Purpose in Life and Cardiovascular Health.

Abstract

A growing body of research suggests that purpose in life may provide a point of intervention to improve the health behaviors and health of the large segment of adults throughout the world who are progressing into old age. Researchers have recently documented robust associations between purpose and enhanced health behaviors and outcomes. Preliminary studies also indicate that purpose can be systematically enhanced. Further research examining the connection between purpose, health behaviors, and outcomes is needed to guide the design of novel and low-cost prevention and intervention programs. To date, little research has investigated purpose in life’s association with cardiovascular health or the possible mechanisms behind this link. In four distinct but linked papers, I use data from the Health and Retirement Study, a nationally representative sample of U.S. adults over the age of 51 to examine this research gap.

The first and second studies examined the connection between purpose and cardiovascular health. Each unit increase in purpose (on a 6-point scale) was longitudinally associated with a decreased risk of stroke (OR = 0.78, 95% CI = 0.67-0.91) and myocardial infarction (OR = 0.73, 95% CI = 0.57-0.93), even after adjusting for an array of covariates. The third study examined a potential mechanism behind the purpose and health connection and tested whether higher baseline purpose predicted increased use of six preventive health care services over time. Results showed that higher purpose predicted higher use of cholesterol tests, mammograms, pap smears, prostate exams, and colonoscopies, but not flu shots. The fourth study used structural equation modeling to longitudinally examine if four health behaviors mediated the association between purpose and myocardial infarction. Results showed that only physical activity (β = -.026; 95% CI = -.042, -.009) and smoking (β = -.016; 95% CI = -.035, .004) mediated the association between purpose and myocardial infarction, while sleep quality and cholesterol tests did not. Taken together, these studies expand the literature by enhancing our knowledge about the association between purpose and cardiovascular health. These results are also the first to illuminate how health behaviors mediate the association between purpose and cardiovascular disease.