International Journal of Behavioral Medicine Copyright © 2005 by 2005, Vol. 12, No. 2, 66–77 Lawrence Erlbaum Associates, Inc. Altruism, Happiness, and Health: It’s Good to Be Good Stephen G. Post Altruistic (other-regarding) emotions and behaviors are associated with greater well-being, health, and longevity. This article presents a summary and assessment of existing research data on altruism and its relation to mental and physical health. It suggests several complimentary interpretive frameworks, including evolutionary bi- ology, physiological models, and positive psychology. Potential public health impli- cations of this research are discussed, as well as directions for future studies. The arti- cle concludes, with some caveats, that a strong correlation exists between the well-being, happiness, health, and longevity of people who are emotionally and behaviorally compassionate, so long as they are not overwhelmed by helping tasks. Key words: kindness, altruism, well-being, happiness, health, public health The vast majority of people in the European Union the case of the stressed caregiver of a loved one with and the United States have more material wealth than dementia (Kiecolt-Glaser, Preacher, MacCallum, Ma- did their parents; the percentage of these populations larkey, & Glaser, 2003), there are health benefits linked that is happy, however, has not increased, and depres- to helping behavior when it is not experienced as over- sion and anxiety rates have risen dramatically whelming. A relevant study (Schwartz, Meisenhelder, (Easterbrook, 2003). The rise in depression rates is in Ma, & Reed, 2003) points to health benefits in generous part due to greater public and medical awareness. behavior but with the important caveat that there are However, such elevated rates require serious reflection clear adverse health consequences associated with be- on our social environment, which has been described ing overly taxed. Although the health benefits of receiv- by one sociologist with the terms “bowling alone” and ing love are widely deemed significant, we want to go loss of “social capital” (Putnam, 2001). These terms beyond the recipient to examine benefits for the agent. suggest that a partial solution to the problem may lie What happens to the health and longevity of people who with the restoration of prosocial altruistic emotions are (a) emotionally kind, (b) charitable in their actions and behaviors. Current research does indeed show a toward others without being overwhelmed, or both? strong association between kindly emotions, helping Emotional states and related behaviors have been behavior, or both, on the one hand, and well-being, studied by mainstream scientists in relation to health health, and longevity, on the other. This article summa- promotion and disease prevention (Oman, Thoresen, & rizes and interprets existing research, points to future McMahon, 1999; Young & Glasgow, 1998). However, research directions, and suggests implications of such the impact of positive emotional states and related be- research for public health. haviorsonhealthconstitutesanovelareaforresearchers If kind emotions, helping behavior, or both are as- (Edwards & Cooper, 1988). In the 1990s, for example, sociated with well-being, health, and longevity, the Danner et al. (2001) reviewed short, personal essays implications for how we think about human nature written by nuns in the 1930s; this was a secondary pro- and prosperity are significant (Hendrick & Hendrick, jectintheirfamousnunstudyonAlzheimerdisease.The 1986; Levin, 2000). Although those who are physically nuns who expressed the most positive emotions were overwhelmed, mentally overwhelmed, or both by the living about 10 years longer than those who expressed needs of others do experience a stressful “burden” that the fewest such emotions, and they were somewhat can have significant negative health consequences, as in protected from the onset of dementia (Danner et al., 2001). In another example, Fredrickson (2003) summa- Stephen G. Post, Department of Bioethics, School of Medicine, rized2decadesofinvestigationandconcludedthatposi- Case Western Reserve University, Cleveland, Ohio 44106–4976, USA. tive emotions were linked with a “broader thought- The author wishes to acknowledge the support of the John action repertoire,” which is to say that “big picture” Templeton Foundation; the Institute for Research on Unlimited creative thinking was enhanced (as measured by stan- Love—Altruism, Compassion, Service; and the Ford Foundation. dard tests). Drawing on her own studies and those of Al- Correspondence concerning this article should be addressed to ice Isen (1987), Frederickson found that “when people Stephen G. Post, Department of