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Wellbeing
Wellbeing S. C. MacKian, Open University, Milton Keynes, UK & 2009 Elsevier Ltd. All rights reserved.
Glossary Eudaimonia A concept first used by Aristotle to indicate human ‘happiness’ or ‘flourishing’. Stemming from the Greek ‘eu’ (happy, well, harmonious) and ‘daimon’ (the individual’s spirit). Health ‘‘A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’’ (World Health Organization (WHO) definition). Welfare Physical and mental health and happiness. A system of help given to support those who need financial, medical, or social assistance. Well-Being A good or satisfactory condition of existence; a state characterized by health, happiness, and prosperity. The state of feeling healthy and happy.
Introduction Well-being is a concept that permeates all aspects of contemporary society, from the individual to the workplace, the hospital to the national economy. To achieve personal well-being is one of Western society’s key aspirations. However, it is not a concept we can all agree upon – it is inherently subjective, relational, and contested – and must be understood within the context in which it emerges.
History of Understandings of Well-Being Historically the search for well-being was a central part of what it meant to be human. As is frequently the case, we can turn to Aristotle for an insight into the philosophical underpinnings to the holistic nature of wellbeing. Aristotle’s notion of ‘eudaimonia’ (best translated as ‘human flourishing’) represented the ultimate human good. However, contrary to key elements we might associate with contemporary understandings of ultimate human good, eudaimonia goes beyond the trappings of wealth, power, and knowledge, to focus on the virtues that underpin a life premised on spiritual, emotional, and material well-being. It highlights strength of character, including courage, honesty, and pride, together with mutually beneficial rationality. The underlying belief in the need to achieve ‘balance’ in the art of living continued to underpin philosophical and popular understandings of well-being, illustrated by
the continued popularity of sanctuaries of rest and relaxation such as spas, from the Roman times onward. With the advent of scientific medicine however, the advancement of the biomedical paradigm and the birth of the Enlightenment subject, this holistic notion of wellbeing was lost as the body became divorced from the mind. As biomedical belief took over from folklore, superstition, and religion as sources for the maintenance and promotion of health and well-being, disease of the ‘body’ became the primary focus and well-being of the ‘person’ was increasingly overlooked. Furthermore, anatomical specialisms subdivided the body and mind so that each instance of disease could be isolated, measured, and diagnosed. This was arguably further compounded in the latter part of the twentieth century with spiritual breakdown and falling formal religious participation, and well-being became increasingly something that could be bought at the counter or obtained from the doctor instead. Western societies had lost the art of locating well-being at the heart of human existence. As it is fundamentally this divorce in Western rational scientific thinking that has resulted in subsequent confusion about what well-being is and how to comprehend, measure, or enhance it, this discussion focuses mainly on developing understandings of well-being in Western societies; although as will become clear the relation to more holistic understandings of well-being rooted in Eastern philosophical and spiritual teachings has been an ongoing undercurrent. In Western society by the twentieth century, or ‘high modern’ period, well-being was predominantly understood, conceptualized, and produced through the institutions of national government; the British Welfare State being the ultimate embodiment of this. As the apparent success of the Welfare State took hold and the worst excesses of ‘illness, ignorance, disease, squalor, and want’ were eradicated, concerns over well-being were relocated to wider structures of nation and economy. Discussion grew in relation to the ‘economic well-being’ of countries alongside the individual right to financial security with the growth of market liberalism. At the root of this was the economic imperative that more wealth would lead to improved well-being, and that material well-being was therefore the solution to many of society’s wider issues and malaises. So much so that social, emotional, or virtuous understandings of well-being in a more holistic sense were almost completely lost, as illustrated by the successful US presidency campaign in the 1990s by Bill
