10: Humor and Physical Health

The idea that humor an laughter have a positive effect on health has gained popularity in recent years, but is nothing new: this notion goes back even to biblical times ("A merry heart does good like a medicine" in Proverbs 17:22) and has remained on the fringes of medical science all along.

While the notion of the "humors" of the body seems primitive, medical science has maintained that mood has a great deal to do with energy and perseverance, which itself is necessary to motivate patients to follow medical advice: they may not perceive the benefits of a treatment, but maintaining a positive mood and a perception of progress is sufficient to make them compliant and cooperative.

A branch of "health psychology" has emerged that specializes in the way in which emotions can influence health and wellness, including resiliency and resistance to illness and disease, albeit with a broader focus on positive/negative emotions than with mirth and humor specifically.

While it is generally a mark of quackery to ignore the traditional (biomedical) aspects of health in favor of psychology, emotion, or even mysticism it has of late become fashionable to consider these factors in addition to traditional approaches in a more holistic approach to treatment and health maintenance.

Reviewing the literature, about fifty articles have been published that report empirical investigations into the relationship between humor and physical health, which the author means to consider in the present chapter.

Popular Beliefs about Humor and Health

Periodically, Americans become dissatisfied with western medicine and seek alternative approaches to health management, which range from the somewhat questionable to outright quackery. Nonetheless, they have some influence on popular beliefs about humor.

The author speculates that humor is attractive to quacks and the patients who seek them out because it is inherently enjoyable and does not require a patient to make any substantial changes in their diet or habits. While there is some legitimate evidence of the benefits of humor, the correlation is rather weaker that popular opinions would suggest.

How Humor Might Affect Health

If humor is beneficial for health, it would stand to reason that people with a greater sense of humor enjoy better health and longer lives. However, it's already been established that some aspects of humor may be healthful whereas others are likely to be detrimental. Additionally, leveraged by those to cope with stressors, poor health being among them.

The benefits of laughter have been purported, somewhat speciously, to be akin to improved respiration and exercise - but the behavior of laughter is so brief and infrequent that any connection would be very tenuous and the suggestion of curative effects are highly suspect. Even so, this separates the notion of laughter from that of humor - to force laughter without experiencing humor would be beneficial, and to experience humor without expressing laughter would not.

A second potential mechanism by which humor might contribute to health is the effect of positive emotion, which impacts the endocrine system and triggers the release of various hormones and chemical compounds. Endorphins, serotonin, and other chemicals have been found to increase during the experience of positive emotions in general, and have been suggested to have beneficial effects on the immune system and other bodily functions. If this hypothesis holds true, it does not necessarily isolate mirth, but sweeps it into a broader category of positive emotions that have benefits to health.

It is also reckoned that humor may have cognitive benefits, which moderate the adverse effects of psychological stress on health. A significant amount of research has been done into the adverse effects of stress and the chronic production of stress-related hormone that have detrimental effects on health. Humor, as a method of coping, avoiding, and decreasing stress would be important - though humor outside of stressful moments would be irrelevant to health.

There is also the notion that humor fosters better interpersonal relationships, which has an indirect impact on health by providing an individual with a support network and a more direct impact by reducing the levels of stress, as previously discussed.

Finally, there is a behavioral mechanism as those who have a healthy sense of humor are considered to have a more optimistic and proactive approach to life, and are more likely to engage in health-promoting activities such as exercise, proper diet, and the like ... though research actually suggests people with a healthy sense of humor are more likely to entertain unhealthy vices. Some studies (such as Kuipper 2004) find correlations between humor and obesity, smoking, and sedentary lifestyles.

In all, there are a number of hypotheses about the relationship between humor and health, but there is a great deal of speculation and conjecture, and significant research must be done to substantiate supporting claims before it could be said with much confidence that a link exists.

Humor and Immunity

One of the problems with claims about immunity is that the immune system itself is so dynamic and complex, and there is not a reliable method for measuring the functionality of the immune system.

However, there is considerable evidence that emotional states do have an influence on various components of the immune system. In general, negative emotions can reduce its functionality and result in poorer health, though because of the social context there can be no one-to-one correspondence between a specific emotion and specific immune system changes.

Details are provided into a number of laboratory studies on the effects of humor on the immune system:

The author indicates the evidence of these studies is "far from conclusive" and many of the studies relied on relatively small sample sizes and few trials.

Humor and Pain

Laughter is alleged to have a pain-reducing effect, based on the release of endorphins when people experience mirthful emotion. Various experiments have been conducted to test the pain threshold of subjects (using immersion in a cold water bath) before and after exposing them to comedy videotapes, as compared to a control group.

In all, the author asserts that the support for the notion that humor improves pain tolerance seem to be consistently supported by these studies, and that it is in relation to mirth rather than the expression of laughter. However, there is correlation between tolerance and negative emotions as well.

Humor, Blood Pressure, and Heart Disease

While there has been speculation that hearty laughter may lead to reduction in blood pressure,. Experiments have observed that laughter is actually associated with short-term increases in blood pressure and heart rate but has no longer-term effects.

Studies into the typical blood pressure of individuals compared to their scores on various humor assessment tests also failed to identify any statistically significant correlation except that women with higher scores tend to have lower systolic pressure while men with higher scores have higher systolic pressure, but not to a degree that would be meaningful to health.

A more longitudinal study did find a correlation between lower rates of coronary heart disease and individuals with higher coping humor, though this is also correlated to lower levels of stress and hostility in general, which are a likely factor in heart disease. The author points to a few possible foibles of this study, suggesting further research is necessary to assert a direct correlation.

Humor and Illness Symptoms

Studies into humor and illness symptoms have been mixed: some have found a correlation between humor and overall health, but others have found there to be no correlation. The author details a few studies that contradict one another, concluding that there is not consistent evidence that people with a greater sense of humor are less likely to become ill.

It's also noted that these are largely self-reporting studies, and that the correlation between humor and neuroticism is such that people with a higher sense of humor are more likely to be attentive to their condition and more likely to share negative experiences than those with a lower sense of humor.

The largest study of health and humor (Svebak 2004) involved over 65.000 participants whop completed a survey about innless symptoms, overall health satisfaction, and took clinical measurements of various factors and correlated this against a short humor evaluation. Even these results provided "very little evidence" of a direct association between humor and general health - but there were correlations that suggested people with higher sense of humor have objectively better health but are less subjectively satisfied with their health.

In view of the larger sample size, the author feels this study is more compelling than others of its kind, but concedes that it is limited in its scope of investigation by its methodology.

Humor and Longevity

Another alleged benefit of humor in relation to health is the assertion that people who more frequently engage in humor and laughter tend to live longer than those who are more dour. There is limited research into this, and the author remarks it is "not very encouraging."

One study considered the life duration of celebrities, particularly actors and writers whose work tended to be humorous in comparison to those whose work was more serious in nature, and found no differences. It's also noted that people in these professions generally have a tendency to die at a significantly younger age than the general population, likely due to the stresses and unhealthy lifestyles of the entertainment industry.

The Tiernan Lifecycle Study, which followed over a thousand individuals for many decades, indicated that those individuals who showed a higher level of cheerfulness at age 12 actually had significantly higher mortality rates as compared to others in the study, across all causes of death, and for both genders.

The study authors interpreted (speculated) this was because more cheerful people tend to be less concerned in terms of risk-taking and health maintenance than people who are habitually more morose. Others have noted that cheerfulness also correlates to unhealthy lifestyle behaviors: cheerful people tend to smoke, drink, and engage in risky hobbies than do their morose counterparts.