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March 2021 (Volume 99)
Quarterly Article
Eric S. Kim
Scott W. Delaney
Louis Tay
Ying Chen
Ed Diener
Tyler J. Vanderweele
March 2024
Feb 27, 2024
Jan 22, 2024
Back to The Milbank Quarterly
Policy Points:
Context: Several intergovernmental organizations (Organisation for Economic Co-operation and Development, World Health Organization, United Nations) are urging countries to use well-being indicators (e.g., life satisfaction) in addition to traditional economic indicators when making important policy decisions. As the number of governments implementing this new approach grows, so does the need to continue evaluating the health and well-being outcomes we might observe from policies aimed at improving life satisfaction.
Methods: We evaluated whether positive change in life satisfaction (between t0;2006/2008 and t1;2010/2012) was associated with better outcomes on 35 indicators of physical, behavioral, and psychosocial health and well-being (in t2;2014/2016). Data were from 12,998 participants in the University of Michigan’s Health and Retirement Study—a prospective and nationally representative cohort of US adults over age 50.
Findings: Participants with the highest (versus lowest) life satisfaction had better subsequent outcomes on some physical health indicators (lower risk of pain, physical functioning limitations, and mortality; lower number of chronic conditions; and higher self-rated health) and health behaviors (lower risk of sleep problems and more frequent physical activity), and nearly all psychosocial indicators (higher positive affect, optimism, purpose in life, mastery, health mastery, financial mastery, and likelihood of living with spouse/partner; and lower depression, depressive symptoms, hopelessness, negative affect, perceived constraints, and loneliness) over the 4-year follow-up period. However, life satisfaction was not subsequently associated with many specific health conditions (i.e., diabetes, hypertension, stroke, cancer, heart disease, lung disease, arthritis, overweight/obesity, or cognitive impairment), other health behaviors (i.e., binge drinking or smoking), or frequency of contact with children, family, or friends.
Conclusions: These results suggest that life satisfaction is a valuable target for policies aiming to enhance several indicators of psychosocial well-being, health behaviors, and physical health outcomes.
Key words: life satisfaction, psychological well-being, outcome-wide epidemiology, public health.
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