Childhood self-control and adult health

Self-control enables people to delay gratification and control impulses. The power to avoid temptation represents a vital human capacity. A strong capacity for self-control is linked with many aspects of healthy living: avoiding high fat and sugar foods, engaging in exercise, and staying clear of addictive substances. These unhealthy behaviours are recognized as major determinants of mortality and morbidity in the UK and globally.

In this project I seek to decipher whether self-control is at the root of many of the unfavourable health behaviours that burden health systems as well as the health problems that afflict many in society. Most existing evidence on the potential contribution of self-control to health comes from small non-representative samples examined in laboratory studies or through surveys with short periods of follow-up and which use self-reported outcomes.

This has meant that it is currently difficult for researchers to know if self-control actually contributes to subsequent health behaviour and health outcomes outside of the laboratory, if this is true of the population rather than of a select few, and if objectively verifiable health-related outcomes are affected. In the proposed programme of research I aim to address squarely these major challenges.

I will provide scientific evidence detailing whether and how individual differences in childhood self-control contribute to the emergence of patterns of health behaviour and health problems over the lifespan. Consistent with the ESRC's Delivery Plan's objective to foster the usage of existing data resources, I will capitalize on the existence of four large population-representative samples which track over 10,000 individuals for between 15 and 50 years with data recorded on multiple occasions from early life into adulthood.

These incredible data resources include detailed measures of child temperament that have not yet been exploited to examine childhood self-control and its health effects but represent a clear opportunity to do so. Crucially, I have identified a set of questions which ostensibly gauge self-control in each of these studies and in this project will empirically test how these items correspond to well-validated self-control measures.

Using the self-control measures derived from this process I will then identify how childhood self-control shapes the uptake, maintenance and decline of smoking, drinking, physical activity, and substance use from adolescence through to middle age. I will track how early life self-control links to later health outcomes (e.g. body mass index, biomarkers of inflammation and cardiovascular risk). Finally, I will implement a series of analyses to unpick the complex interrelationships between self-control, socioeconomic status, and the development of health.

This project represents a unique departure from conventional approaches that have not taken an integrated approach to examine the health impact of self-control at multiple time points, in multiple datasets, over an extensive time horizon. I have the appropriate skillset to ensure this project is a success: pre-existing expertise working with large-scale datasets, biological data, and applying advanced longitudinal analyses to personality and health data.

I request funding to provide protected time and assistance to: i) strengthen and develop important collaborations (e.g. with Prof. Roy Baumeister and Prof. Ian Deary), ii) undertake a detailed programme of skill development activities including training in advanced statistical methods and psychometric techniques, iii) complete and disseminate a programme of research which will provide a solid empirical platform on which existing ideas about the health impact of self-control will be formally tested, and iv) detail the implications of the proposed work for policies which aim to intervene to enhance self-control early in life or to address the impact of low levels of self-control in adulthood.

The goal of the proposed programme of work is to enhance understanding the lifespan health effect of childhood capabilities and the mechanisms that underpin these effects. As such, there will be a broad set of beneficiaries from this project spanning the academic, policy, industry and pubic spheres. Firstly, this research will provide evidence to those who have developed theories of self-control detailing the areas where this capacity appears to be most effectively deployed to enhance health at different points in the life-cycle. Other researchers will undoubtedly employ the self-control measures derived from this project to examine a panoply of key life outcomes further enhancing knowledge regarding the benefits of childhood self-control.

The proposed research will generate novel predictions regarding the potential health benefits of early childhood intervention programmes which specifically target self-control and perseverance. In this way the current research will directly inform the evidence base for innovative policies that aim to capitalize on the malleability of personality traits to promote self-control. To date, evidence supporting the cost-benefit ratio of early intervention policies has focused largely on educational, labour market, and criminality outcomes. I will expand this evidence by providing a comprehensive overview of the potential health benefits of producing persistent changes in self-control early in life. Feeding this work into childhood intervention policy discussions particularly those relating to innovative approaches to reducing health inequalities will foster a more integrated understanding of the evolution of health and the formation of health disparities.

This work will also bring a greater focus on self-control into health policy. Currently, there is a good deal of interest in psychology in creating behaviour change interventions to effectively target health behaviours like smoking, alcohol consumption, and weight gain that place increasingly burdensome costs on both citizens and governments. A parallel literature has developed in behavioural economics detailing policy recommendations for interventions that effectively capitalise on flaws in human decision-making to foster in many instances desirable health behaviours. In both cases, the current work will inform these endeavors, firstly by identifying the segment of the population who are most likely to be in need of behaviour change interventions and when these interventions would be best implemented, and secondly by providing insight into what form such interventions should take. For instance, 'opt-out' policy-strategies in behavioural economics are likely to be most effective amongst those with low self-control as they make healthy choices the default option meaning these are unlikely to be avoided by those who lack strong effortful control and planning abilities.

Similarly, the healthcare and pharmaceuticals industries are increasingly seeking to develop behaviourally informed intervention strategies to promote engagement with health services, particularly amongst the disadvantaged, and to increase medication adherence rates. A better understanding of how self-control contributes to health behaviour and health over the lifespan may therefore be of interest to those within these industries who aim to go beyond segmentation based on sociodemographic characteristics to target and design behavioural interventions based on relevant stable individual difference characteristics.

The early life psychological factors that determine which children go on to take up smoking, become overweight, or engage in other unfavourable health behaviours are inherently interesting to the general public and particularly to parents, teachers and others who are involved in shaping the character skills of young people. This research will generate public awareness of such linkages and how investment in children could ameliorate these.