When it Comes to Health, Is Emotion Just a First World Problem?

Students participate in afterschool activities on March 9, 2009 inside the Agahozo Shalom Youth Village in Rwamagana, Rwanda. Marvi Lacar/Getty

Here’s something to smile about: researchers have known for a while that there’s a connection between emotions and health. People with positive emotions tend to report being healthier—they even live longer—and those with negative emotions report being less healthy. But a limitation of this research was that it was focused on people in the developed world, leaving one team of researchers to wonder if the connection between emotions and health was just a “First World problem.” In other words, in a part of the world where people might not have adequate food or shelter, would emotions still be strongly tied to health?

To answer that question, they surveyed more than 150,000 people in 142 different countries, asking them about recent positive feelings, negative feelings, their self-reported health, and questions about whether they felt safe and secure where they lived, as well as about food and shelter. Their conclusions? Not only was the connection between emotions and health found to hold true globally, but the connection between positive emotions and good health was actually stronger in poorer countries, as their recent article in Psychological Science reports. Sarah Pressman, the study’s lead author and an assistant professor of psychology and social behavior at the University of California, Irvine, says they wanted to know if the emotion-health connection would “matter in a place where people are in wars, where people are starving, where they’re homeless, and surprisingly enough, it not only mattered, but it mattered more, which was quite a big surprise to us.”

A poor country like Rwanda, for example, had a strong connection between positive emotions and good self-reported health, while the same connection was less strong in Peru, and even weaker in Switzerland. Strikingly, people’s reported emotions actually had twice as strong a correlation with their health than their food and shelter situation did. (To be sure, people who reported inadequate food and shelter were less likely to say they were healthy, but their emotions had a stronger relationship with their physical health.)

The researchers were left with a simple question: why would the connection between positive emotions and good health be stronger in the developing world? One theory, Pressman says, is that access to medicine in rich countries might mitigate the connection between emotions and health. For example, medication that lowers blood pressure can help someone who is stressed become physically healthier, while a person without access to that medication might demonstrate an uninterrupted connection between their emotions and their health.

Greg Miller, a psychology professor at Northwestern University who studies the relationship between stress and health, noted that the amount of data the researchers have collected is “impressive,” but said that one limiting factor to the study is that the information on emotions and health was self-reported by the survey participants. And whether or not there is a causal relationship between health and emotions is unclear. “It’s hard to know from these data whether it’s people’s mood that’s affecting their health, their health affecting their mood, [or] their personality that’s affecting both their health and their mood,” he says, adding that in different settings the relationship could be different. The next step, he says, is to “dig deeper.”