Table 2.
Sense of Purpose in Life and Subsequent Health and Well-Being (Health and Retirement Study [HRS]: N = 12,998).a,b,c,d
| Participant characteristics | Purpose in life | ||||||
|---|---|---|---|---|---|---|---|
| Quartile 1 (N = 3,335) | Quartile 2 (N = 3,670) | Quartile 3 (N = 2,750) | Quartile 4 (N = 3,243) | ||||
| (Reference) | RR/OR/β | 95% CI | RR/OR/β | 95% CI | RR/OR/β | 95% CI | |
| Physical Health | |||||||
| All-cause mortality | 1.00 | 0.81 | 0.71, 0.94** | 0.74 | 0.62, 0.89*** | 0.54 | 0.44, 0.66*** |
| Number of chronic conditions | 0.00 | −0.05 | −0.08, −0.01** | −0.07 | −0.10, −0.03*** | −0.08 | −0.12, −0.04*** |
| Diabetes | 1.00 | 1.01 | 0.92, 1.10 | 0.95 | 0.85, 1.07 | 0.97 | 0.87, 1.09 |
| Hypertension | 1.00 | 0.99 | 0.93, 1.05 | 1.00 | 0.94, 1.08 | 1.01 | 0.94, 1.09 |
| Stroke | 1.00 | 0.93 | 0.81, 1.07 | 0.79 | 0.66, 0.94* | 0.77 | 0.62, 0.95* |
| Cancer | 1.00 | 0.98 | 0.88, 1.10 | 1.00 | 0.86, 1.15 | 0.95 | 0.82, 1.11 |
| Heart disease | 1.00 | 0.96 | 0.88, 1.05 | 1.00 | 0.91, 1.11 | 0.94 | 0.84, 1.05 |
| Lung disease | 1.00 | 0.92 | 0.80, 1.05 | 0.85 | 0.72, 1.00* | 0.83 | 0.70, 0.98* |
| Arthritis | 1.00 | 0.98 | 0.92, 1.04 | 0.98 | 0.92, 1.05 | 0.98 | 0.91, 1.06 |
| Overweight/obesity | 1.00 | 1.00 | 0.94, 1.07 | 0.98 | 0.91, 1.05 | 0.97 | 0.90, 1.04 |
| Physical limitations | 1.00 | 0.89 | 0.82, 0.97** | 0.80 | 0.72, 0.89*** | 0.72 | 0.64, 0.81*** |
| Cognitive impairment | 1.00 | 0.95 | 0.86, 1.05 | 0.92 | 0.82, 1.02 | 0.84 | 0.74, 0.96* |
| Chronic pain | 1.00 | 1.00 | 0.93, 1.08 | 0.98 | 0.88, 1.10 | 0.94 | 0.85, 1.05 |
| Self-rated health | 0.00 | 0.09 | 0.04, 0.14*** | 0.13 | 0.07, 0.19*** | 0.17 | 0.10, 0.23*** |
| Health Behaviors | |||||||
| Heavy drinking | 1.00 | 1.02 | 0.80, 1.31 | 0.99 | 0.73,1.33 | 1.03 | 0.76, 1.41 |
| Current smoking | 1.00 | 1.09 | 0.82, 1.44 | 0.98 | 0.66, 1.45 | 1.18 | 0.78, 1.79 |
| Frequent physical activity | 1.00 | 1.10 | 1.02, 1.18** | 1.15 | 1.05, 1.25** | 1.15 | 1.05, 1.25** |
| Sleep problems | 1.00 | 0.95 | 0.88, 1.03 | 0.92 | 0.83, 1.02 | 0.87 | 0.77, 0.99 * |
| Psychological Well-being | |||||||
| Positive affect | 0.00 | 0.25 | 0.20, 0.29*** | 0.38 | 0.33, 0.43*** | 0.59 | 0.53, 0.65*** |
| Life satisfaction | 0.00 | 0.15 | 0.10, 0.20*** | 0.21 | 0.15, 0.27*** | 0.31 | 0.24, 0.38*** |
| Optimism | 0.00 | 0.17 | 0.13, 0.21*** | 0.31 | 0.24, 0.37*** | 0.41 | 0.35, 0.47*** |
| Purpose in life | 0.00 | 0.38 | 0.34, 0.42*** | 0.63 | 0.58, 0.68*** | 0.92 | 0.86, 0.98*** |
| Mastery | 0.00 | 0.19 | 0.14, 0.25*** | 0.31 | 0.24, 0.38*** | 0.44 | 0.36, 0.53*** |
| Health mastery | 0.00 | 0.15 | 0.07, 0.22** | 0.23 | 0.15, 0.31*** | 0.32 | 0.22, 0.42*** |
| Financial mastery | 0.00 | 0.15 | 0.10, 0.21*** | 0.22 | 0.15, 0.28*** | 0.32 | 0.25, 0.40*** |
| Psychological Distress | |||||||
| Depression | 1.00 | 0.85 | 0.75, 0.97* | 0.68 | 0.57, 0.82*** | 0.57 | 0.46, 0.69*** |
| Depressive symptoms | 0.00 | −0.17 | −0.22, −0.12*** | −0.24 | −0.30, −0.19*** | −0.27 | −0.32, −0.21*** |
| Hopelessness | 0.00 | −0.24 | −0.31, −0.18*** | −0.34 | −0.43, −0.25*** | −0.45 | −0.56, −0.35*** |
