Story at a glance

  • For teenagers, feelings of optimism and happiness, along with self-esteem, a sense of belonging and feeling loved, were associated with better cardiometabolic health years later.

  • The link between these positive feelings and good health was especially strong among Black youth.

  • Researchers suggest investing in youth mental health may help improve inequities in cardiometabolic health. 

Teenagers who feel as if they belong, are loved and wanted, and are optimistic or happy may have lower cardiometabolic health risks in adulthood compared with teens who feel fewer of these positive emotions, according to a new study published Wednesday.  

Although just 12 percent of young adults maintained good cardiometabolic health over time, teens who reported feeling more of the positive emotions were 69 percent more likely to maintain their health as young adults, results showed. 

Effects were also cumulative. Each additional positive emotion reported by teens was associated with a 12 percent increase in likelihood of good health down the line. 

The link is especially prominent among Black youth, data show, as these teens reported feeling the most positive emotions and derived the most health benefits from them. 

Researchers suggest the positive emotions may serve as a buffer against the negative effects of social stress teens often feel. 

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“Assets like optimism and other facets of psychological wellbeing also predict greater health-enhancing behaviors across multiple domains, including physical activity, diet, and tobacco use,” they wrote in the study.

Fostering these positive emotions in teenagers could not only help prevent cardiometabolic disease but may also address health inequities, results suggest. 

“We learned a lot in the last few decades about the impact of discrimination and other social risks youth of color face that may explain their elevated rates of cardiometabolic disease,” study author Farah Qureshi, an assistant professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore, said in a statement.

But “much less attention is paid to the inherent strengths they possess and the ways those strengths may be leveraged to advance health equity,” Qureshi said. “In this study, we wanted to shift the paradigm in public health beyond the traditional focus on deficits to one that concentrates on resource building.”

Data were collected from around 3,500 high schoolers first enrolled in the National Longitudinal Study of Adolescent Health in 1994. Participants were followed for over 20 years with the most recent data collected in 2018, when the average participant’s age was 38. 

According to surveys carried out when participants were teenagers, the five positive mental health assets associated with better health outcomes were optimism, happiness, self-esteem, a sense of belonging and feeling loved. 

Researchers compared survey responses with measures of cardiovascular and metabolic disease risk factors — such as blood sugar levels and inflammation — collected when participants were in their late 20s and 30s.  

The greatest health benefits linked with positive feelings were seen among Black teens, though these individuals were least likely to maintain good cardiometabolic health over time.  

Qureshi described this finding as somewhat counterintuitive and noted the absence of positive feelings was particularly damaging to the health of Black youth. 

“For Black youth – who face numerous barriers to achieving and sustaining optimal cardiometabolic health in adulthood – not having these additional mental health resources makes a big difference,” Qureshi said. The findings indicate that investing in youth mental health early may help improve cardiometabolic health equity. 

In the United States, Black Americans are 60 percent more likely to be diagnosed with diabetes than their white counterparts, while Black Americans are also twice as likely to die from the disease. 

Structural racism plays a large role in shaping these health inequities. But fostering feelings of belonging and optimism may help protect youth from the negative effects of structural racism, the authors said.

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