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Volunteering and Subsequent Health and Well-Being in Older Adults: An Outcome-Wide Longitudinal Approach

  • Eric S. Kim
    Correspondence
    Address correspondence to: Eric S. Kim, PhD, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston MA 02215.
    Affiliations
    Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
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  • Ashley V. Whillans
    Affiliations
    Negotiation, Organizations, and Markets Unit, Harvard Business School, Cambridge, Massachusetts
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  • Matthew T. Lee
    Affiliations
    Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
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  • Ying Chen
    Affiliations
    Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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  • Tyler J. VanderWeele
    Affiliations
    Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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      Introduction

      Growing evidence documents strong associations between volunteering and favorable health and well-being outcomes. However, epidemiological studies have not evaluated whether changes in volunteering are associated with subsequent health and well-being outcomes.

      Methods

      Data were from 12,998 participants in the Health and Retirement Study—a large, diverse, prospective, and nationally representative cohort of U.S. adults aged >50 years. Using multiple logistic, linear, and generalized linear regression models, this study evaluated if changes in volunteering (between t0, 2006/2008 and t1, 2010/2012) were associated with 34 indicators of physical health, health behaviors, and psychosocial well-being (in t2, 2014/2016). Models adjusted for sociodemographics, physical health, health behaviors, psychosocial factors, and personality, as well as volunteering and all outcomes in the prebaseline wave (t0, 2006/2008). Results accounted for multiple testing and data were analyzed in 2019.

      Results

      During the 4-year follow-up period, participants who volunteered ≥100 hours/year (versus 0 hours/year) had a reduced risk of mortality and physical functioning limitations, higher physical activity, and better psychosocial outcomes (higher: positive affect, optimism, and purpose in life; lower: depressive symptoms, hopelessness, loneliness, and infrequent contact with friends). Volunteering was not associated with other physical health outcomes (diabetes, hypertension, stroke, cancer, heart disease, lung disease, arthritis, overweight/obesity, cognitive impairment, and chronic pain), health behaviors (binge drinking, smoking, and sleep problems), or psychosocial outcomes (life satisfaction, mastery, health/financial mastery, depression, negative affect, perceived constraints, and contact with other family/children).

      Conclusions

      With further research, volunteering is an activity that physicians might suggest to their willing and able patients as a way of simultaneously enhancing health and society.
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      REFERENCES

      1. Volunteering in America: research. Corporation for National & Community Service. www.nationalservice.gov/serve/via/research. Accessed June 10, 2019.