| Negative affect | 0.00 | −0.13 | −0.19, −0.07*** | −0.20 | −0.28, −0.12*** | −0.30 | −0.39, −0.21*** |
| Perceived constraints | 0.00 | −0.19 | −0.26, −0.12*** | −0.31 | −0.40, −0.22*** | −0.41 | −0.51, −0.31*** |
| Social Factors | |||||||
| Loneliness | 0.00 | −0.17 | −0.22, −0.12*** | −0.23 | −0.31, −0.16*** | −0.35 | −0.41, −0.29*** |
| Not living with spouse/partner | 1.00 | 1.00 | 0.92, 1.08 | 0.97 | 0.89, 1.07 | 0.93 | 0.84, 1.02 |
| Contact children <1x/week | 1.00 | 0.97 | 0.87, 1.09 | 0.91 | 0.81, 1.03 | 0.93 | 0.82, 1.07 |
| Contact other family <1x/week | 1.00 | 0.98 | 0.90, 1.06 | 0.99 | 0.89, 1.11 | 0.97 | 0.86, 1.08 |
| Contact friends <1x/week | 1.00 | 0.89 | 0.82, 0.97* | 0.86 | 0.76, 0.96** | 0.80 | 0.71, 0.90*** |
Abbreviations: CI, confidence interval; OR, odds ratio; RR, risk ratio.
* p < 0.05 before Bonferroni correction; **p < 0.01 before Bonferroni correction; ***p < 0.05 after Bonferroni correction (the p-value cutoff for Bonferroni correction is p = 0.05/35 outcomes = p < 0.001).
a If the reference value is “1,” the effect estimate is OR or RR; if the reference value is “0”, the effect estimate is β.
b The analytic sample was restricted to those who had participated in the baseline wave (t1;2010 or 2012). Multiple imputation was performed to impute missing data on the exposure, covariates, and outcomes. All models controlled for pre-baseline sociodemographic characteristics (age, sex, race/ethnicity, marital status, annual household income, total wealth, level of education, employment status, health insurance, geographic region), pre-baseline childhood abuse, pre-baseline religious service attendance, pre-baseline values of the outcome variables (diabetes, hypertension, stroke, cancer, heart disease, lung disease, arthritis, overweight/obesity, physical functioning limitations, cognitive impairment, chronic pain, self-rated health, binge drinking, current smoking status, physical activity, sleep problems, positive affect, life satisfaction, optimism, purpose in life, mastery, health mastery, financial mastery, depressive symptoms, hopelessness, negative affect, perceived constraints, loneliness, living with spouse/partner, contact children <1x/week, contact other family <1x/week, contact friends <1x/week), personality factors (openness, conscientiousness, extroversion, agreeableness, neuroticism) and the pre-baseline value of the exposure. These variables were controlled for in the pre-baseline wave (in t0; 2006 or 2008).
c We used an outcome-wide analytic approach, and ran a separate model for each outcome. We also ran a different type of model depending on the nature of the outcome: 1) for each binary outcome with a prevalence of ≥10%, we ran a generalized linear model with a log link and Poisson distribution to estimate a R.R.; 2) for each binary outcome with a prevalence of <10%, we ran a logistic regression model to estimate an OR; and 3) for each continuous outcome, we ran a linear regression model to estimate a β.
d All continuous outcomes were standardized (mean = 0; standard deviation = 1), and β was the standardized effect size.