The Health Benefits of Happiness
Exploring the link between positive affect and health.
Posted Oct 04, 2019
When it comes to living a good life, being healthy and happy are at the top of most wish lists. While there are countless ways toward health and happiness, there is growing interest in how these paths converge. Can positive emotions contribute to physical well-being? Research exploring this question has produced promising findings. Joy, it appears, has many health benefits – from lower blood pressure to a longer life.
A recent review (Pressman et al, 2019) examined the mechanisms linking health and happiness and how researchers go about studying their mutual influence.
Measuring Positive Affect and Health
Positive affect (PA) refers to the experience of positive emotions, ranging from high arousal emotions (happiness, excitement) to low arousal emotions (calm, contentment).
When assessing PA in their studies, researchers rely on a variety of methods. Among the most commonly used tools are self-report questionnaires that include multiple adjective scales describing various emotional states. Participants are usually asked to indicate how much they experience these emotions over a period of time – whether in the current moment, during the past week, or in general, as a trait. Depending on the time frame, positive emotions can have different implications for health outcomes. For example, in-the-moment, transient affective states can spur health behaviors and impact current physiological (e.g. cardiovascular and endocrine) states. On the other hand, long-term trait affects can predict more distant health outcomes such as mortality.
Other studies have explored the use of language to assess the link between positive affect and health. Findings from these studies show that high numbers of positive emotion words used in autobiographies were associated with increased longevity of the writer, while the use of PA in Twitter feeds correlated with lower cardiovascular disease.
Another measure of positive affect is smiling. In one study, naturally occurring Duchenne smiles, which have the same neurological pattern in the brain as PA, were shown to speed cardiovascular recovery after stress and were associated with a lower risk of coronary heart disease over 10 years.
Operationalizing health has its own complexities, in part due to there being no one single biological marker of health. Thus, researchers often consider various disease relevant outcomes, morbidity as well as mortality to explore the effects of emotions on health. Meanwhile, changes in physiology, such as a decrease in stress hormones or an increase in immune function, are often considered as a “possible pathway to health.”
Health Outcomes of PA
To study the link between PA and morbidity, researchers often recruit healthy participants and follow up with them over time to see how their emotional experiences are associated with future occurrence of various diseases or injury. Among the most frequently studied outcomes is the effect of emotions on cardiovascular health. For example, when it comes to the heart, studies have shown that more PA is associated with reduced risk of stroke, less readmissions to the hospital of older patients after cardiovascular issues and increased survival of patients with heart disease.
PA can also influence the progression of various cold and flu viruses. For instance, studies reveal that participants who reported lower levels of PA before being exposed to a respiratory virus showed more signs of illness, while those who reported higher PA had more resistance to the virus.
PA can even be predictive of physical function and future injury, with higher PA associated with reduced risk of frailty in older adults and reduced risk of injury in younger participants. Moreover, patients with chronic pain conditions such as rheumatoid arthritis who experience higher PA in their day-to-day lives report less symptoms of pain.
Models of PA and Health
One of the models explaining how PA influences health is the Main Effect Model of PA and Health. According to this model, PA has downstream positive effects on health through various pathways. These pathways include positive health behaviors (for example, physical activity, a nutritious diet, sleep and medication adherence), protective physiological changes (for example, reduced inflammation and faster healing, better cardiovascular function and lower cortisol levels), and social, psychological and physical resources (for example, supportive social relationships, integration, coping resources, as well as sociodemographic factors like education achievement, promotions, financial success.)
Another model – the Stress Buffering Model – claims that the health-boosting merits of PA stem from the ability of positive emotional experiences to decrease stress, and with it, its harmful effects on the body. For instance, PA has been shown to reduce reactivity to stress, improve recovery from stress and impact coping mechanisms. Furthermore, PA can not only influence stress-related physiology and behaviors, but also, as a more direct effect, decrease stress.
Be Happier, Be Healthier?