        • Johnson SS
        • Post SG
        Rx it's good to be good (B2BG) 2017 commentary: prescribing volunteerism for health, happiness, resilience, and longevity.
        Am J Health Promot. 2017; 31: 164-172
        • Carr DC
        • Fried LP
        • Rowe JW
        Productivity & engagement in an aging America: the role of volunteerism.
        Daedalus. 2015; 144: 55-67
        • Morrow-Howell N
        • Backes K
        • O'Neill G
        • Greenfield JC
        Volunteering in later life: policies and programs to support a resilient aging society.
        in: Resnick B Gwyther LP Roberto KA Resilience in Aging: Concepts, Research, and Outcomes. Springer International, Cham, Switzerland2018: 171-189
        • Carr DC
        • Kail BL
        • Rowe JW
        The relation of volunteering and subsequent changes in physical disability in older adults.
        J Gerontol B Psychol Sci Soc Sci. 2018; 73: 511-521
        • Anderson ND
        • Damianakis T
        • Kröger E
        • et al.
        The benefits associated with volunteering among seniors: a critical review and recommendations for future research.
        Psychol Bull. 2014; 140: 1505-1533
        • Burr JA
        • Tavares J
        • Mutchler JE
        Volunteering and hypertension risk in later life.
        J Aging Health. 2011; 23: 24-51
        • Burr JA
        • Han SH
        • Tavares JL
        Volunteering and cardiovascular disease risk: does helping others get “under the skin?.
        Gerontologist. 2016; 56: 937-947
        • Infurna FJ
        • Okun MA
        • Grimm KJ
        Volunteering is associated with lower risk of cognitive impairment.
        J Am Geriatr Soc. 2016; 64: 2263-2269
        • Poulin MJ
        Volunteering predicts health among those who value others: two national studies.
        Health Psychol. 2014; 33: 120-129
        • Konrath S
        • Fuhrel-Forbis A
        • Lou A
        • Brown S
        Motives for volunteering are associated with mortality risk in older adults.
        Health Psychol. 2012; 31: 87-96
        • Musick MA
        • Herzog AR
        • House JS
        Volunteering and mortality among older adults: findings from a national sample.
        J Gerontol B Psychol Sci Soc Sci. 1999; 54: S173-S180
        • Oman D
        • Thoresen CE
        • McMahon K
        Volunteerism and mortality among the community-dwelling elderly.
        J Health Psychol. 1999; 4: 301-316
        • Luoh MC
        • Herzog AR.
        Individual consequences of volunteer and paid work in old age: health and mortality.
        J Health Soc Behav. 2002; 43: 490-509
        • Sabin EP.
        Social relationships and mortality among the elderly.
        J Appl Gerontol. 1993; 12: 44-60
        • Morrow-Howell N
        • Hinterlong J
        • Rozario PA
        • Tang F
        Effects of volunteering on the well-being of older adults.
        J Gerontol B Psychol Sci Soc Sci. 2003; 58: S137-S145
        • Tabassum F
        • Mohan J
        • Smith P
        Association of volunteering with mental well-being: a lifecourse analysis of a national population-based longitudinal study in the UK [published correction appears in BMJ Open. 2016;6(9):e011327corr1].
        BMJ Open. 2016; 6e011327
        • Greenfield EA
        • Marks NF.
        Formal volunteering as a protective factor for older adults’ psychological well-being.
        J Gerontol B Psychol Sci Soc Sci. 2004; 59: S258-S264
        • Pilkington PD
        • Windsor TD
        • Crisp DA
        Volunteering and subjective well-being in midlife and older adults: the role of supportive social networks.
        J Gerontol B Psychol Sci Soc Sci. 2012; 67: 249-260
        • Müller D
        • Ziegelmann JP
        • Simonson J
        • Tesch-Römer C
        • Huxhold O
        Volunteering and subjective well-being in later adulthood: is self-efficacy the key?.
        Int J Dev Sci. 2014; 8: 125-135
        • Aknin L
        • Whillans AV
        • Norton MI
        • Dunn EW
