. 2022 Aug 2;58(1):163–176. doi: 10.1007/s00127-022-02344-5

Table 3.

Associations between strengths of moral character and subsequent health (survey data 2018–2019 merged with health insurance data 2017–2019, United States, N = 1209)

Strengths of moral character (0–10)	Mental health outcome	Physical health outcome
Moral compass
I always know the right thing to do	0.019 (− 0.028, 0.067)	0.881 (0.719, 1.077)	0.694*** (0.554, 0.869)	0.019 (− 0.028, 0.067)	0.976 (0.484, 1.967)
Orientation to promote good
I am willing to face difficulties in order to do what is right	0.062* (0.014, 0.109)	0.866 (0.706, 1.063)	0.703** (0.512, 0.837)	0.039 (− 0.009, 0.087)	0.795 (0.399, 1.582)
I give up personal pleasures whenever it is possible to do some good instead	0.048** (0.002, 0.095)	0.930 (0.749, 1.155)	0.626*** (0.492, 0.798)	0.027 (− 0.021, 0.075)	0.957 (0.482, 1.900
I always act to promote good in all circumstances, even in difficult and challenging situations	0.083*** (0.034, 0.132)	0.927 (0.752, 1.142)	0.735** (0.584, 0.925)	0.076** (0.028, 0.125)	1.266 (0.562, 2.849)
Use of strengths
I get to use my strengths to help others	0.061** (0.010, 0.113)	0.986 (0.786, 1.238)	0.619*** (0.481, 0.797)	0.084** (0.021, 0.136)	0.389* (0.186, 0.811)
Kindness
I always treat everyone with kindness, fairness and respect	0.059* (0.013, 0.104)	1.002 (0.809, 1.240)	0.793* (0.633, 0.993)	0.034 (− 0.012, 0.080)	0.940 (0.444, 1.991)
Delayed gratification
I am always able to give up some happiness now for greater happiness later	0.046 (− 0.001, 0.094)	0.797* (0.650, 0.976)	0.721** (0.573, 0.908)	0.048* (0.000, 0.095)	1.157 (0.545, 2.456)
Strengths of moral character scale (SMC-WBA)	0.118*** (0.048, 0.188)	0.820 (0.609, 1.104)	0.487*** (0.350, 0.678)	0.096** (0.027, 0.165)	0.737 (0.270, 2.010)

Strengths of moral character (0–10)

Mental health outcome

Physical health outcome

Self-reported mental health

Anxiety

Depression

Self-reported physical health

Cardiovascular disease

β^a
95% CI

OR
95% CI

β^a
95% CI

OR
95% CI

Moral compass

I always know the right thing to do

0.019

(− 0.028, 0.067)

0.881

(0.719, 1.077)

0.694***

(0.554, 0.869)

0.019

(− 0.028, 0.067)

0.976

(0.484, 1.967)

Orientation to promote good

I am willing to face difficulties in order to do what is right

0.062*

(0.014, 0.109)

0.866

(0.706, 1.063)

0.703**

(0.512, 0.837)

0.039

(− 0.009, 0.087)

0.795

(0.399, 1.582)

I give up personal pleasures whenever it is possible to do some good instead

0.048**

(0.002, 0.095)

0.930

(0.749, 1.155)

0.626***

(0.492, 0.798)

0.027

(− 0.021, 0.075)

0.957

(0.482, 1.900

I always act to promote good in all circumstances, even in difficult and challenging situations

0.083***

(0.034, 0.132)

0.927

(0.752, 1.142)

0.735**

(0.584, 0.925)

0.076**

(0.028, 0.125)

1.266

(0.562, 2.849)

Use of strengths

I get to use my strengths to help others

0.061**

(0.010, 0.113)

0.986

(0.786, 1.238)

0.619***

(0.481, 0.797)

0.084**

(0.021, 0.136)

0.389*

(0.186, 0.811)

Kindness

I always treat everyone with kindness, fairness and respect

0.059*

(0.013, 0.104)

1.002

(0.809, 1.240)

0.793*

(0.633, 0.993)

0.034

(− 0.012, 0.080)

0.940

(0.444, 1.991)

Delayed gratification

I am always able to give up some happiness now for greater happiness later

0.046

(− 0.001, 0.094)

0.797*

(0.650, 0.976)

0.721**

(0.573, 0.908)

0.048*

(0.000, 0.095)

1.157

(0.545, 2.456)

Strengths of moral character scale (SMC-WBA)

0.118***

(0.048, 0.188)

0.820

(0.609, 1.104)

0.487***

(0.350, 0.678)

0.096**

(0.027, 0.165)

0.737

(0.270, 2.010)

A set of regression models was used to regress each outcome on each character strength exposure separately, to estimate odds ratio (OR) for binary outcomes or β (for continuous outcomes). Each analysis was controlled for demographics (gender, age, race, education, marital status, having children at home, taking care of an elderly), wealth and income (home ownership and salary), lifestyle (voting in the last elections, religious service attendance, spiritual practices, volunteering, community work) and work characteristics (number of work hours, supervisor support, job control, job demand and job meaning). These variables were controlled for in the first wave (in the same wave as the exposure), since only two waves of survey data were available. In addition, in each regression, an outcome prior to exposure as well as the number of diagnosed health conditions (ranging from 0 to 37 possible diagnosed health conditions) prior to exposure were applied as controls

^***p < 0.001, **p < 0.01, *p < 0.05; the p value cutoff for Bonferroni correction = 0.05/5 outcomes = 0.01; CI is confidence interval

^a All continuous outcomes, exposures and controls were standardized and β was the standardized effect size