What are the keys to a longer, happier life? Answers from five decades of health psychology research

doi:10.1016/j.socscimed.2017.11.001

Social Science & Medicine

Volume 196, January 2018, Pages 218-226

https://doi.org/10.1016/j.socscimed.2017.11.001 Get rights and content

Highlights

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Health psychology's biopsychosocial model of illness improves on the biomedical model.
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Without positive coping strategies, stress can result in harmful biological cascades.
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Behavior change is a key target to help improve lifestyles and reduce chronic illnesses.
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Understanding and controlling factors upstream from individuals can improve health.
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Heathy habits along with supportive environments enable successful living and aging.

Abstract

Rationale

It has long been known that factors of the mind and of interpersonal relationships influence health, but it is only in the last 50 years that an independent scientific field of health psychology appeared, dedicated to understanding psychological and behavioral processes in health, illness, and healthcare.

Objective and method

This article (a) reviews important research that answers the question of how human beings can have longer, happier lives; and (b) highlights trends in health psychology featuring articles in Social Science & Medicine as well as other related literature.

Results

Since the 1970s, health psychology has embraced a biopsychosocial model such that biological factors interact and are affected by psychological and social elements. This model has illuminated all subjects of health, ranging from interventions to lower stress and/or to improve people's ability to cope with stressors, to mental and physical health. Importantly, a health psychology perspective is behavioral: The majority of chronic diseases of today can be avoided or reduced through healthy lifestyles (e.g., sufficient exercise, proper diet, sufficient sleep). Thus, behavior change is the key target to help reduce the immense public health burden of chronic lifestyle illnesses. Health psychology also focuses on how social patterns influence health behavior and outcomes, in the form of patient-provider interactions or as social forces in communities where people live, work, and play. Health psychology is congenial to other health sciences, especially when allied with ecological perspectives that incorporate factors upstream from individual behavior, such as networks linked to individuals (e.g., peer groups, communities). Over its history, health psychology research has been responsive to societal and medical needs and has routinely focused on understanding health disparities.

Conclusion

By relying on a strong interdisciplinary approach, research in health psychology provides a remarkably comprehensive perspective on how people can live healthier lives.

Introduction

What are the keys to a healthy, happy, productive life? Along with other scientific fields, this question has been richly addressed by health psychology, which is concerned with psychological and behavioral processes in health, illness, and healthcare. Health psychology emerged in recent decades as an important contributor to a broader effort aimed to ameliorate the most pressing health-related issues in the world today: health, medical care, stress and coping, and how best to prevent, treat, and/or manage chronic disease. Health psychology offers a diverse, interdisciplinary perspective featuring a biopsychosocial model that takes into account psychological, physiological, and environmental influences on health. Health psychology also brings other key factors to bear on health, including culture, socioeconomic factors, stigma, patient-provider interactions, among others. Health psychology is concerned both with morbidity and mortality.

Our main goal in this article is to review health psychology's prominent findings and theoretical perspectives, while giving some sense of the field's history. Of course, it is impossible to do this subject justice in a single article; moreover, it is important to honor all of the history of health psychology as well as influences from related fields, even while we highlight scholarship published in Social Science & Medicine. Many of the trends we observe in health psychology are in fact part of trends in science and health; at key junctures, we elucidate intersections of this field with other disciplines. It is also important to acknowledge that whereas the field of health psychology addresses global health, this review focuses mainly on issues related to Western society and its health. In Section 2, we describe the dominant theoretical perspective in health psychology, the biopsychosocial model, which reveals the often dynamic interrelationships between biological, psychological, and social factors. This model emerged from research on health psychology's most central subject matter, stress. This section highlights the central role that habitual behavior plays in setting the stage for chronic illnesses such as hypertension and coronary heart disease. In Section 3, we consider how social interactions and networks (e.g., patient-provider interactions; community stress) affect health and review interventions to lower stress, to improve people's ability to cope with stressors, and to address other health issues. In Section 4, we offer reflections on trends in health psychology, and Section 5 sums up the field's answers to the question of how best to maximize lives lived.