        Happiness and prosocial behavior: an evaluation of the evidence.
        in: Helliwell JF Layard R Sachs JD World Happiness Report 2019. Sustainable Development Solutions Network, New York, NY2019: 66-85
        • Han SH
        • Kim K
        • Burr JA
        Stress-buffering effects of volunteering on salivary cortisol: results from a daily diary study.
        Soc Sci Med. 2018; 201: 120-126
        • Raposa EB
        • Laws HB
        • Ansell EB
        Prosocial behavior mitigates the negative effects of stress in everyday life.
        Clin Psychol Sci. 2016; 4: 691-698
        • Kim ES
        • Konrath SH.
        Volunteering is prospectively associated with health care use among older adults.
        Soc Sci Med. 2016; 149: 122-129
        • Kim S
        • Ferraro KF.
        Do productive activities reduce inflammation in later life? Multiple roles, frequency of activities, and C-reactive protein.
        Gerontologist. 2014; 54: 830-839
        • Sneed RS
        • Cohen S.
        A prospective study of volunteerism and hypertension risk in older adults.
        Psychol Aging. 2013; 28: 578-586
        • Hong SI
        • Morrow-Howell N.
        Health outcomes of Experience Corps: a high-commitment volunteer program.
        Soc Sci Med. 2010; 71: 414-420
        • Barron JS
        • Tan EJ
        • Yu Q
        • Song M
        • McGill S
        • Fried LP
        Potential for intensive volunteering to promote the health of older adults in fair health.
        J Urban Health. 2009; 86: 641-653
        • Fried LP
        • Carlson MC
        • Freedman M
        • et al.
        A social model for health promotion for an aging population: initial evidence on the Experience Corps model.
        J Urban Health. 2004; 81: 64-78
        • Carlson MC
        • Kuo JH
        • Chuang YF
        • et al.
        Impact of the Baltimore Experience Corps Trial on cortical and hippocampal volumes.
        Alzheimers Dement. 2015; 11: 1340-1348
        • Carlson MC
        • Saczynski JS
        • Rebok GW
        • et al.
        Exploring the effects of an “everyday” activity program on executive function and memory in older adults: Experience Corps®.
        Gerontologist. 2008; 48: 793-801
        • Schreier HM
        • Schonert-Reichl KA
        • Chen E
        Effect of volunteering on risk factors for cardiovascular disease in adolescents: a randomized controlled trial.
        JAMA Pediatr. 2013; 167: 327-332
        • Nelson-Coffey SK
        • Fritz MM
        • Lyubomirsky S
        • Cole SW
        Kindness in the blood: a randomized controlled trial of the gene regulatory impact of prosocial behavior.
        Psychoneuroendocrinology. 2017; 81: 8-13
        • Varma VR
        • Tan EJ
        • Gross AL
        • et al.
        Effect of community volunteering on physical activity: a randomized controlled trial.
        Am J Prev Med. 2016; 50: 106-110
        • Parisi JM
        • Kuo J
        • Rebok GW
        • et al.
        Increases in lifestyle activities as a result of Experience Corps® participation.
        J Urban Health. 2015; 92: 55-66
        • Tan EJ
        • Xue QL
        • Li T
        • Carlson MC
        • Fried LP
        Volunteering: a physical activity intervention for older adults–the Experience Corps program in Baltimore.
        J Urban Health. 2006; 83: 954-969
        • Jenkinson CE
        • Dickens AP
        • Jones K
        • et al.
        Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers.
        BMC Public Health. 2013; 13: 773
        • Whillans AV
        • Seider SC
        • Chen L
        • et al.
        Does volunteering improve well-being?.
        Compr Results Soc Psychol. 2016; 1: 35-50
        • Deaton A
        • Cartwright N
        Understanding and misunderstanding randomized controlled trials.
        Soc Sci Med. 2018; 210: 2-21
      2. VanderWeele TJ, Mathur MB, Chen Y. Outcome-wide longitudinal designs for causal inference: a new template for empirical studies. Stat Sci. In press.