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Clinton with the infamous slogan ‘‘It’s the economy stupid.’’ However, there emerged a growing recognition that GDP cannot alone stand for a measure of well-being. Although well-being appears to increase with increased wealth, this is only to a certain level, and it was progressively recognized that well-being and happiness do not correlate simply with material advancement. This led to the development of a number of ‘indexes’ to measure well-being, and by the end of the twentieth century, wellbeing in a wider sense was firmly on the political and social agenda. In 2005 Tony Blair, the then UK Prime Minister, turned Bill Clinton’s slogan on its head, vowing to find out how ‘happy’ his country was while espousing ‘‘It’s not just the economy stupid.’’ Even the leader of the opposition, David Cameron, spoke of the need to make people happier and to refocus from ‘GDP to GWB’ (general well-being). At the start of the twenty-first century, well-being is thus a central political challenge of our times, a sign of how used to continuous economic growth Western society has become, and how aware we now are of the sometimes hollow benefits that accompany it. Alongside this changing political climate alternative understandings of well-being were being promoted at the margins by the New Age Movement, urging us to leave behind the stresses of mainstream society and develop the mind, body, and spirit holistically in order to achieve well-being. This was essentially a Western reappropriation of Eastern traditions and Pagan histories, reapplied in a postcolonial, postmodern interpretation of well-being for groups finding themselves marginal to the central drives of Western capitalism. It heralded the changing conceptualization of well-being that was to come. The rise of reflexive individualization and self-help was beginning to elevate the individual, allowing the self to take center stage in discourses of well-being by the close of the twentieth century. Well-being from this perspective became firmly located in the individual body, with diet, exercise, and supplements being key components in the regime of the responsible individual who was to maintain his/her own well-being, no longer relying on state institutions. As understanding of well-being has become more sophisticated there has been a proliferation of studies and avenues for exploration and hence a significant variety of contexts within which discourses of well-being are being constructed. The well-being of ‘women’, for example, has come to be seen not just as an issue of dignity and human rights, but as an essential element in global development. Thus the Millennium Development Goals identify women’s well-being as a central component in the eradication of poverty. The well-being of ‘children’ is also of growing international concern, and ‘environmental’ well-being continues to be high on
international, national, and local agendas. Since the 1992 Rio Earth Summit it has been increasingly recognized that the well-being of the environment influences human well-being, and should therefore be of international political concern. At the ‘individual’ level, the turn of the twenty-first century has seen a renewed interest in the mind, body, spirit triadic conceptualization of wellbeing. With the advent of ‘risk society’ and increasing opportunity and necessity for self-reflexivity, the rise of ‘self-help’ literature and the expansion of therapeutic ‘experts’ can be seen as further evidence of the search for a meaningful, knowable focus in a disorientating world.
Elements of Well-Being: Happiness, Health, and Prosperity? The difficulty in defining well-being is in the nature of the factors it hinges upon. Well-being might be understood as ‘happiness, health, and prosperity’. However, ‘health’ itself is a term even the WHO has experienced difficulty in pinning down, and how do we define such relative concepts as ‘happiness’? Alternatively well-being can be conceptualized as a mixture of meeting basic needs and simple desires. Yet again we face the problem that need is a concept that has troubled academics and policymakers alike for centuries, and one person’s desires can impinge upon another’s well-being. It might be more helpful to think of well-being therefore as hinging upon some measurable notions of ‘welfare’ together with some self-ascribed understandings of ‘contentment’. However, a third element must be added to the equation, as without a sense of ‘dignity’ the procurement of the other two may prove to be a hollow victory. Thus well-being is a slippery concept which defies easy definition and varies in time and space. Dictionary definitions suggest it hinges on the state of being well, happy, or prosperous. However, an individual can certainly experience a profound sense of well-being without being prosperous, and health is not a prerequisite for well-being. ‘Subjective well-being’ is generally premised on three components: the presence of pleasant emotions, the relative absence of unpleasant emotions, and personal judgments about satisfaction. Subjective well-being and the judgments of satisfaction attached to it, can relate to specific conditions, such as marriage, home, or work, and can also involve explicit goals or values. Hence the inherent complexity across and within societies, and even within individuals over time and space. ‘General wellbeing’ may on the other hand relate to some assessment of attributes to be found within a society or institution that are taken as proxy measures of ‘satisfaction’. Without wanting to pass judgment on the relative value, weighting, or contribution of each element, Table 1 makes
Wellbeing
Table 1
Elemental table of well-being
Element
Key attributes
Physical
Health, illness, fitness, disability
Social
Economic
Political
Environmental
Emotional
Spiritual
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Explanation
