Death may be inevitable, but that hasn’t stopped health researchers from looking for ways to put it off as long as possible. Their newest candidate is something that’s free, painless, doesn’t taste bad and won’t force you to break a sweat: Gratitude.

A new study of nearly 50,000 older women found that the stronger their feelings of gratitude, the lower their chances of dying over the next three years.

The results are sure to be appreciated by those who are naturally inclined toward giving thanks. Those who aren’t may be grateful to learn that with practice, they might be able to enhance their feelings of gratitude and reap the longevity benefits as well.

“It’s an exciting study,” said Joel Wong, a professor of counseling psychology at the University of Indiana who researches gratitude interventions and practices and wasn’t involved in the new work.

Mounting evidence has linked gratitude with a host of benefits for mental and physical health. People who score higher on measures of gratitude have been found to have better biomarkers for cardiovascular function, immune system inflammation and cholesterol. They are more likely to take their medications, get regular exercise, have healthy sleep habits and follow a balanced diet.

Gratitude is also associated with a lower risk of depression, better social support and having a greater purpose in life, all of which are linked with longevity.

However, this is the first time researchers have directly linked gratitude to a lower risk of earlier death, Wong and others said.

“It’s not surprising, but it’s always good to see empirical research supporting the idea that gratitude is not only good for your mental health but also for living a longer life,” Wong said.

Study leader Ying Chen, an empirical research scientist with the Human Flourishing Program at Harvard University, said she was amazed by the dearth of studies on gratitude and mortality. So she and her colleagues turned to data from the Nurses Health Study, which has been tracking the health and habits of thousands of American women since 1976.

In 2016, those efforts included a test to measure the nurses’ feelings of gratitude. The women were asked to use a seven-point scale to indicate the degree to which they agreed or disagreed with six statements, including “I have so much in life to be thankful for” and “If I had to list everything I felt grateful for, it would be a very long list.”

A total of 49,275 women responded, and the researchers divided them into three roughly equal groups based on their gratitude scores. Compared with the women with the lowest scores, those with the highest scores tended to be younger, more likely to have a spouse or partner, more involved in social and religious groups, and in generally better health, among other differences.

The average age of nurses who answered the gratitude questions was 79, and by the end of 2019, 4,068 of them had died. After accounting for a variety of factors such as the median household income in their census tract, their retirement status, and their involvement in a religious community, Chen and her colleagues found that the nurses with the most gratitude were 29% less likely to have died than the nurses with the least gratitude.

Then they dug deeper by controlling for a range of health issues, including a history of heart disease, stroke, cancer and diabetes. The risk of death for the most grateful women was still 27% lower than for their least grateful counterparts.

When the researchers considered the effects of smoking, drinking, exercise, body mass index and diet quality, the risk of death for the nurses with the most gratitude remained lower, by 21%.

Finally, Chen and her colleagues added in measures of cognitive function, mental health and psychological well-being. Even after accounting for those variables, the mortality risk was 9% lower for nurses with the highest gratitude scores.

The findings were published Wednesday in JAMA Psychiatry.

Although the study shows a clear link between gratitude and longevity, it doesn’t prove that one caused the other. While it’s plausible that gratitude helps people live longer, it’s also possible that being in good health inspires people to feel grateful, or that both are influenced by a third factor that wasn’t accounted for in the study data.

Sonja Lyubomirsky, an experimental social psychologist at UC Riverside who studies gratitude and was not involved in the study, said she suspects all three things are at work.

Another limitation is that all of the study participants were older women, and 97% of them were white. Whether the findings would extend to a more diverse population is unknown, Wong said, “but drawing on theory and research, I don’t see a reason why it wouldn’t.”

There can be downsides to gratitude, the Harvard team noted: If it’s tied to feelings of indebtedness, it can undermine one’s sense of autonomy or accentuate a hierarchical relationship. Lyubomirsky added that it can make people feel like they’re a burden to others, which is particularly dangerous for someone with depression who is feeling suicidal.