        • Ryff CD
        • Singer B
        Understanding healthy aging: key components and their integration.
        in: Bengston VL Gans D Pulney NM Silverstein M Handbook of Theories of Aging. 2nd ed. Springer Publishing Co, New York, NY2009: 117-144
        • Rowe JW
        • Kahn RL
        Human aging: usual and successful.
        Science. 1987; 237: 143-149
        • Reich JW
        • Zautra AJ
        • Hall JS
        Handbook of Adult Resilience.
        Guilford Press, New York, NY2010
        • Aldwin CM
        • Successful Igarashi H.
        optimal, and resilient aging: A psychosocial perspective.
        in: Lichtenberg PA Mast BT Carpenter BD Loebach Wetherell J APA Handbooks in Psychology. APA Handbook of Clinical Geropsychology, Vol. 1. History and Status of the Field and Perspectives on Aging. American Psychological Association, Washington, DC2015: 331-359
        • Depp CA
        • Jeste DV.
        Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies.
        Am J Geriatr Psychiatry. 2006; 14: 6-20
        • Smith J
        • Fisher G
        • Ryan L
        • Clarke P
        • House J
        • Weir D
        Psychosocial and lifestyle questionnaire 2006‒2010: documentation report.
        Institute for Social Research: University of Michigan, Ann Arbor, MIFebruary 2013 (PublishedAccessed June 9, 2019)
        • Fisher GG
        • Faul JD
        • Weir DR
        • Wallace RB
        HRS/AHEAD documentation report: documentation of chronic disease measures in the Health and Retirement Study (HRS/AHEAD).
        Survey Research Center, University of Michigan, Ann Arbor, MIFebruary 10, 2005 (PublishedAccessed June 9, 2019)
        • Jenkins KR
        • Ofstedal MB
        • Weir D
        HRS/AHEAD documentation report: documentation of health behaviors and risk factors measured in the Health and Retirement Study (HRS/AHEAD).
        Survey Research Center, University of Michigan, Ann Arbor, MIFebruary 2008 (PublishedAccessed June 9, 2019)
        • Dunn OJ
        Multiple comparisons among means.
        J Am Stat Assoc. 1961; 56: 52-64
        • VanderWeele TJ
        • Mathur MB.
        Some desirable properties of the Bonferroni correction: is the Bonferroni correction really so bad?.
        Am J Epidemiol. 2019; 188: 617-618
        • VanderWeele TJ
        • Ding P.
        Sensitivity analysis in observational research: introducing the E-value.
        Ann Intern Med. 2017; 167: 268-274
        • Sterne JA
        • White IR
        • Carlin JB
        • et al.
        Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls.
        BMJ. 2009; 338: b2393
        • Moons KG
        • Donders RA
        • Stijnen T
        • Harrell Jr, FE
        Using the outcome for imputation of missing predictor values was preferred.
        J Clin Epidemiol. 2006; 59: 1092-1101
        • Groenwold RH
        • Donders AR
        • Roes KCB
        • Harrell Jr, FE
        • Moons KG
        Dealing with missing outcome data in randomized trials and observational studies.
        Am J Epidemiol. 2012; 175: 210-217
        • Asendorpf JB
        • van de Schoot R
        • Denissen JJ
        • Hutteman R
        Reducing bias due to systematic attrition in longitudinal studies: the benefits of multiple imputation.
        Int J Behav Dev. 2014; 38: 453-460
        • Rawlings AM
        • Sang Y
        • Sharrett AR
        • et al.
        Multiple imputation of cognitive performance as a repeatedly measured outcome.
        Eur J Epidemiol. 2017; 32: 55-66
        • Cumming JJ
        • Goldstein H.
        Handling attrition and non-response in longitudinal data with an application to a study of Australian youth.
        Longit Life Course Stud. 2016; 7: 53-63
        • Weuve J
        • Proust-Lima C
        • Power MC
        • et al.
        Guidelines for reporting methodological challenges and evaluating potential bias in dementia research.
        Alzheimers Dement. 2015; 11: 1098-1109
        • Harel O
        • Mitchell EM
        • Perkins NJ
        • et al.
        Multiple imputation for incomplete data in epidemiologic studies.
        Am J Epidemiol. 2018; 187: 576-584
        • van Ginkel JR
        • Linting M
        • Rippe RCA
        • van der Voort A
        Rebutting existing misconceptions about multiple imputation as a method for handling missing data.
        J Pers Assess. 2020; 102: 297-308
        • Van Willigen M.
        Differential benefits of volunteering across the life course.
        J Gerontol B Psychol Sci Soc Sci. 2000; 55: S308-S318
        • Oman D
        Does volunteering foster physical health and longevity?.
        in: Post SG Altruism and Health: Perspectives From Empirical Research. Oxford University Press, New York, NY2007: 15-32
        • Wheeler JA
        • Gorey KM
        • Greenblatt B
        The beneficial effects of volunteering for older volunteers and the people they serve: a meta-analysis.
        Int J Aging Hum Dev. 1998; 47: 69-79
        • Holt-Lunstad J
        • Smith TB
        • Layton JB
        Social relationships and mortality risk: a meta-analytic review.
        PLoS Med. 2010; 7e1000316
        • Kubzansky LD
        • Huffman JC
        • Boehm JK
        • et al.
        Positive psychological well-being and cardiovascular disease: JACC health promotion series.
        J Am Coll Cardiol. 2018; 72: 1382-1396
        • Kim ES
        • Delaney SW
        • Kubzansky LD
        Sense of purpose in life and cardiovascular disease: underlying mechanisms and future directions.
        Curr Cardiol Rep. 2019; 21: 135
        • Danaei G
        • Tavakkoli M
        • Hernán MA
        Bias in observational studies of prevalent users: lessons for comparative effectiveness research from a meta-analysis of statins.
        Am J Epidemiol. 2012; 175: 250-262
        • Hernán MA.
        Counterpoint: epidemiology to guide decision-making: moving away from practice-free research.
        Am J Epidemiol. 2015; 182: 834-839
        • VanderWeele TJ
        • Jackson JW
        • Li S
        Causal inference and longitudinal data: a case study of religion and mental health.
        Soc Psychiatry Psychiatr Epidemiol. 2016; 51: 1457-1466