Can increasing positive emotions in our lives make us healthier? After all, plenty of studies have shown that positive psychology interventions which generate PA – including practicing gratitude and kindness, savoring positive events, engaging in mindfulness – can increase psychological well-being. As the authors of the review conclude, more long-term studies are needed with diverse populations and methodologies to create effective interventions that will improve health outcomes. For patients with chronic illnesses, for instance, the interventions must take into account the stages of the disease, the context, the kind of PA, and the patient’s psychological needs. In the meantime, however, we can take heart in the promising findings of the current research: A steady and varied diet of positive emotional experiences can be a key contributor to a healthy life.
Diener, E., & Chan, M. Y. (2011). Happy people live longer: Subjective well‐being contributes to health and longevity. Applied Psychology: Health and Well‐Being, 3(1), 1-43.
Pressman, S. D., Jenkins, B. N., & Moskowitz, J. T. (2019). Positive affect and health: what do we know and where next should we go? Annual Review of Psychology, 70, 627-650.
Pressman, S. D., & Cohen, S. (2012). Positive emotion word use and longevity in famous deceased psychologists. Health Psychology, 31(3), 297.
DuBois, C. M., Lopez, O. V., Beale, E. E., Healy, B. C., Boehm, J. K., & Huffman, J. C. (2015). Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: a systematic review. International Journal of Cardiology, 195, 265-280.
Eichstaedt, J. C., Schwartz, H. A., Kern, M. L., Park, G., Labarthe, D. R., Merchant, R. M., ... & Weeg, C. (2015). Psychological language on Twitter predicts county-level heart disease mortality. Psychological Science, 26(2), 159-169.
Ekman, P., & Davidson, R. J. (1993). Voluntary smiling changes regional brain activity. Psychological Science, 4(5), 342-345.
Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56(3), 218.
Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health, 13(1), 119.
Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science & Medicine, 45(8), 1207-1221.
Fredrickson, B., & Levenson, R. W. (1998). Positive emotions speed recovery from the cardiovascular sequelae of negative emotions. Cognition & Emotion, 12(2), 191-220.
Davidson, K. W., Mostofsky, E., & Whang, W. (2010). Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: the Canadian Nova Scotia Health Survey. European Heart Journal, 31(9), 1065-1070.
Ostir, G. V., Markides, K. S., Peek, M. K., & Goodwin, J. S. (2001). The association between emotional well-being and the incidence of stroke in older adults. Psychosomatic Medicine, 63(2), 210-215.
Middleton, R. A., & Byrd, E. K. (1996). Psychosocial factors and hospital readmission status of older persons with cardiovascular disease. Journal of Applied Rehabilitation Counseling, 27(4), 3-10.
Doyle, W. J., Gentile, D. A., & Cohen, S. (2006). Emotional style, nasal cytokines, and illness expression after experimental rhinovirus exposure. Brain, Behavior, and Immunity, 20(2), 175-181.
Park‐Lee, E., Fredman, L., Hochberg, M., & Faulkner, K. (2009). Positive affect and incidence of frailty in elderly women caregivers and noncaregivers: Results of Caregiver–Study of Osteoporotic Fractures. Journal of the American Geriatrics Society, 57(4), 627-633.
Koivumaa-Honkanen, H., Honkanen, R., Viinamäki, H., Heikkilä, K., Kaprio, J., & Koskenvuo, M. (2000). Self-reported life satisfaction and 20-year mortality in healthy Finnish adults. American Journal of Epidemiology, 152(10), 983-991.
Strand, E. B., Kerns, R. D., Christie, A., Haavik-Nilsen, K., Klokkerud, M., & Finset, A. (2007). Higher levels of pain readiness to change and more positive affect reduce pain reports–a weekly assessment study on arthritis patients. Pain, 127(3), 204-213.
Pressman, S. D., & Cohen, S. (2005). Does positive affect influence health? Psychological Bulletin, 131(6), 925.
Blanchflower, D. G., & Oswald, A. J. (2008). Hypertension and happiness across nations. Journal of Health Economics, 27(2), 218-233.