Positive affect during adolescence and health and well-being in adulthood: An outcome-wide longitudinal approach.

BACKGROUND: Several intergovernmental organizations, including the World Health Organization and United Nations, are urging countries to use well-being indicators for policymaking. This trend, coupled with increasing recognition that positive affect is beneficial for health/well-being, opens new avenues for intervening on positive affect to improve outcomes. However, it remains unclear if positive affect in adolescence shapes health/well-being in adulthood. We examined if increases in positive affect during adolescence were associated with better health/well-being in adulthood across 41 outcomes. METHODS AND FINDINGS: We conducted a longitudinal cohort study using data from Add Health-a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if increases in positive affect over 1 year (between Wave I; 1994 to 1995 and Wave II; 1995 to 1996) were associated with better health/well-being 11.37 years later (in Wave IV; 2008; N = 11,040) or 20.64 years later (in Wave V; 2016 to 2018; N = 9,003). Participants were aged 15.28 years at study onset, and aged 28.17 or 37.20 years-during the final assessment. Participants with the highest (versus lowest) positive affect had better outcomes on 3 (of 13) physical health outcomes (e.g., higher cognition (ß = 0·12, 95% CI = 0·05, 0·19, p = 0.002)), 3 (of 9) health behavior outcomes (e.g., lower physical inactivity (RR = 0·80, CI = 0·66, 0·98, p = 0.029)), 6 (of 7) mental health outcomes (e.g., lower anxiety (RR = 0·81, CI = 0·71, 0·93, p = 0.003)), 2 (of 3) psychological well-being (e.g., higher optimism (ß = 0·20, 95% CI = 0·12, 0·28, p < 0.001)), 4 (of 7) social outcomes (e.g., lower loneliness (ß = -0·09, 95% CI = -0·16, -0·02, p = 0.015)), and 1 (of 2) civic/prosocial outcomes (e.g., more voting (RR = 1·25, 95% CI = 1·16, 1·36, p < 0.001)). Study limitations include potential unmeasured confounding and reverse causality. CONCLUSIONS: Enhanced positive affect during adolescence is linked with a range of improved health/well-being outcomes in adulthood. These findings suggest the promise of testing scalable positive affect interventions and policies to more definitively assess their impact on outcomes.

First Decade of Supportive Services for Veteran Families Program and Homelessness, 2012-2022.

As homelessness remains an urgent public health crisis in the United States, specific programs in the US Department of Veterans Affairs (VA) system may serve as a roadmap for addressing it. We examine lessons learned from the first decade (2012-2022) of the Supportive Services for Veteran Families (SSVF) program, a cornerstone in the VA continuum of homeless services aimed at both preventing homelessness among those at risk and providing rapid rehousing for veterans and their families who are currently experiencing homelessness. Drawing on information from annual reports and other relevant literature, we have identified 3 themes of SSVF that emerged as features to comprehensively deliver support for homeless veterans and their families: (1) responsiveness and flexibility, (2) coordination and integration, and (3) social resource engagement. Using these strategies, SSVF reached nearly three quarters of a million veterans and their families in its first decade, thereby becoming one of the VA's most substantial programmatic efforts designed to address homelessness. We discuss how each feature might apply to addressing homelessness in the general population as well as future research directions. (Am J Public Health. 2024;114(6):610-618. https://doi.org/10.2105/AJPH.2024.307625).

Connected communities: Perceived neighborhood social cohesion during adolescence and subsequent health and well-being in young adulthood-An outcome-wide longitudinal approach.

Does higher perceived neighborhood social cohesion in adolescence lead to better health and well-being 10-12 years later? We evaluated this question using data from a large, prospective, and nationally representative sample of US adolescents (Add Health; N = 10,963), and an outcome-wide approach. Across 38 outcomes, perceived neighborhood social cohesion was associated with some: mental health outcomes (i.e., depressive symptoms, suicidal ideation, perceived stress), psychological well-being outcomes (i.e., happiness, optimism), social outcomes (i.e., loneliness, romantic relationship quality, satisfaction with parenting), and civic/prosocial outcomes (i.e., volunteering). However, it was not associated with health behaviors nor physical health outcomes. These results were maintained after robust control for a wide range of potential confounders.

Divine struggles and whole person functioning: a 9-year longitudinal study of middle-aged U.S. adults.