Section snippets

From communicable to non-communicable diseases and the centrality of health behaviors

Medical science has witnessed many revolutions in its history, and these continue to unfold at a quickening pace. As medical science improved, so did public health: Until this era, human lives might in fact be well typified as nasty, brutish, and short, to paraphrase the 17th century political philosopher, Thomas Hobbes. Between 1800 and 2000, lifespans doubled from an average of about 35 years to 70; developed countries led the trend in expanding lifespan, but in recent decades, lagging

Social networks for—or against—health

Section 2 documented the powerful role that stressors play in health and listed some social pressures that are connected to stress (e.g., trauma, stigma). In fact, stresses humans face often result from other people: family obligations, relationships, work stress, financial issues, legal problems, and even minor disruptions like traffic or waiting in line. Furthermore, struggling to maintain healthy behavior (trying a new diet, too much or too little exercise, quitting smoking) can also be a

Trends in health psychology research

Although health psychologists have published their work in a wide variety of outlets, many have appeared in the journal in which this article appears, Social Science & Medicine (SSM), which Pergamon Press established 50 years ago in 1967 (in 1991, Elsevier Limited acquired Pergamon Press). Thus, this article and others in this special issue celebrate SSM's golden jubilee cite numerous classic sources, many of which appeared in SSM (for methods of the current review, see Appendix A in the online

Conclusion: the secret to successful living

To reduce the immense public health burden of chronic disease, health behavior change is necessary at the population level. Positive social networks along with efforts to improve self-regulation are critical to establishing and maintaining healthy attitudes and behavior. Public policy to address income inequality will help alleviate health disparities, but similar to the underlying biological mechanisms of stress, issues surrounding inequality are highly complex and often bidirectional. A wide

Author notes

We thank Frances Aboud, Chris Dunkel Schetter, Emily Alden Hennessy, Benjamin X. White, and Richard Wolferz, Jr. for their very helpful comments on a prior draft of this article; and, we thank Emma Atkinson for her assistance in organizing citations relevant to this article.

The preparation of this article was supported in part by a subcontract from U.S. Public Health Service grant 5U24AG052175.

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Citation Excerpt :
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While the detrimental consequences of problematic substance use behaviors in early adulthood are well-documented, the interpersonal predictors of substance use in the naturalistic context of daily life are less known.
Using ecological momentary assessments to capture moments of binge drinking, marijuana use, nicotine use, and prescription misuse in everyday life, this study explored the romantic relationship contexts (status, quality, partner presence) of substance use among young adults (aged 18–21) attending a university in the Midwestern U.S. Between 2017 and 2019, 296 participants, who had endorsed recent substance use at screening for a larger study on prescription misuse, completed four reports per day for approximately 28 days, resulting in over 23,000 reports for this investigation.
Relationship status, partner support, and partner presence in the moment were all associated with at least one type of substance use behavior. Generalized multilevel models indicated that partnered participants engaged in less marijuana use, nicotine use, and prescription misuse in daily life compared to single participants. Higher partner support predicted less binge drinking, yet also predicted higher nicotine use and prescription misuse. When with a romantic partner in daily life, partnered participants were more likely to engage in binge drinking and marijuana use, and less likely to misuse prescription drugs. Nicotine use was more likely when with a partner, but only if partner support was high.
Findings highlight the intricate links between interpersonal contexts and substance behaviors and indicate supportive relationships are not universally protective against substance use among this population.

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What are the keys to a longer, happier life? Answers from five decades of health psychology research

Highlights

Abstract

Rationale

Objective and method

Results

Conclusion

Introduction

Section snippets

From communicable to non-communicable diseases and the centrality of health behaviors

Social networks for—or against—health

Trends in health psychology research

Conclusion: the secret to successful living

Author notes

J. Psychosomatic Res.

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Am. J. Geriatric Psychiatry

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Mol. cells

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Soc. Sci. Med.

Psychoneuroendocrinology

Soc. Sci. Med.

Lancet

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Soc. Sci. Med.

Soc. Sci. Med.

Mech. Ageing Dev.

Soc. Sci. Med.

Soc. Sci. Med.

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