Subjective wellbeing, health, and ageing

Abstract

Subjective wellbeing and health are closely linked to age. Three aspects of subjective wellbeing can be distinguished-evaluative wellbeing (or life satisfaction), hedonic wellbeing (feelings of happiness, sadness, anger, stress, and pain), and eudemonic wellbeing (sense of purpose and meaning in life). We review recent advances in the specialty of psychological wellbeing, and present new analyses about the pattern of wellbeing across ages and the association between wellbeing and survival at older ages. The Gallup World Poll, a continuing survey in more than 160 countries, shows a U-shaped relation between evaluative wellbeing and age in high-income, English speaking countries, with the lowest levels of wellbeing in ages 45-54 years. But this pattern is not universal. For example, respondents from the former Soviet Union and eastern Europe show a large progressive reduction in wellbeing with age, respondents from Latin America also shows decreased wellbeing with age, whereas wellbeing in sub-Saharan Africa shows little change with age. The relation between physical health and subjective wellbeing is bidirectional. Older people with illnesses such as coronary heart disease, arthritis, and chronic lung disease show both increased levels of depressed mood and impaired hedonic and eudemonic wellbeing. Wellbeing might also have a protective role in health maintenance. In an analysis of the English Longitudinal Study of Ageing, we identify that eudemonic wellbeing is associated with increased survival; 29·3% of people in the lowest wellbeing quartile died during the average follow-up period of 8·5 years compared with 9·3% of those in the highest quartile. Associations were independent of age, sex, demographic factors, and baseline mental and physical health. We conclude that the wellbeing of elderly people is an important objective for both economic and health policy. Present psychological and economic theories do not adequately account for the variations in patterns of wellbeing with age across different parts of the world. The apparent association between wellbeing and survival is consistent with a protective role of high wellbeing, but alternative explanations cannot be ruled out at this stage.

Figure 1. Life evaluation and hedonics and age in wealthy English speaking countries

The Cantril ladder ranges from 0 (worst possible life) to 10 (best possible life), and the graph shows the average. The hedonic experiences are the fractions of each age group reporting that they experienced “a lot of” X in the previous day. Those aged 76 and above are excluded. The countries are United States, Canada, United Kingdom, Ireland, Australia, and New Zealand. There are 13,762 observations for happiness, and a little less than 25,000 for the other measures. Means by age are first calculated for each country, and the regional average obtained by weighting by each country’s total population. Sample size is approximately proportional to the number of countries in the region. Happiness measures were not collected in all waves.

Figure 2. Life evaluation and hedonics and age in the former Soviet Union and Eastern Europe

The countries are Albania, Armenia, Azerbaijan, Belarus, Bosnia Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Georgia, Hungary, Kazakhstan, Kosovo, Kyrgyzstan, Latvia, Lithuania, Macedonia, Moldova, Montenegro, Poland, Romania, Russia, Serbia, Slovakia, Slovenia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. There are 63,325 observations for happiness, and around 113,000 for the other measures. See also notes to Figure 1.

Figure 3. Life evaluation and hedonics and age in sub-Saharan Africa

The countries are Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo (Brazzaville), Congo (Kinshasa), Côte d’Ivoire, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mauretania, Mozambique, Namibia, Niger, Rwanda, Senegal, Sierra Leone, Somaliland, South Africa, Sudan, Tanzania, Togo, Uganda, Zambia, Zimbabwe. There are 124,800 observations in all, with country sample sizes ranging from nearly 7,000 (Mauretania) to 1,000 for six countries. See also notes to Figure 1.

Figure 4. Life evaluation and hedonics and age in Latin America and the Caribbean

The countries are Argentina, Belize, Bolivia, Brazil, Costa Rica, Chile, Colombia, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, Trinidad and Tobago, Uruguay, Venezuela. There are 96,154 observations in all, with country sample sizes ranging from over 5,000 to 500. See also notes to Figure 1.

Figure 5. Eudemonic wellbeing and survival

Kaplan-Meier survival curves for the four quartiles of eudemonic wellbeing in ELSA: highest wellbeing quartile (blue), second wellbeing quartile (purple), third wellbeing quartile (green), lowest wellbeing quartile (red). Survival in months from baseline is modelled after adjustment for age, gender, demographic factors, baseline health indicators, history of depressive illness and depression symptoms, and baseline health behaviours.