Optimism and Social Support Predict Healthier Adult Behaviors Despite Socially Disadvantaged Childhoods

  • Amy L. NonEmail author
  • Jorge Carlos Román
  • Elizabeth S. Clausing
  • Stephen E. Gilman
  • Eric B. Loucks
  • Stephen L. Buka
  • Allison A. Appleton
  • Laura D. Kubzansky
Full length manuscript



Studies have shown adverse effects of a disadvantaged childhood on adult health-promoting behaviors and related outcomes. Optimism and social support have been linked to greater likelihood of engaging in healthy behavior, but it is unclear whether these positive psychosocial factors may buffer harmful effects of early adversity. This study aims to determine if optimism and social support in adulthood can modify effects of childhood disadvantage on health behavior-related outcomes.


Longitudinal data were analyzed from a subset of participants in a US birth cohort established in 1959–1966 (ns of 681–840, per outcome). An index of childhood social disadvantage was derived from adverse socioeconomic and family stability factors reported by mothers at child’s birth and age 7 years. Health behavior-related outcomes were self-reported when participants were of mean age 47 years. Multivariable adjusted robust Poisson regressions were performed.


Regardless of level of childhood social disadvantage, we found higher levels of optimism and social support were both associated with higher probabilities of being a non-smoker (relative risk [RR]optimism = 1.17, 95% confidence interval [CI] = 1.09–1.26; RRsocial support = 1.24, 95%CI = 1.11–1.39), having a healthy diet (RRoptimism = 1.25, 95%CI = 1.10–1.43; RRsocial support = 1.27, 95%CI = 1.04–1.56), and a healthy body mass index (RRoptimism = 1.18, 95%CI = 1.00–1.40; RRsocial support = 1.29, 95%CI = 1.00–1.66). Interactions link higher optimism or social support with lower risk of smoking among those with moderate childhood disadvantage.


Overall, these findings are consistent with the possibility that positive psychosocial resources contribute to maintaining a healthy lifestyle in mid-adulthood and may buffer effects of childhood social disadvantage.


Health behaviors Optimism Social support Psychosocial factors Social disadvantage 



The authors thank all study participants.

Funding Information

This work was supported by the National Institute of Aging (RC2AG036666, R01AG048825, and R01AG023397) and the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Supplementary material

12529_2020_9849_MOESM1_ESM.docx (38 kb)
ESM 1 (DOCX 38 kb)
12529_2020_9849_MOESM2_ESM.docx (29 kb)
ESM 2 (DOCX 29 kb)
12529_2020_9849_MOESM3_ESM.docx (122 kb)
ESM 3 (DOCX 121 kb)
12529_2020_9849_MOESM4_ESM.docx (28 kb)
ESM 4 (DOCX 28 kb)
12529_2020_9849_MOESM5_ESM.docx (29 kb)
ESM 5 (DOCX 28 kb)
12529_2020_9849_MOESM6_ESM.docx (48 kb)
ESM 6 (DOCX 47 kb)