Although health is only one possible, and not necessary, condition of well-being, the body nonetheless represents a key site for the enactment, performance, and securing of well-being. Hence, e.g., the notion of designing ‘therapeutic landscapes’ to enhance well-being and hasten recovery from ill-health and surgery. Nonetheless it is undoubtedly possible to experience a sense of wellbeing during periods of acute illness. People in the situation of long-term illness often end up with a profound sense of well-being on many levels because they have more to come to terms with and have been forced to develop ways of being which most people have never had to contemplate. Thus a subjectively assessed sense of well-being can transcend physiological state. This is also being acknowledged in studies of health and place which are seeking increasingly to move notions of ‘health’ beyond medicalized constructions. Relationships at personal, Social connectedness can lead to both individual well-being and community or community, and society level social well-being. This aspect is reflected in an increasing interest in interconnectedness, interdependence, and notions of ‘social capital’ which have pushed social well-being center-stage. Here the argument is that weakening of social relations has led to a degradation of social networks and the benefits they accrue. This discourse has also infiltrated educational agendas with national governments, local authorities, and individual schools and workplaces recognizing and acting upon the significance of well-being to the smooth running of institutions, communities, and families. Consumption, wealth, material Economic comfort and good health do not automatically equate with a sense of advancement, career, work well-being. Conversely, some who experience what has been identified as a quantifiably poor quality of life may still feel a sense of well-being. The idea of economic well-being can be tied to the national economy, or focus in upon the individual self, particularly in the context of the workplace. Increasingly in a Western context the workplace is being seen as a place where the individual should not have his/her well-being undermined-both for the employees’ dignity and for the economic success of the employer. Indeed measures to promote well-being in the workplace, from Tai Chi classes to the creation of therapeutic outdoor spaces, have been adopted as one strategy toward increased productivity in the workplace. Democracy, dignity, choice, The right to dignity, choice, and an opportunity to make change is a central part of influence well-being. The well-being agenda is now also a big part of political strategy. Politicians and think tanks in countries as far apart as England, Finland, and Australia are bringing well-being and happiness to the political arena, while others, e.g., Bhutan have always held it centrally. From implicitly addressing itthrough, e.g., health, wealth, and housing-to explicit use of the term ‘well-being’ and a wider sense of ‘happiness’ itself. Home, living, nature, global Living environment has long been seen as an issue for health and well-being, from the pioneering work of people like Edwin Chadwick. Although the negative effects of poor housing on well-being continue to be documented, even relatively good-quality housing is now being highlighted as potentially damaging to inhabitants well-being. New housing developments, e.g., have been shown to undermine the well-being of young families with lack of gardens, parks, and play areas. Wider reflections of the importance of environment to well-being are reflected in the development of such measures as NEF’s Happy Planet Index. Self-image, personal growth, self- The Western individual, emerging through the subjective turn and consolidated esteem through the reflexivity of contemporary society is at the heart of current conceptualizations of well-being. Here well-being implies a sense of agency and the ability to live a life that is experienced as meaningful. However the obsessive consumption driven individualization permeating Western society also means the widespread promotion of regimes of health, well-being, mind, and the body beautiful are frequently motivated by fear campaigns that create false needs and induce feelings of personal and emotional ineptitude, thereby undermining emotional well-being. Spirituality, faith, inner peace, life Historically spiritual awareness and development was a fundamental part of wellpath being, be this through self-exploration, holistic treatments for illness, or as part of organized institutional religion. However, with the rise of rationality and modernity, a practical drive to find well-being rooted in the empirically observable physical body lost this edge. To some extent however spiritual wellbeing is reemerging as an essential part of the overall mix. Western society now sees a mix of serious spiritual path finding, as well as an element of susceptibility to the latest consumer trend in the search for spiritual fulfilment.
NEF – New Economics Foundation.
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some attempt to pick apart the notion of well-being, so we can scrutinize each element in a little more detail.
How Do We Measure Well-Being? The history of well-being appears to be one of obsession with measuring the seemingly immeasurable. However, by employing a multimethod approach researchers are able to develop adequate empirical representations of well-being. At an individual level, the most common psychological tools available are self-report surveys, many of which have been developed for use in clinical assessments in a variety of contexts (such as the General Well-Being Index). At the collective level a number of models, indexes, or approaches have been developed to measure well-being. A selection of these are summarized in Figure 1.
