Bretbel-Haurwitz,Marsb Altruistic kidney donations cannot be readily explained others,supporting democracy:Aknin.Dunn.Norton by other dominant self-serving explanations for altruistic 2011;Diener Ryan,2009;Krueger,Hicks,McGue behavior,in luding kir selection, 00I cial behaviors also meet The of these donaio ey e nd thei normative nature have raised many questions about their Bove,2011;Bekkers Wiepking,2011).It remains unclear causes (Henderson et al.,2003). whether subjective well-being can also promote acts of evidence y altruism.This is sed quality of life (Kahneman.Diener. kidney donation is that such donations are exceedingly Schwarz,2003).Objective well-being,which reflects rare;per capita rates of altruistic kidney donation are les than 1 in 10,000.This base rate renders indivi can wa This ob sures that capture,in aggregate,associations Wascher,2003;Oswald Wu,2010).Subjective well- at the individual level (iener Tay.Oishi 2013)A elf rd engagement meaning.and numose and ng D tions and life satisfaction (Diener.2012:Ryan Deci .well-beingindex.com/).Gallup-Healthways hasc nducte 2001).A recently proposed"engine"model of well-being nationwide sampling of well-being since 2008.thereby incorporates these of well-being and creating the m s extensive ollection of well-being ing rep bat. nt inpu the co he index taps into more &C lead to voluntary.beneficent well-being outcomes and 2000 and includes both ex perienced and evaluative well activities (Jayawickreme,Forgeard,&Seligman 2012) being (i.e,self-reported well-being in the moment and Well-being outcomes are retrospectively),which is a recomme pursu thei .CO bute to geneind e06 hneman Riis Our aim in this study was to evaluate the relationshin changes in objective well-being would be anticipated to between this nationally representative index of well well-being.which would lead to being and per capita kidney in s to prom extrao for well-being outcomes.Donors con istently h desire to help another person as their primary motivation median income,age,and physical health,which may be for donating (Henderson et al. 2003: Lennerling associated with both well-being and altruistic donation sberg,Meyer, 201d are not hypothesized to drive the association between the two out exception,donors self-report that donation positively Method affected their psychological well-being and that the 2010 decision to donat again (Mass vant to our hypothe e in on P cally ne tha statistics provided by the United Network for Organ kidney donations between 1999 and 2010 (Organ Sharing (Matas et al., 2013).Together,these factors sup- Procurement and Transplantation Network,2011)and port the hypothesis that increases in well-being may pro ents well-being (Gallup 20 well-b less extreme prosocial behaviors at the individual wide demographic and economic information indices o level (spending money on others,volunteering)and at physical and mental health,and state characteristics of the community level (trusting others,cooperating with collectivism and religiosity.2 Brethel-Haurwitz, Marsh Altruistic kidney donations cannot be readily explained by other dominant self-serving explanations for altruistic behavior, including kin selection, reciprocity, or adher￾ence to social norms (Batson, 2010; Massey et al., 2010). The rarity of these donations and their strongly counter￾normative nature have raised many questions about their causes (Henderson et al., 2003). Converging strands of evidence have suggested that well-being may promote altruistic kidney donation. Well￾being is a broad construct that comprises objectively and subjectively assessed quality of life (Kahneman, Diener, & Schwarz, 2003). Objective well-being, which reflects objectively measured basic human needs (e.g., economic resources, access to clean water, and good health), affords individuals the opportunity to engage in activities that contribute to subjective well-being (Gabriel, Mattey, & Wascher, 2003; Oswald & Wu, 2010). Subjective well￾being incorporates both eudemonic components, such as self-reported engagement, meaning, and purpose, and hedonic components, such as self-reported positive emo￾tions and life satisfaction (Diener, 2012; Ryan & Deci, 2001). A recently proposed “engine” model of well-being incorporates these various elements of well-being and posits that objective indices of well-being represent input variables that promote subjective processes that, in turn, lead to voluntary, beneficent well-being outcomes and activities (Jayawickreme, Forgeard, & Seligman, 2012). Well-being outcomes are defined as outcomes that are pursued for their own sake, contribute to general well￾being, and are characterized and measured indepen￾dently of other outcomes. Under this model, positive changes in objective well-being would be anticipated to increase subjective well-being, which would lead to increases in well-being outcomes. Altruistic kidney donation satisfies these three criteria for well-being outcomes. Donors consistently report the desire to help another person as their primary motivation for donating (Henderson et al., 2003; Lennerling, Forsberg, Meyer, & Nyberg, 2004; Massey et al., 2010). They also report high levels of well-being after donation (Lennerling et al., 2008; Massey et al., 2010); nearly with￾out exception, donors self-report that donation positively affected their psychological well-being and that they would make the same decision to donate again (Massey et al., 2010). Finally, altruistic kidney donation is a con￾crete outcome that can be independently measured using statistics provided by the United Network for Organ Sharing (Matas et al., 2013). Together, these factors sup￾port the hypothesis that increases in well-being may pro￾mote altruistic donation. Researchers have linked subjective well-being to less extreme prosocial behaviors at the individual level (spending money on others, volunteering) and at the community level (trusting others, cooperating with others, supporting democracy; Aknin, Dunn, & Norton, 2011; Diener & Ryan, 2009; Krueger, Hicks, & McGue, 2001). However, these prosocial behaviors also meet a range of self-serving goals, such as adherence to perceived social norms and enhancement of reputation (Bednall & Bove, 2011; Bekkers & Wiepking, 2011). It remains unclear whether subjective well-being can also promote acts of unambiguous and lifesaving extraordinary altruism. This is what we sought to determine in our study. One difficulty in identifying antecedents of altruistic kidney donation is that such donations are exceedingly rare; per capita rates of altruistic kidney donation are less than 1 in 10,000. This very low base rate renders individ￾ual-level assessments infeasible for capturing predictors of donation. This obstacle can be superseded by comparing regional measures that capture, in aggregate, associations at the individual level (Diener, Tay, & Oishi, 2013). A nationally representative regional assessment of subjective well-being in the United States recently became available: the Gallup-Healthways Well-Being Index (http://www .well-beingindex.com/). Gallup-Healthways has conducted nationwide sampling of well-being since 2008, thereby creating the most extensive collection of well-being data in the country. The index taps into more dimensions of well￾being than does most past research (Diener & Seligman, 2004) and includes both experienced and evaluative well￾being (i.e., self-reported well-being in the moment and retrospectively), which is a recommended approach, given the biases that affect each perspective (Kahneman & Riis, 2005). Our aim in this study was to evaluate the relationship between this nationally representative index of well￾being and per capita altruistic kidney donations across states to establish whether well-being promotes extraor￾dinary altruism. We assessed the relationship between these variables while controlling for covariates, including median income, age, and physical health, which may be associated with both well-being and altruistic donation but which are not hypothesized to drive the association between the two. Method We obtained data relevant to our hypotheses using publi￾cally available databases and previously published research. Variables included statistics on nondirected kidney donations between 1999 and 2010 (Organ Procurement and Transplantation Network, 2011) and statewide assessments of well-being (Gallup, 2012). We also accounted for variables that may be confounded with our primary variables of interest, including state￾wide demographic and economic information, indices of physical and mental health, and state characteristics of collectivism and religiosity. Downloaded from pss.sagepub.com by Cai Xing on February 11, 2014