Adolescent psychological well-being and adulthood cardiovascular disease risk: longitudinal association and implications for care quality management


Srinivas, Sharan; Anand, Kavin; & Chockalingam, Anand (2021). Adolescent psychological well-being and adulthood cardiovascular disease risk: longitudinal association and implications for care quality management. Benchmarking: An International Journal.


Purpose: Prior research suggests that 80% of cardiovascular disease (CVD) events can be prevented by modifying certain behaviors, yet it remains the primary cause of mortality worldwide. Early detection and management of critical modifiable factors have the potential to improve cardiovascular care quality as well as the associated health outcomes. This study aims to assess the independent impact of psychological well-being in adolescence, a modifiable factor, on long-term CVD risk and promote targeted early interventions through quality management principles. Design/methodology/approach: Data from the Add Health study, which employed a series of surveys and health tests (Wave 1 – Wave 4) on individuals for 14 years (from adolescence to adulthood), were obtained and analyzed longitudinally. Psychological well-being in adolescence was assessed using four Wave 1 survey questions, and 30-year CVD risk was estimated 14 years later with Wave 4 data. Three different logistic regression models were examined to understand the impact of adding covariates. Findings This study’s sample included 12,116 individuals who responded to all the relevant questions and underwent clinical risk factor measurements in Wave 1 (adolescence) and Wave 4 (young adulthood). Psychological well-being was protective with reduced risk for CVD across the three models tested. There is a statistically significant association, where increasing psychological well-being reduced the 30-year CVD risk exponentially in all the models. The analysis also suggested an exposure–response relationship, where the 30-year risk category of adulthood CVD decreased with an increase in psychological well-being. Practical implications This research uncovers an inverse association between adolescent psychological well-being and adulthood CVD risk. This study also identifies quality management-based preventive tools/techniques to improve psychological well-being in adolescence and therefore reduce CVD risk later in life. Originality/value This study is among the first to establish a long-term association between positive well-being and CVD risk. Also, unlike the existing literature, this work provides implications for improving CVD care from a quality management perspective.



Cardiovascular discease

Reference Type

Journal Article

Journal Title

Benchmarking: An International Journal


Srinivas, Sharan
Anand, Kavin
Chockalingam, Anand

Year Published






Reference ID