Optimism and Cause-Specific Mortality: A Prospective Cohort Study
Open accessAbstract
Growing evidence has linked positive psychological attributes like optimism to a lower risk of poor health outcomes, especially cardiovascular disease. It has been demonstrated in randomized trials that optimism can be learned. If associations between optimism and broader health outcomes are established, it may lead to novel interventions that improve public health and longevity. In the present study, we evaluated the association between optimism and cause-specific mortality in women after considering the role of potential confounding (sociodemographic characteristics, depression) and intermediary (health behaviors, health conditions) variables. We used prospective data from the Nurses' Health Study (n = 70,021). Dispositional optimism was measured in 2004; all-cause and cause-specific mortality rates were assessed from 2006 to 2012. Using Cox proportional hazard models, we found that a higher degree of optimism was associated with a lower mortality risk. After adjustment for sociodemographic confounders, compared with women in the lowest quartile of optimism, women in the highest quartile had a hazard ratio of 0.71 (95% confidence interval: 0.66, 0.76) for all-cause mortality. Adding health behaviors, health conditions, and depression attenuated but did not eliminate the associations (hazard ratio = 0.91, 95% confidence interval: 0.85, 0.97). Associations were maintained for various causes of death, including cancer, heart disease, stroke, respiratory disease, and infection. Given that optimism was associated with numerous causes of mortality, it may provide a valuable target for new research on strategies to improve health.
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An optimistic frame of mind is associated with healthy aging and a lower risk of CVD, including stroke and heart failure, and a lower risk of all-cause mortality.
“An optimistic frame of mind has been shown to be associated with healthy aging 60 and a lower risk of CVD, 61 including stroke 62 and heart failure, 63 and a lower risk of all-cause mortality. 64”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [64]
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- Authors
- Kim, E. S., Hagan, K. A., Grodstein, F., DeMeo, D. L., De Vivo, I., & Kubzansky, L. D.
- Affiliations
- Harvard University (US)
- Corresponding author
- Kim, Eric S.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-12-07
- Volume
- 185
- Issue
- 1
- Pages
- 21-29
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC5209589
- OpenAlex
- W2560546734
- Cited by
- 200
- References
- 14
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 16 · 2023: 21 · 2022: 36 · 2021: 26 · 2020: 21 · 2019: 32 · 2018: 20 · 2017: 10
- FWCI
- 31.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institutes of Health (P01 CA87969, UM1 CA186107, T32 HL 098048)
- Topics
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- optimism, dispositional optimism, cause-specific mortality, all-cause mortality, women, Nurses' Health Study, depression, health behavior, health conditions, cancer mortality, cardiovascular mortality, stroke, respiratory mortality, infection-related mortality, longevity
- MeSH terms
- Optimism, Aged, Cause of Death, Death Certificates, Depression, Female, Humans, Longitudinal Studies, Middle Aged, Socioeconomic Factors, United States, Health Behavior, Proportional Hazards Models, Women's Health, Resilience, Psychological
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