OBJECTIVE: This longitudinal study examined the associations of divine struggles with 25 psychological distress, psychological well-being, social well-being, prosociality, physical health, and health behavior outcomes assessed approximately nine years later. METHODS: We used three waves of data from the National Survey of Midlife Development in the United States (N = 4041): M1 (1995-1996), M2 (2004-2006), and M3 (2013-2014). Following the analytic template for outcome-wide longitudinal designs, our primary analysis employed a series of regression models to estimate the associations between a continuous measure of divine struggles assessed at M2 with each outcome assessed at M3. All models adjusted for a rich set of covariates, including prior values of all outcomes. RESULTS: There was modest evidence suggesting that divine struggles were associated with worse subsequent functioning on one or more outcomes for each domain except health behaviors (effect sizes were generally very small). CONCLUSIONS: Divine struggles have the potential to degrade long-term functioning across multiple domains of life. Practitioners should attend to and address divine struggles in their clinical work.

Reliability and Validity of a Multidimensional Measure of Subjective Community Well-Being.

An individual's flourishing is sustained by and dependent on their community's well-being. We provide one of the first studies of a measure of communal subjective well-being, focusing on individuals' relationships with their community. Using two samples from the Greater Columbus, Ohio region, we provide evidence of the reliability and validity of the Subjective Community Well-being (SCWB) assessment. The five domains of the SCWB are Good Relationships (α = .92), Proficient Leadership (α = .93), Healthy Practices (α = .92), Satisfying Community (α = .88), and Strong Mission (α = .81). A community-based sample (N = 1,435) and an online sample of Columbus residents (N = 692) were scored on the SCWB and compared across domains. We found evidence that the SCWB scores differentiate between active and less active community members. We discuss the appropriate uses of the SCWB as a measure of well-being and provide recommendations for research that could profitably utilize the SCWB measure to examine community well-being.

Hope in adolescence and subsequent health and well-being in adulthood: An outcome-wide longitudinal study.

BACKGROUND: A sense of hopelessness is rising at alarming levels among adolescents in the United States. There is urgent need to understand the potential implications of being hopeful on adolescents' future health and wellbeing. METHODS: This study utilized data from the National Longitudinal Study of Adolescent to Adult Health (N = 11,038, mean age at baseline = 15 years) to prospectively examine the relationship between baseline hope and a wide range of outcomes 12 years later. Thirty-eight outcomes were examined in the domains of physical health, health behavior, mental health, psychological well-being, social factors, and civic and prosocial behavior. Regression models were used to regress each outcome on baseline hope separately. Models controlled for a wide range of factors as well as prior values of the exposure (hope) and outcomes. RESULTS: Having hope for the future in adolescence was associated with improvements in 11 subsequent outcomes after Bonferonni correction, including higher cognition and self-rated health, less physical inactivity, fewer depressive symptoms, lower perceived stress, and improvement on a number of psychological and social factors including greater happiness, more satisfaction with parenting, and increased voting and volunteering in adulthood. There were also a number of associations that were close to the null, which are equally important to explore and understand. IMPLICATIONS: The results of the study may have important implications for hope-based efforts and programs aimed at improving the lives of young people and promoting their current and future well-being.

A brief measure of complete subjective well-being in Germany: A population-based validation of a German version of the Flourish Index (FI) and the Secure Flourish Index (SFI).

Measuring subjective well-being in a multidimensional, valid, reliable, and parsimonious way is important for both social science research and social policy. Here, we present an efficient measure of distinct domains of subjective well-being and overall flourishing. The Flourishing Index (FI) consists of five sub-domains: 1. happiness and life satisfaction, 2. physical and mental health, 3. meaning and purpose, 4. character and virtue, and 5. close social relationships. The Secure Flourishing Index (SFI) adds the sub-domain financial and material stability, which is thought to be necessary to sustain the other domains over time. We developed a German version of these measures in a multi-stage translation and scale testing process. The results of an exploratory factor analysis in Study 1 (N = 192) suggest a unidimensional structure of the FI and a two-dimensional structure of the SFI. Moreover, both indices (and most sub-domains) revealed acceptable to good reliability. The factor structures were confirmed in Study 2 (N = 13,268). We provide indications for measurement invariance of both indices with regard to gender and age. We furthermore examined inter-correlations with related constructs such as importance of health, self-efficacy, and social support. Study 3 (N = 317) finds evidence for high convergent validity of both the FI and the SFI with overall well-being as well as sub-scores of the PERMA-Profiler. These results suggest that the FI and the SFI are efficient measures of distinct domains of subjective well-being and overall flourishing. Our translation of the FI and SFI, along with the empirical relationships that we found among the measures that we reviewed, will help scholars in Germany (and beyond) explore an expanded range of domains of well-being, including the comparatively neglected domains of character and virtue, physical health, and financial and material stability.