  1. 1.
    Non AL, Roman JC, Gross CL, et al. Early childhood social disadvantage is associated with poor health behaviours in adulthood. Ann Hum Biol. 2016;43(2):144–53.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Bull ER, McCleary N, Li X, Dombrowski SU, Dusseldorp E, Johnston M. Interventions to promote healthy eating, physical activity and smoking in low-income groups: a systematic review with meta-analysis of behavior change techniques and delivery/context. Int J Behav Med. 2018;25(6):605–16.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. Jama. 2004;291(10):1238–45.PubMedCrossRefGoogle Scholar
  4. 4.
    Windle M, Haardorfer R, Getachew B, et al. A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students. J Am Coll Health. 2018:1–6.Google Scholar
  5. 5.
    Chen E, Miller GE. “Shift-and-persist” strategies: why low socioeconomic status Isn't always bad for health. Perspect Psychol Sci. 2012;7(2):135–58.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Matthews KA, Gallo LC, Taylor SE. Are psychosocial factors mediators of socioeconomic status and health connections? A progress report and blueprint for the future. Ann N Y Acad Sci. 2010;1186:146–73.PubMedCrossRefGoogle Scholar
  7. 7.
    Scheier MF, Carver CS. Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychol. 1985;4(3):219–47.PubMedCrossRefGoogle Scholar
  8. 8.
    Mann T. Effects of future writing and optimism on health behaviors in HIV-infected women. Ann Behav Med. 2001;23(1):26–33.PubMedCrossRefGoogle Scholar
  9. 9.
    Kelloniemi H, Ek E, Laitinen J. Optimism, dietary habits, body mass index and smoking among young Finnish adults. Appetite. 2005;45(2):169–76.PubMedCrossRefGoogle Scholar
  10. 10.
    Browning C, Sims J, Kendig H, Teshuva K. Predictors of physical activity behavior in older community-dwelling adults. J Allied Health. 2009;38(1):8–17.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Weinstein ND. Optimistic biases about personal risks. Science. 1989;246(4935):1232–3.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Boehm JK, Chen Y, Koga H, Mathur MB, Vie LL, Kubzansky LD. Is optimism associated with healthier cardiovascular-related behavior? Meta-Analyses of 3 Health Behaviors. Circ Res. 2018;122(8):1119.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Lin N, Simeone RS, Ensel WM, Kuo W. Social support, stressful life events, and illness: a model and an empirical test. J Health Soc Behav. 1979;20(2):108–19.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Shaikh AR, Yaroch AL, Nebeling L, Yeh MC, Resnicow K. Psychosocial predictors of fruit and vegetable consumption in adults a review of the literature. Am J Prev Med. 2008;34(6):535–43.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Tay L, Tan K, Diener E, Gonzalez E. Social relations, health behaviors, and health outcomes: a survey and synthesis. Appl Psychol Health Well Being. 2013;5(1):28–78.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Steptoe A, Wardle J, Pollard TM, Canaan L, Davies GJ. Stress, social support and health-related behavior: a study of smoking, alcohol consumption and physical exercise. J Psychosom Res. 1996;41(2):171–80.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Pearlin LI, Bierman A. Current issues and future directions in research into the stress process. In: Aneshensel CS, Phelan JC, Bierman A, editors. Handbook of the sociology of mental health: Springer Science + Business Media; 2013. p. 325–40.Google Scholar
  18. 18.
    Peterson JA, Yates BC, Hertzog M. Heart and soul physical activity program: social support outcomes. Am J Health Behav. 2008;32(5):525–37.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Malouff JM, Schutte NS. Can psychological interventions increase optimism? A meta-analysis. J Posit Psychol. 2017;12(6):594–604.CrossRefGoogle Scholar
  20. 20.
    Non AL, Rewak M, Kawachi I, Gilman SE, Loucks EB, Appleton AA, et al. Childhood social disadvantage, cardiometabolic risk, and chronic disease in adulthood. Am J Epidemiol. 2014;180(3):263–71.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Gilman SE, Huang Y-T, Jimenez MP, et al. Early life disadvantage and adult adiposity: tests of sensitive periods during childhood and behavioural mediation in adulthood. Int J Epidemiol. 2018:dyy199-dyy.Google Scholar
  22. 22.
    Jaffee SR, Takizawa R, Arseneault L. Buffering effects of safe, supportive, and nurturing relationships among women with childhood histories of maltreatment. Psychol Med. 2017;47(15):2628–39.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Winning A, Glymour MM, McCormick MC, Gilsanz P, Kubzansky LD. Childhood psychological distress as a mediator in the relationship between early-life social disadvantage and adult cardiometabolic risk: evidence from the 1958 British birth cohort. Psychosom Med. 2016;78(9):1019–30.PubMedCrossRefGoogle Scholar
  24. 24.
    Appleton AA, Buka SL, McCormick MC, Koenen KC, Loucks EB, Kubzansky LD. The association between childhood emotional functioning and adulthood inflammation is modified by early-life socioeconomic status. Health Psychol. 2012;31(4):413–22.PubMedCrossRefGoogle Scholar
  25. 25.
