Doctors tell us. Medicare tells us. Our insurance companies tell us.

Watch your waistline, exercise, keep your mind active, socialise, go for your medical checkups.

But there's something else, less cited, that apparently can add years to our lives: our attitude.

Attitude counts

A couple of Harvard publications suggest that practicing gratitude and optimism might benefit us about as dramatically as taking our blood pressure pills or joining a water aerobics class.

The first publication, a press release from Harvard's T.H. Chan School of Public Health, tells how researchers from the school found gratitude was associated with greater longevity among seniors.

Harvard scientist Ying Chen, the lead researcher, said earlier studies had already shown an association between gratitude and a lower risk for mental distress, as well as greater emotional and social well-being.

A new study, published in JAMA Psychiatry in July, demonstrated a positive link to physical health.

"Our study provides the first empirical evidence on this topic," Chen is quoted as saying.

Chen and colleagues used data from the Nurses' Health Study to assess levels of gratitude and mortality among almost 50,000 older women, whose average age was 79.

The women completed a gratitude questionnaire measuring their agreement or disagreement with statements such as, "I have so much in life to be thankful for," and, "If I had to list everything that I felt grateful for, it would be a very long list."

Four years later, the researchers followed up, looking at deaths from all causes among the women. Participants whose gratitude scores were in the highest one-third of the group had a 9 percent lower incidence of death than those who scored in the bottom one-third.

Gratitude, the scholars said, appeared to protect against every cause of mortality. The results were controlled for demographics, prior health issues and lifestyle factors such as social participation, religion and even optimism, which is closely related to gratitude.

The other piece I saw was a 2019 Harvard Medical School blog by David R. Topor, then a clinical psychologist on the medical school's faculty.

"Plenty of research suggests optimistic people have a reduced risk of heart disease, stroke, and declines in lung capacity and function," his blog entry began. "Optimism is also associated with a lower risk of early death from cancer and infection. And now a new study links optimism to living a longer life."

That study found highly optimistic people had longer lives and also a greater chance of achieving "exceptional longevity" — living past 85.

It controlled for diseases such as high blood pressure or high cholesterol and for health behaviors such as smoking or alcohol use.

Granted, the first thing I learned in my graduate-school courses in research methods is that correlation is not causation. The fact that two things are linked doesn't automatically mean one caused the other.

We might find — I'm making this up — that 97 percent of drivers involved in fatal car wrecks are wearing shoes at the time of their accidents. That wouldn't mean shoes cause car crashes.

Similarly, discovering that grateful and/or optimistic people often live longer than ungrateful and/or sour people doesn't necessarily prove either group's attitudes are causing their outcomes.

Still. These studies and basic common sense suggest that our attitudes do play a role in our physical and mental health, not to mention our very will to live.

Fortunately, as Topor said, all of us can take steps to improve our disposition and with it, perhaps our long-term health.

Among other things, he suggested practicing the half-smile, a technique to cope with sad feelings. You practice smiling a few minutes each day. If you can't force a full smile, a half-smile will do. Then you note how your thoughts and mood change.

He suggested setting aside time to focus on the positive. At a set time each day, think about the day's positive aspects. What went well? What made you happy or proud?

Self-help tactics

I'm not naturally a Dr. Pangloss. But as I've aged I've worked on myself.

A trick I do when I'm experiencing what my dad used to call "the mulligrubs": I force myself to make a mental list of things I'm grateful for. It's like the old hymn said, "Count your blessings, name them one by one." I do that and, hey, it works. I feel better despite myself.

Another tactic: I remind myself that everybody has setbacks, failures, fears. Often it's not so much what happens to us that determines our lot, but what we do with what happens. We can be discouraged or we can look for opportunities to grow and conquer.

As Hamlet put it, "There is nothing either good or bad, but thinking makes it so."

Will my efforts to focus on the positive earn me bonus years? Who knows?

But this I do know. I feel better when I count my blessings instead of cursing my woes, and when I expect the best instead of assuming the worst.

• First published in the Herald Leader; republished by Religion Unplugged
• Paul Prather is a rural Pentecostal pastor in Kentucky and writes a regular column about faith and religion for the Herald-Leader

How do we name this 'Other'?

There is a general lament from institutional churches that numbers are down. Immediately we equate this with a loss of the 'sense of the sacred', the holy, the profound. I disagree.

Perhaps it is that when we enter a church now, it often feels different, strange, irrelevant, without context, unfamiliar, archaic. The sacred is no longer contained nor constrained within these walls. We now feel free; are graced; to see and experience the sacred in our profane world. Our world is our cathedral.

Consider these every day graced moments...

• a hot mince pie, in a paper bag, given to a homeless man busking on the street … Eucharist?
• the welcome of open doors and smiling faces at the local cafe or tavern, as opposed to the locked doors of multi-million dollar cathedrals … which reveals the hospitality of God?
• the heartfelt generosity of the overweight, unwashed man in black leathers who stands to give me his seat on the bus, compared to the Chanel-scented woman in pearls who berates me for sitting in her pew in church … who reveals the loving-kindness of God?
• the friendly wave of the early morning dog-walkers acknowledging our commonality, and the fellow worshipper, uncomfortable at the human contact of the Sign of Peace … who reflects the incarnate God?
• the succinct, even prophetic messages of bumper stickers ..."LIVE SIMPLY THAT OTHERS MAY SIMPLY LIVE" or "AND WHAT DIFFERENCE DO YOU MAKE?" or "INSATIABLE IS NOT SUSTAINABLE" and the long-winded, over-worked exegesis of a tired preacher … who breaks open the word of God in a releveant, meaningful way?
• a woman raising a plastic spoon of pureed food to the lips of her terminally-ill husband … a consecrated act?
• a gentle, loving kiss on a toddler's sore finger … a holy anointing?
• a hand-written note of apology from a repentant son … reconiliation?

We are blessed to recognise and to name and to experience God in the actions and words and presence of each other. But we have no name for this. No category or box to tick.

How do we broaden the concept of the sacramental presence of God?

How do we invite people to worship in the 'cathedral of life'?

• Liz Pearce, a mother of three adult children, loves story, writing, and dollmaking www.heartfeltdolls.weebly.com