While low levels of negative emotion or high levels of cardiorespiratory fitness are predictors of long-term survival in men and women, being both fit and not unhappy provides a strong combined effect, reducing premature death by 63 percent, according to this study.

Although it is known that psychological well-being and cardiorespiratory fitness are both associated with survival, little research has looked at their interaction. From 1988-1997, 4,888 U.S. participants–mostly Caucasian, well-educated, working as professionals or executives, and from middle to high socioeconomic strata–were evaluated for levels of cardiorespiratory fitness, negative emotion and positive emotion. Subjects were then followed for approximately 15 years. Analysis was adjusted for significant health factors such as age, BMI, physical activity, smoking and alcohol consumption.

Key Findings:

• Men and women with high levels of negative emotion were 1.5 times more likely to die than those with lower levels of negative emotion.
• Individuals with low fitness levels were 1.8 times more likely to die than those less fit.
• But whether individuals had higher or lower levels of positive emotion did not change their mortality rate.
• Having both a low level of negative emotion and being fit reduced premature death by 63 percent, compared to unfit peers with high levels of negative emotion.
• There was no difference in these findings between those over 60 years of age versus those younger, nor between healthy and unhealthy people.

Although this study did not investigate causality, the authors suggest lower levels of negative emotion may reduce people’s susceptibility to disease and increase their abilities to problem-solve, concentrate and socialize. These findings suggest, in order to reduce premature death, health care professionals should be assessing and providing interventions to increase the physical fitness and psychological well-being of patients.

This study is one in a series supported by the Robert Wood Johnson Foundation’s Pioneer Portfolio to explore Positive Health, an emerging concept that seeks to demonstrate that in addition to health risks, people also have health assets, which can be strengthened to produce a healthier life. These health assets could include biological factors, such as high heart rate variability; subjective factors, such as optimism; and functional factors, such as a stable marriage.