According to a new study published in the Journal of the American Heart Association, teenagers who reported feeling optimism, self-esteem, happiness, belongingness, and feeling loved and wanted were more likely to have better cardiometabolic health in their 20s and 30s compared to teens with fewer positive mental health assets. This association appeared stronger in the case of Black youth.
Although previous studies have found that psychological aspects of well-being, such as optimism and happiness, can positively influence cardiometabolic health, most of this research was conducted among older adults. By contrast, this new study focused on earlier life and took into consideration a broader measure of cardiometabolic health, including indicators of blood sugar levels and inflammation.
“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, however, much less attention is paid to the inherent strengths they possess and the ways those strengths may be leveraged to advance health equity,” said lead study author Farah Qureshi, an assistant professor of Social Epidemiology at the Johns Hopkins Bloomberg School of Public Health. “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.”
The scientists examined data related to health and well-being from nearly 3,500 U.S. teenagers from 1994 to 2018. Half of the participants were girls, 67 percent were white youth, 15 percent Blacks, 11 percent Latinos, and six percent Native American, Asian, or other. By using initial responses from when the participants were teenagers, the researchers identified five mental health assets related to better cardiometabolic health: optimism, happiness, self-esteem, a sense of belonging, and feeling loved.
In addition, seven health measures aiming to examine cardiometabolic health were included and collected during clinical visits when participants were in their 20s and 30s: high-density lipoprotein (HDL), or “good” cholesterol, non-HDL cholesterol, systolic blood pressure, diastolic blood pressure, hemoglobin A1c (a measure of blood sugar), C-reactive protein (a measure of inflammation), and body mass index.
The analysis revealed that teens with four to five positive mental health assets were 69 percent more likely to maintain positive cardiometabolic health as young adults, and each additional asset conferred a 12 percent greater probability of positive cardiometabolic health. Although the assets were found to be protective across all racial and ethnic groups, the largest benefits were observed among Black youth, who also reported having more of these assets than participants from other groups.
However, racial disparities in cardiometabolic health were still apparent in adulthood. “These somewhat counterintuitive findings were surprising,” Qureshi said. “When we dug deeper, we found that the absence of psychological assets being was particularly health-damaging for 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.”
“This work suggests that early investments in youth mental health may be a critical new frontier in the advancement of cardiometabolic health equity. We need more large-scale studies to monitor these and other positive mental health factors starting in childhood to understand how these assets may influence health and disease over the life course. This information may help us identify new ways to improve health and reduce disparities,” she concluded.
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