Bioethics, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106–4976, USA. feel good, their thinking becomes more creative, inte- E-mail: [email protected] grative, flexible and open to information” (p. 333). She 66 ALTRUISM, HAPPINESS, AND HEALTH also found that positive emotions enhanced psychologi- in a major longitudinal prospective study of Harvard calandphysicalresilienceandinterpretedthiseffectasa graduates over a 50-year period (Vaillant, 2002). result of the “undoing” of negative emotions that are It is already well established that compassion, clearly physically harmful. However, “helpful compas- love, and social support have health benefits for re- sionate acts,” she also argued, just allow people to feel cipients (Ainsworth et al., 1978; Harlow, 1958). Re- elevated and good about themselves and others (Post, searchers in the late 1970s, for example, were study- Underwood, Schloss, & Hurlbut, 2002). ing the effects of a diet high in fat and cholesterol in There are few new ideas in the world. The link be- rabbits. One subgroup of rabbits had 60% less athero- tween “reasonable” altruism—that is, helping behav- sclerosis than the group as a whole, even though they ior that is not overwhelming—and health is at the core ate the same diet. The only notable difference in of Dickens’ story of Ebenezer Scrooge; for with each treatment was that the healthier subgroup was fed and new expression of benevolence, Scrooge became more cared for by a lab assistant who took them out of their buoyant, until finally he was among the most generous cages, petted them, and talked to them before feed- of men in all of England and appeared all the more ef- ing. The study was repeated twice with the same re- fervescent and fit. He surely felt a great deal happier sults and was reported in Science (Nerem, Levesque, with life the more generous he became, following the & Cornhill, 1980). Also in this early period, research- pattern of the “helper’s high” (Luks, 1988). There is no ers followed 10,000 Israeli men aged 40 years and either–or dualism between quickening that innate ca- older to clarify the risk factors for angina pectoris. pacity for benevolence and the fuller actualization of a Anxiety and severe psychosocial problems were con- happier and healthier self (Frankl, 1956). Setting aside firmed risks; in addition, “those who perceived their preoccupation with “purity” and perfectly selfless mo- wives to be loving and supportive had half the rate of tives, it may be that people who live generous lives angina of those who felt unloved and unsupported” soon become aware that in the giving of self lies the un- (Medalie & Goldbourt, 1976, p. 917). A wife’s love sought discovery of self as the old selfish pursuit of was later associated with lowered risk of duodenal ul- happiness is subjectively revealed as futile and short- cers (Medalie, Stange, Zyzanski, & Goldbourt, 1992). sighted. Dostoyevsky’s images of the Elder Zossima Studies show depressed lymphocyte function after have the same buoyancy. Jewish, Hindu, Buddhist, Is- bereavement (Bartrop, Lazarus, Luckhurst, Kiloh, & lamic, and Native American spiritual traditions high- Penny, 1977). When love is lost due to the death of a light the flourishing that follows from a life of unself- beloved spouse, T and B cells in the immune system ish love—a life in tune with one’s true self (Post, behave abnormally and, for many months, must be 2002). Thus, there is an alternative image to that of the stimulated to perform their usual functions (Rees & selfless ascetic who seems intent on withering away, Lutkins, 1967, Zisook, 1987). In a remarkable study (Goode, 1959). that needs to be replicated, 126 healthy young men Scientifically speaking, however, is a generous and were randomly selected in the early 1950s from the loving life typically happier, healthier, and longer Harvard classes of 1952 and 1954 and given ques- than a life of negative affect and solipsism? Is it un- tionnaires about their perceptions of the love they felt healthy to feel and behave as though one is the center from their parents. Thirty-five years later, 91% of of the universe, relating to others only in so far as participants who did not perceive themselves to have they contribute to “my” agendas? The link between had warm relationships with their mothers had diag- altruism and health is important to how we think of nosed midlife diseases (coronary artery disease, high human nature and human fulfillment, and it was al- blood pressure, duodenal ulcer, and alcoholism), as luded to a half century ago. Sorokin (1954/2002), in compared to only 45% of those who reported a warm his classic 1954 treatise entitled The Ways and Power relationship with their mothers; 82% of those indi- of Love, began his “Preface” with the assertion that cated