Positive Psychological Well-Being and Mortality: A Quantitative Review of Prospective Observational Studies
Abstract
OBJECTIVE: To review systematically prospective, observational, cohort studies of the association between positive well-being and mortality using meta-analytic methods. Recent years have witnessed increased interest in the relationship between positive psychological well-being and physical health. METHODS: We searched general bibliographic databases: Medline, PsycINFO, Web of Science, and PubMed up to January 2008. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. RESULTS: There were 35 studies (26 articles) investigating mortality in initially healthy populations and 35 studies (28 articles) of disease populations. The meta-analyses showed that positive psychological well-being was associated with reduced mortality in both the healthy population (combined hazard ratio (HR) = 0.82; 95% Confidence Interval (CI) = 0.76-0.89; p < .001) and the disease population (combined HR = 0.98; CI = 0.95-1.00; p = .030) studies. There were indications of publication bias in this literature, although the fail-safe numbers were 2444 and 1397 for healthy and disease population studies, respectively. Intriguingly, meta-analysis of studies that controlled for negative affect showed that the protective effects of positive psychological well-being were independent of negative affect. Both positive affect (e.g., emotional well-being, positive mood, joy, happiness, vigor, energy) and positive trait-like dispositions (e.g., life satisfaction, hopefulness, optimism, sense of humor) were associated with reduced mortality in healthy population studies. Positive psychological well-being was significantly associated with reduced cardiovascular mortality in healthy population studies, and with reduced death rates in patients with renal failure and with human immunodeficiency virus-infection. CONCLUSIONS: The current review suggests that positive psychological well-being has a favorable effect on survival in both healthy and diseased populations.
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Subjective well-being can predict important life outcomes such as health, longevity, and disease.
“Lastly, subjective well-being can predict important life outcomes such as health, longevity, and disease (Williams and Schneiderman, 2002; Lyubomirsky et al., 2005; Chida and Steptoe, 2008).”
From The relationship between nature connectedness and happiness: a meta-analysis (2014) · cites this paper as Chida and Steptoe, 2008
Positive emotion is uniquely associated with a lower risk of morbidity and mortality in healthy and chronically ill samples, independent of the effects of negative emotion.
“This work is built upon the importance of positive emotion in the maintenance of psychological and physical well-being [11] and evidence that positive emotion is uniquely associated with a lower risk of morbidity and mortality in healthy and chronically ill samples, independent of the effects of negative emotion [12-15].”
Positive psychological states such as positive affect or optimism are prospectively and independently linked to improvements in health behaviors.
“these constructs have been prospectively and independently linked to improvements in health behaviors.”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [25]
Positive psychological states may play a substantial and independent beneficial role in health outcomes.
“In contrast to negative syndromes, positive psychological states may play a substantial and independent beneficial role in health outcomes.”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [25]
Psychological well-being is associated with lower rates of mortality in both initially healthy and medically ill populations, independent of traditional risk factors.
“A meta-analysis of 26 studies (N > 4000) found that psychological well-being was associated with lower rates of mortality in both initially healthy and medically ill populations, independent of traditional risk factors [25].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [25]
The effects of positive states on health behaviors and outcomes in medical illnesses persist even after accounting for negative affect/depression.
“Furthermore, the effects of positive states on health behaviors and outcomes in medical illnesses persist even after accounting for negative affect/depression [25, 28, 29, 36].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [25]
Well-being constructs are distinct from depression, and their positive effects occur independently of depression and anxiety.
“Collectively termed “well-being constructs,” these indicators are not simply the flip-side of depression [12, 13], and their beneficial effects have been demonstrated independently from the adverse effects of depression and anxiety [14, 15].”
From Well-being interventions for individuals with diabetes: A systematic review (2019) · cites this paper as [14]
Positive mental health or mental well-being has recently emerged as an important predictor of overall health and longevity.
“Positive mental health or mental well-being has recently emerged as an important predictor of overall health and longevity.12–14”
From Major health-related behaviours and mental well-being in the general population: the Health Survey for England (2014) · cites this paper as [13]
Evidence suggests that well-being is connected to health care utilization, psychosocial adaptation and functioning, and work productivity.
“Evidence suggests that well-being is clearly connected to health care utilization, psychosocial adaptation and functioning, and work productivity (Chida and Steptoe, 2008, Keyes, 2004, Keyes and Grzywacz, 2005)”
From The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention (2018) · cites this paper as Chida and Steptoe, 2008
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The Prediction of Mortality in Elderly Institution Residents
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Subjective wellbeing, health, and ageing
Steptoe, A., Deaton, A., & Stone, A. A. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61489-0 · Cited by 2,538 · see citing works
Self-citationHappy People Live Longer: Subjective Well‐Being Contributes to Health and Longevity
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Flourishing Across Europe: Application of a New Conceptual Framework for Defining Well-Being
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On the promotion of human flourishing
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The relationship between nature connectedness and happiness: a meta-analysis
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“Lastly, subjective well-being can predict important life outcomes such as health, longevity, and disease (Williams and Schneiderman, 2002; Lyubomirsky et al., 2005; Chida and Steptoe, 2008).”
BackgroundHandbook of Religion and Health
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · doi:10.1093/oso/9780190088859.001.0001 · Cited by 1,150 · see citing works
Advances and Open Questions in the Science of Subjective Well-Being
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Cortisol awakening response and psychosocial factors: a systematic review and meta-analysis
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Optimism and Physical Health: A Meta-analytic Review
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Happy People Live Longer: Subjective Well-Being Contributes to Health and Longevity
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If, Why, and When Subjective Well‐Being Influences Health, and Future Needed Research
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New findings and future directions for subjective well-being research.