But in most cases, gratitude is an emotion worth cultivating, Lyubomirsky said. Clinical trials have shown that gratitude can be enhanced through simple interventions, such as keeping a gratitude journal or writing a thank-you letter and delivering it by hand.

“Gratitude is a skill that you can build,” she said.

And like diet and exercise, it appears to be a modifiable risk factor for better health.

Lyubomirsky has found that teenagers who were randomly assigned to compose letters of gratitude to their parents, teachers or coaches took it upon themselves to eat more fruits and vegetables and cut back on junk food and fast food — a behavior not shared by classmates in a control group. Perhaps after reflecting on the time, money and other resources invested in them, the teens were inspired to protect that investment, she said.

More research will be needed to see whether interventions like these can extend people’s lives, but Chen is optimistic.

“As the evidence accumulates, we’ll have a better understanding of how to effectively enhance gratitude and whether it can meaningfully improve people’s long-term health and well-being,” she said.

Naloxone has long been hailed as a life-saving drug in the face of the opioid epidemic. But its capacity to save someone from an overdose can be limited by the potency of the opioid — a person revived by naloxone can still overdose once it wears off.

Stanford researchers have found a companion drug that can enhance naloxone’s effect — and reduce withdrawal symptoms. Their research on mice, led by Stanford University postdoctoral scholar Evan O’Brien, was published today in Nature.

Typically, overdose deaths occur when opioids bind to the part of the brain that controls breathing, slowing it to a stop. Naloxone reverses overdoses by kicking opioids off pain receptors and allowing normal breathing to resume.

However, it is only able to occupy pain receptors for 30 to 90 minutes. For more potent opioids, such as fentanyl, that may not be long enough.

To determine how the naloxone companion drug, which researchers are calling compound 368, might boost naloxone’s effectiveness, researchers conducted an experiment on pain tolerance in mice, said Jay McLaughlin, a professor of pharmacology at the University of Florida. How quickly would mice pull their tails out of hot water, depending on which combination of opioids and treatments they were given?

Mice that were injected with only morphine did not respond to the hot water — given their dulled pain receptors. Mice given morphine and naloxone pulled their tails out within seconds. No surprises yet.

When the dosage of naloxone was reduced and compound 368 was added, the compound was found to amplify naloxone’s effects, as if a regular dose was used. When used on its own, the compound had no effect, indicating that it is only helpful in increasing the potency of naloxone.

What researchers did not expect, however, was that the compound reduced withdrawal symptoms.

McLaughlin said withdrawal is one reason that people who have become physically dependent on opioids may avoid naloxone.

“Opioid withdrawal will not kill you, but I have talked to a number of people who have gone through it, and they have all said the same thing: … ‘I wished I was dead,’” McLaughlin said. “It has a massive range of nasty, horrible effects.”

The idea that the compound could amplify naloxone’s effect at a lower dosage, while limiting withdrawal symptoms, indicates that it may be a “new therapeutic approach” to overdose response, McLaughlin said.

The research team said their next step is to tweak the compound and dosage so that the effects of naloxone last long enough to reverse overdoses of more potent drugs.

Though the compound is not yet ready for human trials, the researchers chose to release their findings in the hope that their peers can double check and improve upon their work, said Susruta Majumdar, another senior author and a professor of anesthesiology at the Washington University School of Medicine in St. Louis.

“We may not be able to get that drug into the clinic, but somebody else may,” Majumdar said. He added: “Let them win the race.”

The death of a parent is typically a gutting and disorienting experience for adults. For a child, it’s even worse, stoking feelings of frustration and abandonment and sometimes self-destructive behaviors such as drug use that can continue well into adulthood. This has particularly serious implications when the child is Black and therefore more likely to end up in the child welfare system.

