Inequalities in Life Expectancy and All-Cause Mortality in the United States by Levels of Happiness and Life Satisfaction: A Longitudinal Study
Background: Despite having one of the highest Gross Domestic Product (GDP) per capita levels, United States (US) ranks lower in subjective well-being, including happiness and life satisfaction, compared with European countries. Studies of the impact of happiness and life satisfaction on life expecta...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Global Health and Education Projects, Inc.
2020-07-01
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| Series: | International Journal of Maternal and Child Health and AIDS |
| Online Access: | https://www.mchandaids.org/index.php/IJMA/article/view/392 |
| _version_ | 1818975216550805504 |
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| author | Hyunjung Lee, PhD, MPP, MBA Gopal K. Singh, PhD, MS, MSc |
| author_facet | Hyunjung Lee, PhD, MPP, MBA Gopal K. Singh, PhD, MS, MSc |
| author_sort | Hyunjung Lee, PhD, MPP, MBA |
| collection | DOAJ |
| description | Background: Despite having one of the highest Gross Domestic Product (GDP) per capita levels, United States (US) ranks lower in subjective well-being, including happiness and life satisfaction, compared with European countries. Studies of the impact of happiness and life satisfaction on life expectancy and mortality in the US are limited or non-existent. Using a national longitudinal dataset, we examined the association between levels of happiness/life satisfaction and US life expectancy and all-cause mortality.
Methods: We analyzed the 2001 National Health Interview Survey (NHIS) prospectively linked to 2001-2014 mortality records in the National Death Index (NDI) (N=30,377). Cox proportional hazards regression was used to model survival time as a function of happiness, life satisfaction, and sociodemographic and behavioral covariates.
Results: Life expectancies at age 18 among adults with high levels of happiness and life satisfaction were, respectively, 7.5 and 8.9 years higher compared to those with low levels of happiness and life satisfaction. In Cox models with 14 years of mortality follow-up, all-cause mortality risk was 82% higher (hazard ratio [HR]=1.82; 95% CI=1.59,2.08) in adults with little or no happiness, controlling for age, and 36% higher (HR=1.36; 95% CI=1.17,1.57) in adults with little/no happiness, controlling for sociodemographic, behavioral and health characteristics, when compared with adults reporting happiness all of the time. Mortality risk was 107% higher (HR=2.07; 95% CI=1.80,2.38) in adults who were very dissatisfied with their life, controlling for age, and 39% higher (HR=1.39; 95% CI=1.20,1.60) in adults who were very dissatisfied, controlling for all covariates, when compared with adults who were very satisfied.
Conclusions and Global Health Implications: Adults with higher happiness and life satisfaction levels had significantly higher life expectancy and lower all-cause mortality risks than those with lower happiness and satisfaction levels. These findings underscore the significance of addressing subjective well-being in the population as a strategy for reducing all-cause mortality.
Key words: • Inequalities • Disparities • Happiness • Life satisfaction • Life expectancy • Mortality • Longitudinal • Social determinants
Copyright © 2020 Lee and Singh. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited. |
| first_indexed | 2024-12-20T15:52:26Z |
| format | Article |
| id | doaj.art-15ea53d2efe74a2baf09b0ce0da70ce3 |
| institution | Directory Open Access Journal |
| issn | 2161-8674 2161-864X |
| language | English |
| last_indexed | 2024-12-20T15:52:26Z |
| publishDate | 2020-07-01 |
| publisher | Global Health and Education Projects, Inc. |
| record_format | Article |
| series | International Journal of Maternal and Child Health and AIDS |
| spelling | doaj.art-15ea53d2efe74a2baf09b0ce0da70ce32022-12-21T19:34:37ZengGlobal Health and Education Projects, Inc.International Journal of Maternal and Child Health and AIDS2161-86742161-864X2020-07-019310.21106/ijma.392Inequalities in Life Expectancy and All-Cause Mortality in the United States by Levels of Happiness and Life Satisfaction: A Longitudinal StudyHyunjung Lee, PhD, MPP, MBA0Gopal K. Singh, PhD, MS, MSc1Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37831, USAUS Department of Health and Human Services, Health Resources and Services Administration, Office of Health Equity, 5600 Fishers Lane, Rockville, MD 20857, USABackground: Despite having one of the highest Gross Domestic Product (GDP) per capita levels, United States (US) ranks lower in subjective well-being, including happiness and life satisfaction, compared with European countries. Studies of the impact of happiness and life satisfaction on life expectancy and mortality in the US are limited or non-existent. Using a national longitudinal dataset, we examined the association between levels of happiness/life satisfaction and US life expectancy and all-cause mortality. Methods: We analyzed the 2001 National Health Interview Survey (NHIS) prospectively linked to 2001-2014 mortality records in the National Death Index (NDI) (N=30,377). Cox proportional hazards regression was used to model survival time as a function of happiness, life satisfaction, and sociodemographic and behavioral covariates. Results: Life expectancies at age 18 among adults with high levels of happiness and life satisfaction were, respectively, 7.5 and 8.9 years higher compared to those with low levels of happiness and life satisfaction. In Cox models with 14 years of mortality follow-up, all-cause mortality risk was 82% higher (hazard ratio [HR]=1.82; 95% CI=1.59,2.08) in adults with little or no happiness, controlling for age, and 36% higher (HR=1.36; 95% CI=1.17,1.57) in adults with little/no happiness, controlling for sociodemographic, behavioral and health characteristics, when compared with adults reporting happiness all of the time. Mortality risk was 107% higher (HR=2.07; 95% CI=1.80,2.38) in adults who were very dissatisfied with their life, controlling for age, and 39% higher (HR=1.39; 95% CI=1.20,1.60) in adults who were very dissatisfied, controlling for all covariates, when compared with adults who were very satisfied. Conclusions and Global Health Implications: Adults with higher happiness and life satisfaction levels had significantly higher life expectancy and lower all-cause mortality risks than those with lower happiness and satisfaction levels. These findings underscore the significance of addressing subjective well-being in the population as a strategy for reducing all-cause mortality. Key words: • Inequalities • Disparities • Happiness • Life satisfaction • Life expectancy • Mortality • Longitudinal • Social determinants Copyright © 2020 Lee and Singh. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.https://www.mchandaids.org/index.php/IJMA/article/view/392 |
| spellingShingle | Hyunjung Lee, PhD, MPP, MBA Gopal K. Singh, PhD, MS, MSc Inequalities in Life Expectancy and All-Cause Mortality in the United States by Levels of Happiness and Life Satisfaction: A Longitudinal Study International Journal of Maternal and Child Health and AIDS |
| title | Inequalities in Life Expectancy and All-Cause Mortality in the United States by Levels of Happiness and Life Satisfaction: A Longitudinal Study |
| title_full | Inequalities in Life Expectancy and All-Cause Mortality in the United States by Levels of Happiness and Life Satisfaction: A Longitudinal Study |
| title_fullStr | Inequalities in Life Expectancy and All-Cause Mortality in the United States by Levels of Happiness and Life Satisfaction: A Longitudinal Study |
| title_full_unstemmed | Inequalities in Life Expectancy and All-Cause Mortality in the United States by Levels of Happiness and Life Satisfaction: A Longitudinal Study |
| title_short | Inequalities in Life Expectancy and All-Cause Mortality in the United States by Levels of Happiness and Life Satisfaction: A Longitudinal Study |
| title_sort | inequalities in life expectancy and all cause mortality in the united states by levels of happiness and life satisfaction a longitudinal study |
| url | https://www.mchandaids.org/index.php/IJMA/article/view/392 |
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