Preventive health care is a powerful tool for keeping medical costs down. Contraception is cheaper than pregnancy and childbirth; a cholesterol test is cheaper than a triple bypass. It is therefore in society’s interest to encourage the use of preventive health care services like cancer screening, especially for elderly people in aging populations. Increased use of preventive health care also leads to healthier, longer-lived people.

Unfortunately, people aren’t particularly good about preventive health care; not even half of all people over the age of 65 in the US are up to date with recommended preventive services. How can we do better?

A recent PNAS study identified one factor that could help: the more that people feel like they have a purpose in life, the more likely they are to use preventive health care. Purpose was also found to be associated with a lower likelihood of needing overnight hospital visits—possibly as a result of improved health care.

Why am I here?

Purpose—feeling a sense of meaning in life and having goals to strive for—is one facet of psychological well-being. Purpose and other measures of well-being are associated with improved physical and mental health, including a better waist/hip ratio, higher levels of ‘good’ cholesterol, and even enhanced expression of antiviral response genes. It isn’t clear what drives this improved health, but we do know that people with more purpose engage in healthier behaviors like resting and exercising.

Some previous research has shown that people with purpose use preventive health care more, but sample sizes were small and possibly biased. To explore the question with a more robust sample, the recent study tracked more than 7,000 US adults over the age of 50 for six years, keeping records of their health care usage.

The participants also took part in a survey that measured purpose on a six-point scale, along with other psychological factors like depression and anxiety. Confounds that could influence the results were also taken into account, including: religiosity, geographic factors like rural or urban living, chronic illnesses, current health behaviors like smoking, and sociodemographic factors like wealth and ethnicity.

After adjusting for these potential confounds, the results showed that higher purpose resulted in a significantly higher likelihood of getting a cholesterol test or a colonoscopy. For females, it was also related to a higher chance of having a mammogram or pap smear; for males, it was associated with a higher chance of a prostate exam. (However, flu shots were not among the benefits of having purpose.)

People with higher purpose also spent less time in the hospital: after adjusting for sociodemographic factors, each point increase in purpose was associated with 17 percent fewer overnight hospital stays.

Why does it work?

It’s not clear why purpose is associated with preventive health care. The researchers suggest that people with a stronger sense of purpose may have more motivation to stay healthy and therefore feel “more incentive to take preventive measures that seem time consuming, costly, fear inducing, or painful.” Although this is a convincing explanation, more research is needed to confirm it. After all, it is possible that another mechanism could be at work or even that causality could be working in the other direction, with improved use of health care services somehow resulting in a stronger purpose in life.

Although this study is a significant improvement over previous work, it does have limitations. Most notably, the data on health care use was self-reported, which isn’t always reliable. Although self-reported health care has been shown to agree with medical records, future research will likely use a different source of data to corroborate the results.

Can we actually use these results to improve healthcare? There is reason to think that the right kinds of therapy can improve people’s sense of purpose. Some small, randomized control trials on cancer patients and survivors indicate that meaning-based therapy could (as its name suggests) improve feelings of meaning and purpose. Interventions such as volunteer programs for older people could have a similar effect. Future studies may test whether these ultimately result in improved preventive health care use.

In a society that expects to see double the current number of adults over 65 by 2050, resulting in Medicare costs doubling from 3.7 percent of GDP to 7.3 percent, tactics to increase preventive health care use and lower medical costs are an important avenue to pursue. Reducing strain on the nation’s medical budget while helping people become happier with their lives would be a resounding victory for quality of life.

PNAS, 2014. DOI: 10.1073/pnas.1414826111. (About DOIs).