A recent report by federal researchers provides the fullest picture yet of the sprawling impact of overdose deaths on Black children in Los Angeles and other cities — and what we can do about it.

From 2011 to 2021, the report found, more than 321,000 American children lost a parent to a drug overdose. Black children experienced the highest increases in the rate of such losses during those years, compounding a long-standing public health crisis across Black America. Like much of the United States, Los Angeles has seen drug overdoses soar in recent years, with disproportionate losses among the city’s Black adults.

Black people are significantly more likely to experience drug-related deaths due to limited access to treatment and resources such as naloxone, which can reverse overdoses. When they’re parents, the toll on their children is both rapid and deep. Parental drug use is highly associated with use among children.

Although Black children make up just 7.4% of the Los Angeles County population, they represented 24% of those who entered the child welfare system in one recent year. One study found that about 47% of Black children in California were the subject of a maltreatment investigation before the age of 18, with substance use accounting for 41% of the state’s child maltreatment cases.

The disproportionate number of Black children in Los Angeles’ child welfare system has been scrutinized since the late 1980s, the height of Los Angeles’ heroin and crack epidemics. The drugs, then largely addressed as a criminal issue through heavy-handed policing and prosecution, consigned a generation of young and middle-aged Black Angelenos, both users and dealers, to premature death and incarceration. Many of their children wound up in the city’s fragmented child welfare system and, all too often, on a similar path toward addiction and entanglement with the legal system.

When a child’s parent dies, other family members — the child’s other parent, grandparents, aunts or uncles — are the first resort to assume responsibility for their care. But Black children, especially those from low-income communities, often end up in the child welfare system instead.

Why? The child’s surviving family members may lack the resources to fill the breach. But racial biases also predispose child welfare workers to remove Black children from their families and impede reunification efforts.

Research has consistently shown that child welfare workers more readily define Black parents’ behavior as abusive or neglectful even when it’s comparable to the conduct of parents of other races. Child welfare workers are also more likely to regard Black families as less loving of their children and less redeemable.

Children who enter the child welfare system due to parental death already spend twice as much time in the system. Black children tend to remain in the system even longer because of bias.

The twin depredations of Los Angeles’ opioid epidemic and its child welfare system are daunting but not beyond repair. The first necessity is to revamp the city’s racially biased child removal process. Los Angeles officials have been piloting a “blind removal” approach in which investigations are followed by a decision-making process that excludes demographic details such as the child’s race. This is a step in the right direction.

However, a UCLA study of the pilot program revealed that racial disproportionality persists, demonstrating how deep-seated child welfare biases are. For blind removal to be effective in eliminating racial disparities, it must be supplemented by greater transparency, expanded civilian review boards and training in implicit bias.

Second, we need a better understanding of the consequences of placing Black children in the child welfare system. In general, Black children in the system are highly stigmatized, especially when they come from families with histories of drug abuse. That contributes to making them less likely to be adopted. The trauma of losing a parent also means they’re more likely to experience depression and anxiety.

These experiences frequently devolve into social isolation, poor academic outcomes, limited employment prospects and incarceration. Officials must work to identify these patterns early and provide resources such as mental health care to disrupt this harmful cascade.

Lastly, policymakers must continue to explore the benefits of guaranteed basic income to provide a cushion for personal and professional growth. Another California pilot program would provide guaranteed basic income to those who age out of foster care at 21 or older. The state should lower the eligibility age to 18 to account for the steep challenges in housing and employment Black youths face as soon as they become adults. Researchers at Stanford and other institutions have found that such policies support better health, housing security and employment prospects.

Addressing the deepening overdose epidemic in Los Angeles’ Black communities requires attention not just to the immediate risks to drug users but also to the childhood experiences that often drive them to use. One of our most powerful tools for preventing future overdoses is to take better care of the children most directly affected by today’s losses.

Jerel Ezell is an assistant professor of community health sciences at UC Berkeley who studies the racial politics of substance use.