Prospective associations between strengths of moral character and health: longitudinal evidence from survey and insurance claims data

Variations in character involving an orientation to promote good across sociodemographic groups in 22 countries

An orientation to promote good (i.e., a disposition to take actions that contribute to the good of oneself and others) has been associated with better health and well-being outcomes. However, less is known about how orientation to promote good differs across countries and across sociodemographic groups within different countries. Using a sample of 202,898 adults from 22 diverse countries, this study examined the distribution of orientation to promote good across key sociodemographic groups within each country separately, and cross-nationally by pooling estimates across countries. Our results suggest that population mean levels of promoting good vary substantially across countries. In the pooled results, the means of promoting good also vary across most of the sociodemographic factors that we examined. Specifically, individuals who are older, female, married, employed or retired, highly educated, attending religious services frequently, and native-born reported higher means of promoting good than those in other demographic groups. In country-specific analyses, the sociodemographic variation in promoting good also differs across countries, indicating diverse societal influences. This study provides novel insights into the social distribution of orientation to promote good, which paves the way for future investigations into sociocultural influences that may shape individuals' expression of character across different national contexts.

Multidimensional versus unidimensional approaches to well-being

Interest in the scientific study of well-being has grown substantially, spanning various disciplines and sectors of society, while also gaining greater relevance in policymaking. In this Perspective, we compare and contrast unidimensional versus multidimensional understandings of well-being, and corresponding measures of life satisfaction or life evaluation versus flourishing. We consider conceptual, empirical, pragmatic and policy arguments that have been put forward for each of these understandings and measurement approaches. While we argue that well-being needs to be conceptually and scientifically understood, and empirically studied, as a multidimensional construct, we acknowledge the pragmatic and policy challenges of doing so and how in some circumstances relying on a unidimensional assessment may sometimes be practically necessary. We put forward some proposals as to how researchers and policymakers might navigate these various challenges.

Positive epidemiology, revisited: the case for centering human rights and economic justice

In recent years, a growing body of research in positive epidemiology has sought to expand the traditional focus of epidemiologic research beyond risk factors for disease and towards a more holistic understanding of health that includes the study of positive assets that shape well-being more broadly. While this paradigm shift holds great promise for transforming people's lives for the better, it is also critiqued for showcasing decontextualized perspectives that could cause great harm to the public's health if translated uncritically into population-based interventions. In this commentary, we argue for orienting positive epidemiology within a human rights and economic justice framework to mitigate this threat, and we discuss two examples of previously proposed health assets (religious involvement and marriage) that demonstrate the urgent need for positive epidemiologic research to center health equity. Finally, to advance the field, we provide recommendations for how future research can address shortcomings of the extant literature by moving from individual-level to societal-level applications. In doing so, we believe that positive epidemiology can be transformed into a powerful force for health equity. This article is part of a Special Collection on Mental Health.

The Impact of Negative Moral Character on Health and the Role of Spirituality: A Narrative Literature Review

Although negative moral character is highly prevalent, it is not included in the International Classification of Diseases (ICD). Along with the modification of WHO ICD-11, spirituality should be acknowledged for its potetnial role in the prevention of negative moral traits. This study aimed to explore the effects of negative moral character on health and determine the role of spirituality in improving negative moral traits. This narrative literature review was conducted from 2020 to 2023 in Kabul, Afghanistan. The articles were obtained from the Web of Science, PubMed, and Google Scholar databases. As demonstrated in this narrative literature review, most of the relevant experimental and observational studies have found that negative moral character can have significant negative impact on overall health and well-being. Many studies have established the positive role of spirituality in improving negative moral character. These studies concluded that facilities must be available within schools, universities, and communities for everyone to gain knowledge of spirituality and improve their negative moral character. Considering the adverse impacts of negative moral character on health, the current study proposes the addition of moral disorder to the WHO International Classification of Diseases. According to this literature review, spirituality will improve negative moral character and strengthen excellent moral traits.

Vitality Revisited: The Evolving Concept of Flourishing and Its Relevance to Personal and Public Health

Human flourishing, the state of optimal functioning and well-being across all aspects of an individual's life, has been a topic of philosophical and theological discussion for centuries. In the mid-20th century, social psychologists and health scientists began exploring the concept of flourishing in the context of health and high-level wellness. However, it is only in recent years, in part due to the USD 43 million Global Flourishing Study including 22 countries, that flourishing has entered the mainstream discourse. Here, we explore this history and the rapid acceleration of research into human flourishing, defined as "the relative attainment of a state in which all aspects of a person's life are good" by the Harvard University's Flourishing Program. We also explore the construct of "vitality", which refers to a sense of aliveness, energy, and motivation; we contend that this has been neglected in the flourishing movement. We explore why incorporating measures of vitality, together with a broader biopsychosocial approach, considers all dimensions of the environment across time (the total exposome), which will greatly advance research, policies, and actions to achieve human flourishing.