Recent studies suggest that engaging in volunteer work may result in longer life and better health. Two studies published this year found that participating in volunteer work was associated with lower rates of death over the next five to seven years, suggesting that volunteer work may have casual benefits upon health (Oman, Thoresen and McMahon, 1999; Musick, Herzog and House, 1999). If these findings are generalizable and are found to be casual, there are important implications for health promotion and disease prevention efforts at both individual and community levels. The practice of volunteering would be confirmed as a valid form of self-care to be encouraged by health professionals. The two recent studies mentioned above found that volunteering had an independent salutary effect on mortality after adjusting for potential confounding variables. One study also found salutary cross-sectional relationships between volunteering and health behaviors, and both studies found statistical interactions (effect modification) between volunteering and other psychosocial variables. No prospective studies have yet examined associations between volunteering and incident morbidity, however. The long- term objectives of this study are to deepen understanding of volunteering and health by testing the generalizability of recent studies liking volunteering with mortality, as well as to lay groundwork for future studies that will seek to elucidate underlying casual pathways. We will examine the generalizability of previous studies and the relationship between volunteering and morbidity in three large epidemiologic cohorts. Using data from the Alameda County Study (with 23 years of follow-up), the Normative Aging Study (with 24 years of follow-up), and the Sonoma Study (5 years of follow-up), we will address the following specific aims: 1. Determine the whether previous findings that volunteering is independently prospectively associated with protection from mortality can be generalized to other cohorts of older and middle-aged adults. 2. Determine the extent to which previous findings of salutary cross-sectional associations between volunteering and health behaviors are generalizable to other cohorts. 3. Examine whether higher levels of volunteering are associated with greater protective effects against mortality than are lower levels of volunteering (i.e., what is the nature of dose-response relationships). 4. Determine which interactions in predicting mortality between volunteering and other variables, especially various types of social or cognitive support (social connections, religious involvement) are generalizable. 5. Examine the prospective association of volunteering with major types of morbidity (hypertension, myocardial infarction, stroke, cancer, diabetes, and respiratory diseases) in a variety of cohorts of older and middle-aged adults.