Relevance and Significance of WellBeing: Why Does Well-Being Matter? Since the days of Charles Booth mapping of poverty, health and other objective indicators of quality of life have had clear applications for policymakers and practitioners. However, these measures may miss the varying degrees of resilience and emotional thriving that individuals demonstrate. It is often this individual response to and judgment of circumstances which influence the degree to which any one individual copes with the same environmental factors – even in crisis situations. Hence objective measurements should not be taken alone in quality of life assessments and this is where the notion of well-being adds substantially to the quality of life debate. While the obvious benefits of adequate income, good health, and solid social relationships might be clear, research suggests that a sense of subjective well-being can
Gross National Happiness •
A term coined and developed in Bhutan from the 1970s to reflect the importance of spiritual development alongside material development in order to secure human well-being. Based on four principles: Equitable and sustainable socioeconomic development Preservation and promotion of cultural values Conservation of the natural environment Good governance
The Ottawa Charter •
In 1986 an international health promotion conference identified three key components to securing physical, mental, and social well-being. The ability to: Identify and realize aspirations Satisfy needs Cope with or change the environment
Capabilities Approach • An emerging approach to poverty in the1990s which emphasizes the importance of: Practical choice and agency Beyond simple notions of availability or access to resources or utilities Human Development Index • Developed in Pakistan in 1990 measuring average achievements in a country based on: Life expectancy Literacy rates and education enrolment Standard of living Genuine Progress Indicators (GPIs) • Idea first developed in California in 1995, and now taken on board in a number of different contexts (e.g., the Canadian Index of Well-being, GPI Atlantic, GPI Online Australia). Originally based on 26 social, economic, and environmental variables covering: Indicators and measures of progress Assessment of economic value of nonmarket social and environmental assets Happy Planet Index • Developed by the UK New Economics Foundation (NEF) in 2006, linking environmental well-being explicitly with social well-being. NEF assessed the ecological efficiency with which human well-being was being achieved. This combines a measurement of: Ecological footprint Measures of life satisfaction Life expectancy
Figure 1 Well-being indexes.
Wellbeing
in itself influence well-being and success in other areas. Someone who is happy most of the time is likely to have more self-confidence, perform better economically, and may even live longer. So what is the wider significance of well-being? In relation to this it is worth expanding a little upon three main areas.
Individuals and the ‘Well-Being Industry’ In contemporary interpretations, self-responsibility and self-actualization emerge as key ideals in the procurement of well-being, and there is a growing social structure and commercial network emerging to accommodate that. Lash and Urry describe the rise of ‘reflexivity enhancers’ – personal trainers, personal shoppers, stylists, dieticians, Tai-Chi instructors, health spas; all those who offer the promise of luxurious self-improvement and an enhanced sense of well-being with the swipe of a credit card. The self is very much a project to be worked on and these individuals and institutions provide the promise of achieving soul satisfaction. The pinnacle perhaps being the ‘life coach’ – the expert charged with the total physical, mental, and spiritual rescue of the failing individual. In short, a thriving well-being industry has been born in response to the modern search for our very own eudaimonia.
Politics: A New Development Agenda? Beyond a certain level, an increase in material wealth does not lead to an equal rise in overall well-being. Thus, economic prosperity does not always impact positively on the subjective well-being of a nation. Progress and economic opportunity for some may lead to misery in other aspects of their lives and social or environmental degradation more generally. For example, the rise of private car use although ensuring freedom of movement in privacy and comfort for large sections of the world’s population, has also led to parental paranoia and childhood obesity as the street became transformed into a car-dominated space of fear. At global levels it has contributed to damaging the Earth’s atmosphere and is a factor in increasingly polarized wealth. In recognition of such trends, a wider ‘well-being agenda’ is progressively underpinning government policy drives in wealthy industrialized countries and political discourse around well-being has grown. From health and education to work–life balance and responsible consumption patterns, political rhetoric and structures are opening up to facilitate choices and actions aimed at enhancing individual well-being. Politically understandings of well-being are also therefore hinged upon individual agency and responsibility, and the number of areas where we might exercise that responsibility is growing.
