Scientists explore how happiness might help our resistance to disease

Everyone, from Aristotle to The Beatles and the Dalai Lama to Coca-Cola, seems to have a take on what happiness is. But while these ideas on happiness have traditionally been rather ethereal, in recent times the subject has turned scientific, attracting the attention of researchers seeking to unravel its mysteries – in particular, the link between positive emotions and good health.

Could being optimistic mean fewer colds and less heart disease? Does a sense of enthusiasm for life protect against hypertension and diabetes? Do happier people live longer, and, if so, why?

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These questions – and many more – are on the minds of researchers, including Laura Kubzansky, a professor of social and behavioural science at the Harvard T.H. Chan School of Public Health.

Studies have shown conditions that may be directly or indirectly affected by emotional well-being include some of the world’s biggest killers, such as heart disease, obesity, hypertension, smoking-related diseases, suicide, and conditions related to alcohol dependency and binge drinking.

A recent study published online in March in the journal BMC Public Health spanning 162 counties in mainland China found the connection between physical health and emotions, both positive and negative, was common across different levels of socio-economic development. This result supports other recent studies indicating that emotional states affect health independently of country-level gross domestic product.

“There’s a growing body of evidence that suggests higher psychological well-being is associated with better health, but which aspects of psychological well-being matter is still very much undetermined because nobody has taken a systematic look at it,” says Kubzansky. This is set to change, however, with the recent launch of a specialised health and happiness research centre at the T.H. Chan School, funded by US$21 million from Hong Kong-based food company Lee Kum Kee.

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The Lee Kum Sheung Centre for Health and Happiness – named after Lee Kum Kee’s founder, who invented oyster sauce in 1888 in Guangdong – seeks to identify the psychological, social and emotional strengths and assets that may protect people against some diseases and enable them to enjoy longer, happier, and healthier lives.

“So, not just trying to achieve the absence of a problem, but to get to the presence of something really positive and something higher than just not having a problem, on the belief that health is more than just the absence of disease,” says Kubzansky, the centre’s co-director.

The studies will involve Harvard experts across a wide range of disciplines – health communications, psychology, nutrition, exercise physiology, basic biology, medicine, epidemiology and population sciences. Ultimately, the centre’s goal is to make discoveries that can inform personal behaviours, medical care, public health programmes and wide-ranging public policies not traditionally associated with health care and medicine.

The benefits will go beyond just personal health gains; reducing toxic psychological states early in life may actually help prevent chronic diseases that take a heavy toll on public health care costs.

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Over the past few decades, numerous studies have shown negative states, such as depression, anger, anxiety and hostility, to be detrimental to cardiovascular health. But less is known about how positive psychological characteristics are related to heart health.

Kubzansky is at the forefront of such research. In a 2007 study that followed more than 6,000 people aged 25 to 74 for 20 years, for example, she found that emotional vitality – a sense of enthusiasm, of hopefulness, of engagement in life and the ability to face life’s stresses with emotional balance – appears to reduce the risk of coronary heart disease. The protective effect was distinct and measurable, even when taking into account such wholesome behaviours as not smoking and regular exercise.

Her other studies suggest sense of optimism, sense of purpose and social integration also have links to better health in relation to cardiovascular disease and longevity.

“I would say that all the signs are very promising but understanding the biological mechanisms and the causal pathways, that’s all still to be worked out,” she says. “That’s really the question that people debate – do happiness and positive psychological well-being directly help people to maintain better physical health? Can we identify clear mechanisms by which these factors play out?”

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Happiness is known to be at least partially genetic. In a new international study published in Nature Genetics, Dutch scientists at Vrije Universiteit Amsterdam reported their discovery of the first happiness genes based on an analysis of more than 298,000 people. They found three genetic variants for happiness, two variants that can account for differences in symptoms of depression, and 11 locations on the human genome that could account for varying degrees of neuroticism.

Previously, researchers at the University of Minnesota have found that identical twins appear to share not only the same DNA, but the same general level of happiness, regardless of whether they were raised together or separately.

Social factors also affect one’s happiness, says Kasisomayajula Viswanath, co-director of the centre and a professor of health communication.

“It’s particularly important to understand that happiness is influenced by a number of not only internal intrinsic psychological factors but also external stressors such as employment, poverty, inequality, social conflict, family conflict and so on.”

Further complicating this subject is the fact that definitions of happiness and factors that affect psychological well-being differ among individuals, cultures and locations.

“For example, it may be density of housing in Hong Kong that may be more influential on one’s happiness here, but the lack of social support could play a bigger role in some other place,” says Viswanath.

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Interestingly, Kubzansky’s research in the US has shown that people with higher educational attainment are much more optimistic than people with low educational attainment. However, in Hong Kong, the reverse was found to be true in the 2011 ING LIFE Happiness Survey conducted by Lingnan University. Of the 8,500 Hongkongers surveyed online, those who had only a primary-school education were the happiest, scoring 8.59 on a scale of 10 on the Lingnan-designed happiness index. The second happiest demographic, in terms of education, has no formal schooling whatsoever.

“The goal of the centre is to really understand how these factors play a role in different places, and also the weight one gives to different factors,” says Viswanath.

The centre will begin with three initial projects. Viswanath’s will examine the role of communications – ranging from television programming to social media – on engagement, health and happiness. He intends to involve Hong Kong researchers and participants in the study.

The second project will be led by School of Public Health colleagues Drs Lilian Cheung and Kirsten Davison, who aim to determine the effects of interventions promoting psychological well-being, such as mindfulness-based practices on diseases like diabetes and cancer, and on mental health issues including anxiety, depression and bipolar disease.

The third project, led by Kubzansky, seeks to understand the relationship between psychological well-being and cardiovascular health, healthy ageing and longevity. The goal is to identify and develop a positive psychological well-being index, or “happiness index”, that can assess psychological well-being in a systematic and scientifically sound manner.

“Our hope is that such an index can be used for research and monitoring around the world,” says Kubzansky.

Sammy Lee, chairman and managing director of LKK Health Products Group (a member of the Lee Kum Kee Group), says the new centre is a fitting tribute to his great-grandfather, Lee Kum Sheung. “‘si li ji ren’ (considering others’ interests) is Lee Kum Kee’s core value, so we are very proud to support scientific advancement for the good of people around the globe,” says Lee.