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Does happiness itself directly affect mortality? The prospective UK Million Women Study

BACKGROUND: Poor health can cause unhappiness and poor health increases mortality. Previous reports of reduced mortality associated with happiness could be due to the increased mortality of people who are unhappy because of their poor health. Also, unhappiness might be associated with lifestyle fact...

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Autores principales: Liu, Bette, Floud, Sarah, Pirie, Kirstin, Green, Jane, Peto, Richard, Beral, Valerie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075047/
https://www.ncbi.nlm.nih.gov/pubmed/26684609
http://dx.doi.org/10.1016/S0140-6736(15)01087-9
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author Liu, Bette
Floud, Sarah
Pirie, Kirstin
Green, Jane
Peto, Richard
Beral, Valerie
author_facet Liu, Bette
Floud, Sarah
Pirie, Kirstin
Green, Jane
Peto, Richard
Beral, Valerie
author_sort Liu, Bette
collection PubMed
description BACKGROUND: Poor health can cause unhappiness and poor health increases mortality. Previous reports of reduced mortality associated with happiness could be due to the increased mortality of people who are unhappy because of their poor health. Also, unhappiness might be associated with lifestyle factors that can affect mortality. We aimed to establish whether, after allowing for the poor health and lifestyle of people who are unhappy, any robust evidence remains that happiness or related subjective measures of wellbeing directly reduce mortality. METHODS: The Million Women Study is a prospective study of UK women recruited between 1996 and 2001 and followed electronically for cause-specific mortality. 3 years after recruitment, the baseline questionnaire for the present report asked women to self-rate their health, happiness, stress, feelings of control, and whether they felt relaxed. The main analyses were of mortality before Jan 1, 2012, from all causes, from ischaemic heart disease, and from cancer in women who did not have heart disease, stroke, chronic obstructive lung disease, or cancer at the time they answered this baseline questionnaire. We used Cox regression, adjusted for baseline self-rated health and lifestyle factors, to calculate mortality rate ratios (RRs) comparing mortality in women who reported being unhappy (ie, happy sometimes, rarely, or never) with those who reported being happy most of the time. FINDINGS: Of 719 671 women in the main analyses (median age 59 years [IQR 55–63]), 39% (282 619) reported being happy most of the time, 44% (315 874) usually happy, and 17% (121 178) unhappy. During 10 years (SD 2) follow-up, 4% (31 531) of participants died. Self-rated poor health at baseline was strongly associated with unhappiness. But after adjustment for self-rated health, treatment for hypertension, diabetes, asthma, arthritis, depression, or anxiety, and several sociodemographic and lifestyle factors (including smoking, deprivation, and body-mass index), unhappiness was not associated with mortality from all causes (adjusted RR for unhappy vs happy most of the time 0·98, 95% CI 0·94–1·01), from ischaemic heart disease (0·97, 0·87–1·10), or from cancer (0·98, 0·93–1·02). Findings were similarly null for related measures such as stress or lack of control. INTERPRETATION: In middle-aged women, poor health can cause unhappiness. After allowing for this association and adjusting for potential confounders, happiness and related measures of wellbeing do not appear to have any direct effect on mortality. FUNDING: UK Medical Research Council, Cancer Research UK.
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spelling pubmed-50750472016-10-25 Does happiness itself directly affect mortality? The prospective UK Million Women Study Liu, Bette Floud, Sarah Pirie, Kirstin Green, Jane Peto, Richard Beral, Valerie Lancet Articles BACKGROUND: Poor health can cause unhappiness and poor health increases mortality. Previous reports of reduced mortality associated with happiness could be due to the increased mortality of people who are unhappy because of their poor health. Also, unhappiness might be associated with lifestyle factors that can affect mortality. We aimed to establish whether, after allowing for the poor health and lifestyle of people who are unhappy, any robust evidence remains that happiness or related subjective measures of wellbeing directly reduce mortality. METHODS: The Million Women Study is a prospective study of UK women recruited between 1996 and 2001 and followed electronically for cause-specific mortality. 3 years after recruitment, the baseline questionnaire for the present report asked women to self-rate their health, happiness, stress, feelings of control, and whether they felt relaxed. The main analyses were of mortality before Jan 1, 2012, from all causes, from ischaemic heart disease, and from cancer in women who did not have heart disease, stroke, chronic obstructive lung disease, or cancer at the time they answered this baseline questionnaire. We used Cox regression, adjusted for baseline self-rated health and lifestyle factors, to calculate mortality rate ratios (RRs) comparing mortality in women who reported being unhappy (ie, happy sometimes, rarely, or never) with those who reported being happy most of the time. FINDINGS: Of 719 671 women in the main analyses (median age 59 years [IQR 55–63]), 39% (282 619) reported being happy most of the time, 44% (315 874) usually happy, and 17% (121 178) unhappy. During 10 years (SD 2) follow-up, 4% (31 531) of participants died. Self-rated poor health at baseline was strongly associated with unhappiness. But after adjustment for self-rated health, treatment for hypertension, diabetes, asthma, arthritis, depression, or anxiety, and several sociodemographic and lifestyle factors (including smoking, deprivation, and body-mass index), unhappiness was not associated with mortality from all causes (adjusted RR for unhappy vs happy most of the time 0·98, 95% CI 0·94–1·01), from ischaemic heart disease (0·97, 0·87–1·10), or from cancer (0·98, 0·93–1·02). Findings were similarly null for related measures such as stress or lack of control. INTERPRETATION: In middle-aged women, poor health can cause unhappiness. After allowing for this association and adjusting for potential confounders, happiness and related measures of wellbeing do not appear to have any direct effect on mortality. FUNDING: UK Medical Research Council, Cancer Research UK. Elsevier 2016-02-27 /pmc/articles/PMC5075047/ /pubmed/26684609 http://dx.doi.org/10.1016/S0140-6736(15)01087-9 Text en © 2016 Liu et al. Open Access article distributed under the terms of CC BY http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Articles
Liu, Bette
Floud, Sarah
Pirie, Kirstin
Green, Jane
Peto, Richard
Beral, Valerie
Does happiness itself directly affect mortality? The prospective UK Million Women Study
title Does happiness itself directly affect mortality? The prospective UK Million Women Study
title_full Does happiness itself directly affect mortality? The prospective UK Million Women Study
title_fullStr Does happiness itself directly affect mortality? The prospective UK Million Women Study
title_full_unstemmed Does happiness itself directly affect mortality? The prospective UK Million Women Study
title_short Does happiness itself directly affect mortality? The prospective UK Million Women Study
title_sort does happiness itself directly affect mortality? the prospective uk million women study
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075047/
https://www.ncbi.nlm.nih.gov/pubmed/26684609
http://dx.doi.org/10.1016/S0140-6736(15)01087-9
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