Exposure to negative life events, change in their perceived impact, and subsequent well-being among U.S. adults: A longitudinal outcome-wide analysis.

OBJECTIVE: Negative life events have the potential to undermine an individual's ability to function and thrive, but less is known about the implications of changes in subjective appraisals of those events for long-term well-being. This research examines how exposure to negative life events and subsequent changes in the perceived impact of those events are related to longer-term well-being in adulthood. METHOD: Drawing on three waves of data from the Midlife in the United States study (M1: 1995-1996, M2: 2004-2006, M3: 2013-2014), we applied the analytic template for outcome-wide longitudinal designs to investigate associations of (a) negative life event exposure between M1 and M2 and (b) change in the perceived impact of negative life event exposure assessed at M2 with 25 outcomes across several domains of well-being assessed approximately 9 years later at M3: psychological distress, psychological well-being, social well-being, prosociality, physical health, and health behavior. RESULTS: Whereas negative life event exposure was associated with worse subsequent well-being on selected outcomes (5/25 in total) in some domains, positive change in the perceived impact of negative life event exposure was associated with better well-being on one or more outcomes in most domains (11/25 in total). Effect sizes in both sets of analyses were generally small, with more consistent associations found for psychological and social outcomes. CONCLUSION: Subjective appraisals of negative life events (particularly positive changes in those appraisals over time) may be more closely related to individual well-being in the long run than mere exposure to negative life events themselves. The findings bring attention to the possibility that positive changes in a person's subjective appraisal of negative life events could have beneficial consequences for long-term well-being.

Residential instability during adolescence and health and wellbeing in adulthood: A longitudinal outcome-wide study.

Although prior research suggests that residential instability during adolescence can have long-term impacts on health and wellbeing, few studies have identified a robust comparison group and considered a broad set of outcomes. To address these knowledge gaps, we examined the associations between residential instability during adolescence and a wide range of adult health and wellbeing outcomes using an outcome-wide design in the National Longitudinal Study of Adolescent to Adult Health. We defined residential instability as two or more moves between Waves I and II (ages 13-18 years). We assessed outcomes at ages 33-43 years (Wave V) in nine domains: biomarkers, physical health, health behaviors, psychological distress, psychological wellbeing, social behaviors, social wellbeing, trauma/victimization, and socioeconomic attainment. Results of doubly-robust targeted maximum likelihood estimation, adjusting for pre-exposure values of the outcome variables and cofounders (Wave I), showed little evidence of an association for certain outcomes, all of which disappeared after accounting for multiple comparisons. Our results suggest that residential instability in adolescence does not lead to worse health and wellbeing in adulthood, but rather, outcome differences between groups are due to pre-existing differences prior to residential instability in adolescence.

How painful is a recession? An assessment of two future-oriented buffering mechanisms.

RATIONALE AND OBJECTIVE: Guided by stress process theory, this study investigates the association between the economic downturn and chronic pain interference, as well as the role of two future-oriented buffering mechanisms (anticipated stressor duration and pre-recession financial optimism) in this relationship. This research integrates both an objective measure of the recession based on negative personal experiences, as well as subjective event-based appraisals of how the recession impacted people's lives. METHOD: Drawing on longitudinal data from the National Survey of Midlife Development in the United States, linear lagged dependent variable models are used to estimate associations between recession-era stressors and chronic pain interference among 1113 adults. The analysis further examines the moderating influences of anticipated stressor duration and pre-recession financial optimism. RESULTS: Findings reveal that both an accumulation of adverse experiences and global appraisals of the economic recession have harmful associations with chronic pain interference; however, their magnitude varied according to future-oriented moderating factors. Specifically, people with high pre-recession financial optimism fared better when confronted with recession-related stressors than did those with low levels of financial optimism. Moreover, pain interference was greater among individuals who appraised the recession as having a negative impact on their lives, but only if they perceived the recession would extend into the future. CONCLUSIONS: This study demonstrates distinctive links between two recession-related measures and pain interference. Findings suggest that positive future orientations can be protective during an economic crisis, whereas negative orientations heighten the pain.