Death may be inevitable, but that doesn’t stop health researchers from looking for ways to delay it for as long as possible. Their newest candidate is something free, painless, tastes good, and won’t make you sweat: gratitude.
A new study of nearly 50,000 older women found that the stronger their feelings of gratitude, the less likely they were to die over the next three years.
The results will certainly be appreciated by those who are naturally inclined to give thanks. Those who are not may be grateful to learn that with practice, they may be able to improve their feelings of gratitude and reap the longevity benefits as well.
“This is an exciting study,” said Joel Wong, a professor of counseling psychology at Indiana University who studies gratitude interventions and practices and was not involved in the new work.
A growing body of evidence has linked gratitude to numerous mental and physical health benefits. People who score higher on gratitude measures have better biomarkers for cardiovascular function, immune system inflammation, and cholesterol. They are more likely to take their medications, exercise regularly, have good sleep habits, and eat a balanced diet.
Gratitude is also associated with a lower risk of depression, better social support and greater purpose in life, all of which are linked to longevity.
However, this is the first time researchers have directly linked gratitude to a lower risk of premature death, Wong and others said.
“It’s not surprising, but it’s always good to see empirical research supporting the idea that gratitude is not only good for your mental health, but also for living longer,” Wong said.
Ying Chen, an empirical researcher at Harvard University’s Human Flourishing Program, said she was surprised by the lack of studies on gratitude and mortality. So she and her colleagues turned to data from the Nurses Health Study, which has tracked the health and lifestyle habits of thousands of American women since 1976.
In 2016, these efforts included a test to measure nurses’ feelings of gratitude. Women were asked to use a seven-point scale to indicate how much they agreed or disagreed with six statements, including “I have so many things in life to be grateful for” and “If I had to list everything I’m grateful for, the list would be very long.”
A total of 49,275 women responded to the survey, and the researchers divided them into three roughly equal groups based on their gratitude scores. Compared with women with the lowest scores, those with the highest scores tended to be younger, more likely to have a spouse or partner, more involved in social and religious groups, and in better general health, among other differences.
The average age of nurses who responded to the gratitude questions was 79, and by the end of 2019, 4,068 of them had died. After controlling for factors such as their census area’s median household income, retirement status, and religious involvement, Chen and her colleagues found that nurses who were most grateful were 29 percent less likely to die than those who were least grateful.
They then took their research further by taking into account a range of health conditions, including a history of heart disease, stroke, cancer and diabetes. The risk of death for the most grateful women was still 27% lower than for their least grateful counterparts.
When the researchers took into account the effects of smoking, alcohol consumption, exercise, body mass index and diet quality, the risk of death for the most grateful nurses remained 21 percent lower.
Finally, Chen and colleagues added measures of cognitive function, mental health, and psychological well-being. Even after accounting for these variables, the risk of mortality was 9% lower for nurses with the highest gratitude scores.
The results were published Wednesday in JAMA Psychiatry.
While the study shows a clear link between gratitude and longevity, it doesn’t prove that one causes the other. While it’s plausible that gratitude helps people live longer, it’s also possible that being healthy makes people feel grateful, or that both are influenced by a third factor that wasn’t accounted for in the study’s data.
Sonja Lyubomirsky, an experimental social psychologist at UC Riverside who studies gratitude and was not involved in the study, said she suspects all three factors are at work.
Another limitation is that all of the study participants were older women, and 97 percent of them were white. It’s unclear whether the findings would generalize to a more diverse population, Wong said, “but based on theory and research, I don’t see why they wouldn’t.”
Gratitude can have downsides, the Harvard team noted: If it’s tied to feelings of indebtedness, it can undermine a sense of autonomy or emphasize hierarchical relationships. Lyubomirsky added that it can make people feel like a burden to others, which is particularly dangerous for someone with depression who is having suicidal thoughts.
But in most cases, gratitude is an emotion worth cultivating, Lyubomirsky said. Clinical trials have shown that gratitude can be strengthened through simple interventions, such as keeping a gratitude journal or writing a thank-you letter and hand-delivering it.
“Gratitude is a skill you can develop,” she said.
And like diet and exercise, it appears to be a modifiable risk factor for better health.
Lyubomirsky found that teens randomly assigned to write thank-you letters to their parents, teachers or coaches decided to eat more fruits and vegetables and cut back on junk and fast food, behaviors not shared by their classmates in the control group. Perhaps after reflecting on the time, money and other resources invested in them, the teens were motivated to protect that investment, she said.
More research will be needed to determine whether interventions like these can extend people’s lives, but Chen is optimistic.
“As the evidence accumulates, we will better understand how to effectively enhance gratitude and whether it can meaningfully improve people’s long-term health and well-being,” she said.