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Entrepreneurship and well-being: Past, present, and future
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Findings All Psychologists Should Know From the New Science on Subjective Well-Being
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Effectiveness of positive psychology interventions: a systematic review and meta-analysis
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Personality, Well-Being, and Health*
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Self-citationPositive Affect and Psychobiological Processes Relevant to Health
Steptoe, A., Dockray, S., & Wardle, J. (2009) · Journal of Personality · doi:10.1111/j.1467-6494.2009.00599.x · Cited by 520 · see citing works
Self-citationA functional genomic perspective on human well-being
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Psychological Language on Twitter Predicts County-Level Heart Disease Mortality
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Positive Affect and Health: What Do We Know and Where Next Should We Go?
Pressman, S. D., Jenkins, B. N., & Moskowitz, J. T. (2019) · Annual Review of Psychology · doi:10.1146/annurev-psych-010418-102955 · Cited by 452 · see citing works
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Religiosity/Spirituality and Mortality
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Self-citationThe influence of subjective aging on health and longevity: a meta-analysis of longitudinal data
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Self-rated health is associated with subsequent functional decline among older adults in Japan
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To Flourish or Not: Positive Mental Health and All-Cause Mortality
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Measures of self-perceived well-being
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A three-dimensional taxonomy of achievement emotions.
Pekrun, R. H., Marsh, H. W., Elliot, A. J., Stockinger, K., Perry, R. P., Vogl, E., Goetz, T., van Tilburg, W. A. P., Lüdtke, O., & Vispoel, W. P. (2022) · Journal of Personality and Social Psychology · doi:10.1037/pspp0000448 · Cited by 344 · see citing works
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Workplace happiness: work engagement, career satisfaction, and subjective well-being
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Psychological consequences of COVID-19 home confinement: The ECLB-COVID19 multicenter study
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Emotional Well-Being: What It Is and Why It Matters
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Using wellbeing for public policy: Theory, measurement, and recommendations
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Positive Psychology in Cancer Care: Bad Science, Exaggerated Claims, and Unproven Medicine
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Positive affect and psychobiological processes
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Self-citationPsychological Well-Being and Physical Health: Associations, Mechanisms, and Future Directions
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“…research indicating that constructs such as optimism, positive affect, life satisfaction, and happiness are associated with longer life, independent of the effect of negative constructs (Chida & Steptoe, 2008; Diener & Chan, 2011; Howell, Kern, & Lyubomirsky, 2007; Pressman & Cohen, 2005).”
BackgroundDoes happiness itself directly affect mortality? The prospective UK Million Women Study
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Eudaimonic and Hedonic Well-Being
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Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults
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Clinimetrics: the science of clinical measurements
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The self in context: brain systems linking mental and physical health
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Randomized controlled trial of a positive affect intervention for people newly diagnosed with HIV.
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Loneliness, eudaimonia, and the human conserved transcriptional response to adversity
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Expanding the Paradigm of Occupational Safety and Health
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Optimism is associated with exceptional longevity in 2 epidemiologic cohorts of men and women
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Self-citationEmotional Reactivity and Mortality: Longitudinal Findings From the VA Normative Aging Study
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Positive affect measured using ecological momentary assessment and survival in older men and women
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Self-citationSelf-Reported and Objectively Measured Activity Related to Biomarkers Using NHANES
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Positive affect and sleep: A systematic review
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Self-citationForgive to Live: Forgiveness, Health, and Longevity
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A route to well-being: Intelligence versus wise reasoning.
Grossmann, I., Na, J., Varnum, M. E. W., Kitayama, S., & Nisbett, R. E. (2012) · Journal of Experimental Psychology General · doi:10.1037/a0029560 · Cited by 171 · see citing works
Considerations for Incorporating “Well-Being” in Public Policy for Workers and Workplaces
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Resilience in chronic diseases: A systematic review
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Resilience: Promoting Well-Being Through Recovery, Sustainability, and Growth
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Why People Are in a Generally Good Mood
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Age-Friendly Communities Initiative: Public Health Approach to Promoting Successful Aging
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The impact of a brief gratitude intervention on subjective well-being, biology and sleep
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Assessing Psychological Well-Being: Self-Report Instruments for the NIH Toolbox
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- Authors
- Chida, Y., & Steptoe, A.
- Affiliations
- University College London (GB)
- Corresponding author
- Chida, Yoichi
- ORCID
- Steptoe, Andrew
- Venue
- Psychosomatic Medicine
- Published
- 2008-09
- Volume
- 70
- Issue
- 7
- Pages
- 741-756
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2071627530
- Cited by
- 1,592
- References
- 97
- Citations by year
- 2026: 44 · 2025: 80 · 2024: 76 · 2023: 119 · 2022: 87 · 2021: 90 · 2020: 272 · 2019: 91 · 2018: 106 · 2017: 91 · 2016: 105 · 2015: 80 · 2014: 83 · 2013: 68 · 2012: 68
- FWCI
- 5.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- British Heart Foundation
- Topics
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Keywords
- positive psychological well-being, mortality, positive affect, life satisfaction, optimism, hope, vigor, cardiovascular mortality, renal failure, HIV infection, negative affect
- MeSH terms
- Adaptation, Psychological, Cardiovascular Diseases, Emotions, Female, Health Status, Humans, Male, Mental Health, Mortality, Neoplasms, Personal Satisfaction, Prospective Studies, Self Concept, Meta-Analysis as Topic, Cohort Studies, HIV Infections
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