Most approaches to health over the centuries have focused on the absence of illness. In contrast, we are investigating Positive Health—well-being beyond the mere absence of disease. In this article, we describe our theoretical framework and empirical work to date on Positive Health. Positive Health empirically identifies health assets by determining factors that predict health and illness over and above conventional risk factors. Biological health assets might include, for example, high heart rate variability, high levels of HDL, and cardiorespiratory fitness. Subjective health assets might include positive emotions, life satisfaction, hope, optimism, and a sense of meaning and purpose. Functional health assets might include close friends and family members; a stable marriage; meaningful work; participation in a social community; and the ability to carry out work, family, and social roles.
Health assets are desirable in their own right, but research has clearly demonstrated the relevance of biological assets and suggested the importance of functional health assets to overall health. Still to be determined is whether and how subjective health assets contribute to health-related outcomes, including:
- Quality-adjusted life years
- Prognosis when illness strikes
- Health care utilization and cost
Even less is known about the inter-relations between subjective, functional, and biological health assets.
We have begun a program of research that considers the relevance of these assets in relation to health, and we describe several of our recent studies. Initial work has focused on subjective health assets, with additional research planned to look at the inter-relations between subjective, functional, and biological health assets.
This work builds on prior research demonstrating strong links between psychosocial factors and cardiovascular disease (CVD) and uses existing datasets to explore how psychological assets influence cardiovascular health and disease. Because existing datasets are heavily weighted toward what goes wrong in life, we needed to derive valid measures of psychological assets from them. Having done so, our studies consistently show that subjective health assets are meaningfully associated with reduced risk of cardiovascular disease. Therefore, we believe that certain health assets may protect against illness and building these assets may be an effective and inexpensive strategy for prevention.
This white paper divides into three sections: the Overarching Endeavor, the First Empirical Studies, and the Measurement of Health Assets.