relevant for population mental health and physical health. Public health policies promoting SMC are likely to receive positive reception from the general public because character is both malleable and aligned with the nearly universal human desire to become a better person.

Vitality Revisited: The Evolving Concept of Flourishing and Its Relevance to Personal and Public Health

“…In a recent longitudinal study, an orientation to promote good (consistent thoughts and taking actions that contribute to the good of oneself and others) was positively associated with multiple measures of well-being—including the subsequent life satisfaction and happiness, self-assessed mental health and physical health, social connectedness, and purpose, and meaning in life, as well as a lower risk of anxiety, loneliness, and depression [ 94 ]. These results are supported by separate longitudinal and multinational cross-sectional studies linking character strengths with health and overall quality of life [ 95 , 96 ].…”

Associations of orientation to promote good in challenging situations with distress and well‐being: Multi‐study evidence from three non‐Western Longitudinal samples

“…Our results also indicate the protective role of orientation to promote good against anxiety, consistent with prior evidence that suggested a prospective association with self-assessed anxiety and depression and diagnosed depression but not with diagnosed anxiety at a 1-year follow-up in an American sample (Weziak-Bialowolska, Bialowolski, VanderWeele, et al, 2021;Weziak-Bialowolska, Lee, et al, 2023). However, in this prior work, only two waves of longitudinal data were used, and it is possible that concerns about reverse causality were more adequately addressed with the three waves of data used in this study.…”

“…Although we recognize that multi-item measures are typically recommended for character and personality assessments, a single item was used because the surveys in each study were extensive and time-consuming for participants to complete. Nevertheless, a similar approach was applied in prior studies and has proved to be useful in providing evidence on the role of an orientation to promote good in the Western context (Weziak-Bialowolska, Bialowolski, VanderWeele, et al, 2021 ;Weziak-Bialowolska, Lee, et al, 2023).…”

Associations between the Importance of Well-Being Domains and the Subsequent Experience of Well-Being

“…The measure has good psychometric properties, including evidence of construct validity, convergent and discriminant validity, and test-retest reliability, as well as satisfactory internal consistency for domain-specific and overall scores [5]. The utility of the overall measure and separate sub-scales has also been demonstrated in several recent studies of well-being [14,16,26].…”

“…The role of character strengths seems especially relevant for other domains of well-being. In particular, recent research found that it predicts future emotional health, physical health, social connectedness, and meaning and purpose [14][15][16][17]. What remains uncertain is whether valuing character strengths serves as a determinant of these other well-being domains.…”