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Effects of stress not truly understood

   Stressed out
   Stressed out
   Laurence Mouton / Getty Images

   Although a new study raises doubts about unhappiness and stress having
   negative health effects, a closer look at the study shows stress can't
   be eliminated as a factor in shortening life spans.

   Although a new study raises doubts about unhappiness and stress having
   negative health effects, a closer look at the study shows stress can't
   be eliminated as a factor in shortening life spans.
   (Laurence Mouton / Getty Images)
   Peter OrszagBloomberg View

   Differences in life expectancy by education and income are increasing.
   And while differential trends in smoking and other habits partly
   explain the life-span gap, it's mostly a puzzle. I suspect that a major
   factor is stress — that prolonged exposure to stress has risen more
   among families of moderate income than it has among those of high
   income, and that the stress is literally killing people.

   A new study raises doubts about this hypothesis. The researchers found
   that British women aged 50 to 69 who said they were unhappy or felt as
   if they had no control over their lives were more likely to die over
   the next decade than those who did not. But when the researchers
   adjusted for self-reported health at the beginning of the study, the
   correlation effectively disappeared.

   The researchers concluded that the women in worse health had shorter
   life expectancy, and that their health problems were also what caused
   them to feel stress and unhappiness. As the lead author, Bette Liu of
   the University of New South Wales, commented, "Illness makes you
   unhappy, but unhappiness doesn't make you ill."

   That would certainly undercut the idea that stress is a killer — were
   it not for three things that got almost no attention in the press
   coverage of the study.

   First, previous studies have found a stronger association between
   happiness and health for men than for women.

   Second, if unhappiness and stress do affect health, they may begin to
   do so well before the age of 50. In that case, when the authors of the
   British women study adjusted for self-reported health at the start of
   their research, they would have removed the connection they claim
   doesn't exist. One of their appendix tables shows that, among the women
   who said they were unhappy, 40 percent reported fair or poor health at
   the beginning of the study, compared with only 15 percent of those who
   said they were happy. The researchers argue that this shows that those
   in bad health are unhappy, rather than the other way around, but that's
   not necessarily the case. (These numbers, by the way, exclude those
   who, at the beginning of the study, had cancer, heart disease, stroke
   or chronic obstructive airways diseases. But to the extent that
   unhappiness and stress before age 50 could contribute to those
   conditions, the point is even stronger.)

   The authors of the British study did find that, after age 50, there is
   effectively no association between life span and happiness or stress.
   Indeed, this is perhaps their strongest finding and understandably
   raises questions about how unhappiness affects health.

   But it also brings me to my third caveat. The unhappy people who
   reported being in excellent health when the study started may well be
   exceptions for whom unhappiness imposes no harm. Other research from
   Britain shows that the harm from stress depends a lot on one's beliefs
   about it. If you're under stress but believe it doesn't affect your
   health, it doesn't. And if you believe it does, it does. This was true
   among subjects who rated their health as good as well as those who
   rated it as poor. So it's entirely possible that the unhappy women in
   the more recent study who were in excellent health view the effects of
   their unhappiness and stress differently than other unhappy, stressed
   people do.

   Given that we still don't know what's widening the life-span gap, and
   that stress cannot be eliminated as a possible factor, the academic and
   medical communities need to explore much more aggressively how stress
   affects different people.

   Peter Orszag, a Bloomberg View columnist, was formerly President Barack
   Obama's director of the Office of Management and Budget.
   Copyright © 2016, Chicago Tribune
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