A happier country equals a healthier one — but only above a certain threshold

Happiness is but one facet of a person’s health. Genetic, behavioural and environmental factors also play a role. (mapodile/E+/Getty Images via CNN Newsource)

Happier people are more successful in their careers, have more fulfilling relationships and live longer, healthier lives, previous research has shown. Now, scientists say they have identified the “happiness threshold” needed for a country’s population as a whole to achieve certain health benefits.

Specifically, a nation’s happiness level can influence its people’s risk of premature death from chronic illnesses such as cancer, heart disease, diabetes and respiratory disease, according to a study published October 20 in the journal Frontiers in Medicine.

The research team used a scale called the Life Ladder to estimate the happiness levels of 123 countries. Zero represents the worst possible life imaginable and 10 the best.

Once a country surpassed a score of 2.7, its happiness was tied to a decrease in deaths due to chronic or noncommunicable diseases among people 30 to 70 years old, researchers found.

Scores ranged from 2.18 to 7.97, with an average of 5.45. The United States was among the countries analyzed, but individual Life Ladder scores weren’t published in the study. However, the 2025 World Happiness Report ranks the US as the world’s 24th-happiest country, with a score of 6.72.

“Policies that lift national Life-Ladder scores above the 2.7 threshold — through investments in health systems, anti-corruption reforms, social safety nets, and healthy urban environments — can initiate a reinforcing cycle of higher happiness and lower mortality,” lead study author Iulia Iuga said in an email.

“The evidence suggests that raising well-being while curbing obesity, alcohol use, and pollution could produce dual dividends: stronger happiness and healthier, longer lives.”

For countries at or above the 2.7 threshold, “improving well-being can measurably extend life expectancy when societies reach a basic level of stability and satisfaction,” said Iuga, a professor in the department of finance and accounting at 1 Decembrie 1918 University of Alba Iulia in Romania.

Iuga hopes her team’s work has implications for governing bodies and public health organizations that can influence happiness and health at the population level. She plans to continue her research by testing the happiness threshold against other health metrics, such as years lived with a disability.

‘More than just fun and pleasure’

Each 1 per cent increase in well-being correlated to a 0.43 per cent decrease in the chronic-disease mortality rate among adults 30 to 70 years old, according to the study.

This research adds to the existing body of literature linking happiness to health, said Sonja Lyubomirsky, a distinguished professor of psychology and director of the Positive Activities and Well-Being Laboratory, or PAWLab, at the University of California, Riverside, who wasn’t involved in the study.

“Traditionally, happiness is seen as a little bit of a luxury. It feels good,” Lyubomirsky said. The new study shows “that happiness could be the public health variable. It’s about more than just fun and pleasure.”

Happiness is but one facet of a person’s health. Genetic, behavioural and environmental factors also play a role in the risk of dying from chronic disease.

“We don’t want to leave people the impression that if only they were happier, they would be healthier, they would be fine,” Lyubomirsky said.

It’s also important to avoid placing blame, she said.

“You don’t want to say, ‘If you don’t live as long, then it’s your fault because you’re not happy enough,’” she said. Not to mention, you only have so much control over your happiness as it relates to where you live. You might be born into a politically unstable country through no fault of your own or unable to afford to move out of an area with poor air quality.

Having spent decades studying the well-being of individuals, Lyubomirsky said gauging the happiness of entire countries comes with challenges.

“It’s really hard,” she said. “You cannot get a sample of every single person in the country, so you want to make sure that’s a representative sample.”

Researchers cited incomplete data on countries in conflict and low-income nations as a limitation of the study. In addition, longevity analysis is limited because mortality data for noncommunicable diseases didn’t go beyond age 70.

Saida Heshmati, director of the Human Emotion and Relationships across Time and Culture, or HEART Lab, at Claremont Graduate University in California, said happiness isn’t the word she’d use to describe what the study is trying to measure.

“When we say ‘happiness,’ people tend to think about experiencing more positive emotions — joy and having meaning in life and having a sense of accomplishment,” said Heshmati, also an assistant professor of psychology, who wasn’t involved in the research. “The (Life Ladder) doesn’t necessarily get into those components.”

Heshmati referred to the Cantril Self-Anchoring Striving Scale, sometimes called Cantril’s Ladder, a standardized well-being assessment that serves as the basis for the Life Ladder scores in the study.

“This isn’t about happiness as a fleeting emotion,” Heshmati said. “It’s really about this general life satisfaction cognitive evaluation, which is a reflection of whether societies are providing those material, social and psychological foundations for people to thrive.”

How can countries be healthier by being happier?

The authors of the new study pulled data about health factors including air pollution, body mass index and alcohol consumption from the Gallup World Poll, World Health Organization and World Development Indicators collected from 2006 through 2021.

Noncommunicable diseases accounted for at least 43 million deaths globally, or 75 per cent of non-pandemic-related deaths, in 2021, according to WHO. Nearly 42 per cent of those people died prematurely, before age 70.

Eighty percent of premature deaths due to noncommunicable diseases that year were attributed to four disease groups: heart disease (19 million deaths); cancer (10 million deaths); chronic respiratory disease (4 million deaths); and diabetes (2 million deaths).

Countries with higher per-person health spending — what a person spends on doctor visits and prescription medications, for example — generally exceeded the happiness threshold. Ethiopia had the lowest per-capita spending at US$9 in 2006, while the US had the highest at $12,000 in 2021. The average across all countries evaluated was $1,300.

Heshmati likes to think of the happiness threshold as a stability threshold.

“When you’re below that threshold, it seems you’re in stress mode and survival mode,” she said, which can have physiological consequences.

While individual well-being adds up to represent the happiness of a nation, Heshmati cautions against applying the study’s conclusions to your own health and risk of death from chronic disease.

“We can’t just say that becoming or feeling slightly happier directly changes your biology,” she said.

Heshmati recommends thinking about your own happiness holistically. Simple pleasures matter, she said, but they come and go and can leave a sense of emptiness due to their fleeting nature. Instead, focus on lasting markers of well-being such as maintaining strong social ties, cultivating a sense of purpose and pursuing goals that make you feel accomplished.

“Those are more of the long-term virtues that help us live life to the fullest,” she said.

By Lindsey Leake, CNN