Prospective associations between strengths of moral character and health: longitudinal evidence from survey and insurance claims data

PURPOSE: Excellent character, reflected in adherence to high standards of moral behavior, has been argued to contribute to well-being. The study goes beyond this claim and provides insights into the role of strengths of moral character (SMC) for physical and mental health. METHODS: This study used longitudinal observational data merged with medical insurance claims data collected from 1209 working adults of a large services organization in the US. Self-reported physical and mental health as well as diagnostic information on depression, anxiety, and cardiovascular disease were used as outcomes. The prospective associations between SMC (7 indicators and a composite measure) and physical and mental health outcomes were examined using lagged linear and logistic regression models. A series of sensitivity analyses provided evidence for the robustness of results. RESULTS: The results suggest that persons who live their life according to high moral standards have substantially lower odds of depression (by 21–51%). The results were also indicative of positive associations between SMC and self-reports of mental health (β = 0.048–0.118) and physical health (β = 0.048–0.096). Weaker indications were found for a protective role of SMC in mitigating anxiety (OR = 0.797 for the indicator of delayed gratification) and cardiovascular disease (OR = 0.389 for the indicator of use of SMC for helping others). CONCLUSIONS: SMC may be considered relevant for population mental health and physical health. Public health policies promoting SMC are likely to receive positive reception from the general public because character is both malleable and aligned with the nearly universal human desire to become a better person. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00127-022-02344-5.