    Chen E, Miller GE, Lachman ME, Gruenewald TL, Seeman TE. Protective factors for adults from low-childhood socioeconomic circumstances: the benefits of shift-and-persist for allostatic load. Psychosom Med. 2012;74(2):178–86.PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the life orientation test. J Pers Soc Psychol. 1994;67(6):1063–78.PubMedCrossRefGoogle Scholar
  27. 27.
    Carver CS, Scheier MF. Dispositional optimism. Trends Cogn Sci. 2014;18(6):293–9.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Cohen S, Mermelstein R, Kamarck T, Hoberman H. Measuring the functional components of social support. In: Sarason IG, Sarason BR, editors. Social support: theory, research and application. The Hague: Martinus Nijhoff; 1985. p. 73–94.CrossRefGoogle Scholar
  29. 29.
    von Hippel PT. 4. Regression with missing Ys: an improved strategy for analyzing multiply imputed data. Sociol Methodol. 2007;37(1):83–117.CrossRefGoogle Scholar
  30. 30.
    Roberts JL, Weeks E. Stigmatizing the unhealthy. J Law Med Ethics. 2017;45(4):484–91.CrossRefGoogle Scholar
  31. 31.
    Heinonen K, Räikkönen K, Keltikangas-Järvinen L. Self-esteem in early and late adolescence predicts dispositional optimism-pessimism in adulthood: a 21-year longitudinal study. Personal Individ Differ. 2005;39(3):511–21.CrossRefGoogle Scholar
  32. 32.
    Chen E, Lee WK, Cavey L, Ho A. Role models and the psychological characteristics that buffer low-socioeconomic-status youth from cardiovascular risk. Child Dev. 2013;84(4):1241–52.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Berkman LF, Krishna A. In: Berkman LF, Kawachi I, Glymour MM, editors. Social epidemiology. 2nd ed. Oxford: Oxford University Press; 2014. p. xvii. 615 pages.Google Scholar
  34. 34.
    Boehm JK, Vie LL, Kubzansky LD. The promise of well-being interventions for improving health risk behaviors. Curr Cardiovasc Risk Rep. 2012;6(6):511–9.CrossRefGoogle Scholar
  35. 35.
    Nes LS, Segerstrom SC. Dispositional optimism and coping: a meta-analytic review. Personal Soc Psychol Rev. 2006;10(3):235–51.CrossRefGoogle Scholar
  36. 36.
    Carver CS, Scheier MF, Segerstrom SC. Optimism. Clin Psychol Rev. 2010;30(7):879–89.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Solberg Nes L, Evans DR, Segerstrom SC. Optimism and college retention: mediation by motivation, performance, and adjustment1. J Appl Soc Psychol. 2009;39(8):1887–912.CrossRefGoogle Scholar
  38. 38.
    Segerstrom SC. Optimism and resources: effects on each other and on health over 10 years. J Res Pers. 2007;41(4).CrossRefGoogle Scholar
  39. 39.
    Cohen S, Lemay EP. Why would social networks be linked to affect and health practices? Health psychology : official journal of the Division of Health Psychology, Am Psychol Assoc 2007;26(4):410–417.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Cohen S. Social relationships and health. Am Psychol. 2004;59(8):676–84.PubMedCrossRefGoogle Scholar
  41. 41.
    Steinemann N, Grize L, Ziesemer K, Kauf P, Probst-Hensch N, Brombach C. Relative validation of a food frequency questionnaire to estimate food intake in an adult population. Food Nutr Res. 2017;61(1):1305193.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Slopen N, Koenen KC, Kubzansky LD. Cumulative adversity in childhood and emergent risk factors for long-term health. J Pediatr. 2014;164(3):631–8 e1–2.PubMedCrossRefGoogle Scholar
  43. 43.
    Southwick SM, Charney DS. The science of resilience: implications for the prevention and treatment of depression. Science. 2012;338(6103):79–82.PubMedCrossRefGoogle Scholar
  44. 44.
    Nurius PS, Green S, Logan-Greene P, Borja S. Life course pathways of adverse childhood experiences toward adult psychological well-being: a stress process analysis. Child Abuse Negl. 2015;45:143–53.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Mancuso CA, Choi TN, Westermann H, Wenderoth S, Hollenberg JP, Wells MT, et al. Increasing physical activity in patients with asthma through positive affect and self-affirmation: a randomized trial. Arch Intern Med. 2012;172(4):337–43.PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Hogan BE, Linden W, Najarian B. Social support interventions: do they work? Clin Psychol Rev. 2002;22(3):383–442.PubMedCrossRefGoogle Scholar
  47. 47.
    Wijtzes AI, van de Gaar VM, van Grieken A, et al. Effectiveness of interventions to improve lifestyle behaviors among socially disadvantaged children in Europe. Eur J Pub Health. 2017;27(2):240–7.CrossRefGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2020

Authors and Affiliations

  1. 1.Department of AnthropologyUniversity of CaliforniaLa JollaUSA
  2. 2.Department of Math and StatisticsSan Diego State UniversitySan DiegoUSA
  3. 3.Social and Behavioral Sciences Branch, Division of Intramural Population Health ResearchEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentRockvilleUSA
  4. 4.Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  5. 5.Department of EpidemiologyBrown University School of Public HealthProvidenceUSA
  6. 6.Department of Epidemiology and BiostatisticsUniversity at Albany School of Public HealthRensselaerUSA
  7. 7.Department of Social and Behavioral Sciences and Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public HealthBostonUSA

Personalised recommendations