Behavioral Health Minute

September 2011 - Got ikigai?

The short summary

Epidemiological research points to “purpose” and “life worth living” as protective factors in health.

The modestly longer reflection

Over the years, epidemiologists have always been interested in identifying risk factors that imperil health.  If you smoke, drink too much, lead a sedentary life or, for that matter, have a pessimistic or hostile outlook, your health prospects are less good than they would otherwise be.

Increasingly, epidemiologists have been also interested in positive factors that promote health.  An early sociologist used the word “salutogenic” (as opposed to “pathogenic”) to refer to these factors.

In the last 3 or 4 years, there have been three good prospective studies in Japan that have explored the epidemiological implications of ikigai.  Personally, my Japanese is limited to such words as “Ichiro” and “Daisuke” (Dice-K), but apparently ikigai is a well-understood construct in Japanese culture, meaning “purpose” or “life worth living.”

One of these studies, in 2008, followed 43,000 subjects for 7 years and looked at the relationship of ikigai with mortality from various causes.  Controlling for socioeconomic factors, psychological factors, physical function, lifestyle habits and history of illness, they found that the mortality rates for people who indicated that they had ikigai were about two thirds those of people who indicated that they did not have ikigai, with respect to all-cause mortality, cardiovascular disease and “external” mortality (the largest mechanism of which was suicide).  Cancer mortality in the ikigai people was about three quarters that of the no-ikigai people, although it didn’t quite reach a conservative p level.

A second study published in 2009 looked at 73,000 people with a follow-up of 12 years.  With similar controls, they found the yes-ikigai people having about 75 to 85% the mortality rates of the no-ikigai people for all-cause mortality, cardiovascular disease and external causes. 

In both studies, about half of the people indicated that they had ikigai.  The definition of not having ikigai was broader in the second study, which may account for the still-significant but slightly-lesser mortality differences.

If you’re interested in the research, by the way, go to PubMed and type in “ikigai.”  Other than a gentleman (or gentlewoman) named H. Ikigai who does research on metallic coatings on steel that mitigate biofilm formation, the mesh term “ikigai” gets you directly to this research.

So what?

Well… it seems to me that this line of research (along with other lines of research that I won’t push my demands on your time to read this far to describe) suggest that factors like “purpose” and “life worth living” play a vital role in health and well-being.  We screen for seat belt use, guns locked in cabinets, depression symptoms and domestic violence; should we be screening for life worth living?

Follow-up

I’ve used my minute (or two).  For now, think about how you might screen for “purpose” or “life worth living.”  We’ll come back to this next month.

Cross-reference

Create vision for the future [October 2008]
Link health values with life values [November 2008]
Healing connections [October 2010]
Link health values with life values [November 2010]

Fred Craigie, PhD