New Evidence for the Effect of Gratitude on Life Expectancy

Amid the frustrations and undeniable difficulties of life — from your ever-mounting pile of email or snail-paced commute, to the loss of a job or the death of your beloved — it is easy for any of us to become complacent about or indifferent to the extraordinary array of good adorning and sustaining even the most challenging circumstances. We can miss the thousand ways that we have been and are being loved into being, by family and friends or by mentors and colleagues. And the millions of ways in which our world — its air and trees, its architecture and innovations, even the language with which we engage it and one another — is largely given to us from without, a gift not of our devising, even if we can embellish it in turn. 

One of our best checks against this descent into cynicism or melancholy is gratitude, the practice of acknowledging some good in our life as, at least in part, a gift for which the proper response is thanksgiving, whether that is owed to another person (your mother or the stranger who held the door when your hands were full), to God as the giver of “every perfect gift” (Jas 1:17), or simply to the natural order itself, which gives itself to us in such varied and seemingly gratuitous profusion. 

Gratitude and Well-Being

There is substantial empirical evidence that the cultivation and practice of gratitude enhances well-being. And simple, easy-to-use interventions have been developed to increase gratitude in life, and thereby to promote flourishing. One might, for instance, try writing down three things one is grateful for three times a week over the course of a month or two, or for even longer. 

Evidence from numerous randomized trials (summarized in this meta-analysis) suggests that simple activities like focusing the mind on what is good in one’s past or present can help increase happiness, relieve symptoms of depression, and perhaps even improve sleep. There are, of course, numerous variations on this exercise of expressing gratitude, but study after study has suggested a positive effect of gratitude on enhancing well-being, and it is for this reason that we’ve included such gratitude exercises previously among helpful and evidence-based activities for flourishing. 

Gratitude and Mortality

While many studies have indicated beneficial effects of gratitude on a variety of flourishing outcomes, it has long been unclear whether gratitude affects overall life expectancy. In a paper recently published at JAMA Psychiatry, we have taken up this question. We used data on over 49,000 women in the Nurses’ Health Study and followed up with them over four years after the initial gratitude assessment to examine mortality risk of those with high versus low levels of gratitude. Given that objective circumstances, such as baseline health, might affect both gratitude and subsequent mortality risk, we controlled for a host of baseline health measures, as well as many other social, demographic, economic, health behavior, and psychological variables, including other aspects of psychological well-being, such as depressive symptoms and optimism. Such rigorous control, with longitudinal data over time, is needed if we want to have any hope of making causal inferences. 

In spite of those rigorous controls, we found that those with high levels of gratitude were nine percent less likely to die over the four years of followup than those with low levels of gratitude, and 15 percent less likely to die from cardiovascular disease in particular. While the mortality reduction is not huge, it is meaningful; and while the effect of gratitude may be somewhat smaller than what one finds with optimism per se, these effects of gratitude are present above and beyond the potential protective effects of optimism (for which control was made).

Public Health Implications

Anyone can practice gratitude — that is why this information is important. It can be hard to change optimism in any straightforward manner, and indeed some of the interventions that have tried to bring about such changes have failed. 

Once again, anyone can practice gratitude. Anyone can recognize what is good around them. And, as noted above, there are interventions that we know work to increase gratitude and to increase well-being. Our study suggests that such practices could help reduce mortality risk as well.

Given the effects of gratitude interventions on well-being and on health, this information and these gratitude exercises could be widely disseminated in schools, in workplaces, in neighborhoods and communities. In each of these settings, it may be possible to run mini-gratitude campaigns, discussing the results of such research, providing examples of gratitude exercises, and perhaps even taking some time out of the day — in a school, at a workplace, or around the dinner table — to practice gratitude together. In day-to-day life, such gratitude practices recognize the good around us, help us to be grateful for one another, contribute to our well-being, and bring life to our communities.

“What do you have which you have not received?”

Christians have particularly strong reasons for placing gratitude at the center of our lives. After all, every Christian knows themself to belong to a cosmos that, in every moment of its existence, is called forth out of nothing by God, not to satisfy any lack in himself, but as a free and gracious expression of his love. Paul could ask the Corinthians, “What do you have which you have not received?” in the assurance that the only reasonable answer is, “Nothing” (1 Cor 4:7). Every atom of our bodies and every trait we admire is a gift. “Thy life’s a miracle,” Edgar tells Gloucester in King Lear — so it is, and so is the world’s very fabric. 

Not only should Christians practice gratitude; they very likely already practice it in most of their prayers. “When people pray … often they try to change the way they think, feel, and attend so that those mental acts are in line with the way they would rather be — with the world as it should be. … In expressing gratitude, they alter what they remember of the day: not the irritating comment but the warm smile, not the cold morning but the lovely afternoon,” anthropologist Tanya Luhrmann perceptively observes in How God Becomes Real. Luhrmann goes so far as to suggest that “the cognitive restructuring that is the basic mechanism of gratitude prayer is also the goal of cognitive behavioral therapy.” This isn’t to cultivate a naïve disregard for the world’s evils, but rather, it is a deliberate effort to focus attention on the good. 

The point, of course, is not to cultivate gratitude in order to alleviate anxiety, much less to lower one’s blood pressure, even if those personal benefits might provide an initial spur to undertake such practices. More plausibly, we might take it that the expression of gratitude — in prayer, in thank you notes, in words of affirmation to our beloveds — promotes flourishing on so many levels because it fits the actual shape of the world. If the world is a gift — if our lives really are miracles — then those who clutch proudly at what they have been given, or scorn the riches lavished on them in every moment, are living in profound and self-defeating denial of the conditions for their flourishing, gulping saltwater as they sit beside a fresh spring. By contrast, perhaps the grateful flourish because they see and respond to the world as it truly is.