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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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“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
In the citing paper
“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].”
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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Cited by
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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
Self-citationHappy People Live Longer: Subjective Well‐Being Contributes to Health and Longevity
Diener, E., & Chan, M. Y. (2011) · Applied Psychology: Health and Well-Being · doi:10.1111/j.1758-0854.2010.01045.x · Cited by 2,260
Flourishing Across Europe: Application of a New Conceptual Framework for Defining Well-Being
Huppert, F. A., & So, T. T. C. (2013) · Social Indicators Research · doi:10.1007/s11205-011-9966-7 · Cited by 1,864
On the promotion of human flourishing
VanderWeele, T. J. (2017) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1702996114 · Cited by 1,387
The relationship between nature connectedness and happiness: a meta-analysis
Capaldi, C. A., Dopko, R. L., & Zelenski, J. M. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00976 · Cited by 1,183
“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).”
Background
Metadata
- 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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