It is always interesting when conventional wisdom is challenged. A new study provides a classic example of the danger of inferring causation from correlation. There have been studies that show that people who are unhappy have higher mortality rates and thus shorter life spans. It has become conventional to think that being unhappy is bad for you. But a new large ten-year study says that rather than unhappiness leading to increased mortality, it is poor health that leads people to be unhappy and that is the reason for the correlation.
The summary of the paper says the following:
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.
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.
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.
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.
You can read the paper that appeared in the British medical journal The Lancet here.
If these results hold up, that would be encouraging for people who are unhappy. Happiness seems to be something that is largely beyond one’s control. It depends on one’s personality and temperament and circumstances. It is no use telling an unhappy person that they should be happier or they will die sooner. If one has the misfortune to be unhappy for whatever reason, the belief that it shortens one’s life will likely make them more fretful and unhappier and compound the problem.
Realizing that they are not shortening their own lives may have the benefit of making unhappy people less unhappy, and that is surely a good thing.