To Flourish or Not: Positive Mental Health and All-Cause Mortality

OBJECTIVES: We investigated whether positive mental health predicts all-cause mortality. METHODS: Data were from the Midlife in the United States (MIDUS) study (n = 3032), which at baseline in 1995 measured positive mental health (flourishing and not) and past-year mental illness (major depressive episode, panic attacks, and generalized anxiety disorders), and linked respondents with National Death Index records in a 10-year follow-up ending in 2005. Covariates were age, gender, race, education, any past-year mental illness, smoking, physical inactivity, physical diseases, and physical disease risk factors. RESULTS: A total of 6.3% of participants died during the study period. The final and fully adjusted odds ratio of mortality was 1.62 (95% confidence interval CI = 1.00, 2.62; P = .05) for adults who were not flourishing, relative to participants with flourishing mental health. Age, gender, race, education, smoking, physical inactivity, cardiovascular disease, and HIV/AIDS were significant predictors of death during the study period. CONCLUSIONS: The absence of positive mental health increased the probability of all-cause mortality for men and women at all ages after adjustment for known causes of death.