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Moral Imperatives: Individual Choices in a Global World The British political system invented the Welfare State and in some senses may therefore consider itself to have the moral upper hand in terms of enhancing individual and national well-being. Yet, it continues to contribute to international humanitarian atrocities, including war, arms trading, and environmental degradation, with apparent scant regard for well-being beyond its own borders. Thus, there are inevitably times where one person’s well-being may hinder that of another. Britain is far from alone in setting such double standards. Nonetheless, a growing exploration of well-being and heightened political awareness can only serve to raise the profile of such inconsistencies and offer opportunities for individuals and civil society to respond. The rise of movements such as Reclaim the Streets, Guerrilla Gardening, and Greenpeace all offer opportunities to highlight social and environmental issues affecting well-being, together with suggesting avenues for action. Thus, the ‘responsible individual’ does not relate solely to self-focused choices, but can also involve choices made through a moral sense of responsibility to others, and can therefore act as an agent of change.
The Future of Well-Being? Well-being as a concept and goal has been with us since the earliest philosophical and moral debates, and continues to transform through political appropriations and changing social aspirations. As the world changes, so will our requirements, expectations, and measurements of well-being. Perhaps we will become more in tune with the likes of the Bhutanese in realizing that with advances in modernization comes the threat of loss of other fundamental components of well-being, such as tranquility, happiness, and spirituality. Around the world most studies report an element of subjective well-being among populations regardless of, and often in spite of, economic or environmental circumstances. Thus, out of all the elements of well-being discussed it is perhaps the subjective one, and ultimately the one most difficult to measure satisfactorily, which should be our key concern. Continued advances in information technology, biogenetics, and the automation of society are likely to raise new questions, in particular around our understanding of relative and experiential rather than absolute notions of well-being. With the use of new technologies, maps of physical and emotional well-being are already being produced in a variety of inventive ways. Physiological measurements of heartbeat, skin response, and neurological activity have been mapped to plot the ‘well-being’ of people-places. Such work has the potential to tell us a lot more about what well-being ‘really’ looks like and
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offers hope for innovative and useful understanding in the future. The likelihood of well-being emerging as something we can conceptualize simply and definitively remains unlikely, but the growth of political interest in the concept means it is likely to be increasingly central in both economic and social analysis. At the time of writing, major contemporary texts in human geography omit well-being from the index completely. It is unlikely such an omission can continue. Geographical variations in interpretations, cultural experiential factors, and the uniqueness of individual subjectivity all ensure that the difficult task of nailing this nebulous concept will continue for sometime yet, and geographers should be playing a key part in that undertaking. The growth of academic work on reenchantment and spirituality, the continued popularity of grassroots activism addressing global imbalances, and a vastly expanding and thriving well-being industry, are all indicative that well-being is set to remain on the agenda and continue to raise interest. It is now more than ever a concept pushing at the doors not only of the philosophers, but of world leaders, policymakers, and academics alike. See also: Affect; Emotional Geographies; Health Geography; Therapeutic Landscapes.
Further Reading Adam, B., Beck, U. and van Loon, J. (eds.) (2000). The Risk Society and Beyond Critical Issues for Social Theory. London: Sage. Alkire, S. (2005). Valuing Freedoms: Sen’s Capability Approach and Poverty Reduction. Oxford: Oxford University Press. Crossley, N. (2001). The Social Body: Habit, Identity and Desire. London: Sage. Deneulin, S. (2006). The Capability Approach and the Praxis of Development. Basingtoke: Palgrave. Diener, E. and Eunkook, M. S. (eds.) (2000). Culture and Subjective Well-being. London: MIT Press.
Gaston, J. and Vogl, L. (2005). Psychometric properties of the General Well-Being Index. Quality of Life Research 14(1), 71--75. Giddens, A. (1991). Modernity and Self Identity: Self and Society in the Late Modern Age. Cambridge: Polity Press. Griffin, J. (2002). Well-being: Its Meaning, Measurement and Moral Importance. Oxford: Clarendon. Lash, S. and Friedman, J. (1992). Modernity and Identity. London: Blackwell. Lash, S. and Urry, J. (1994). Economies of Signs and Space. London: Sage. McCready, S. (ed.) (2001). The Discovery of Happiness. Naperville, IL: Sourcebooks. Putnam, R. (2000). Bowling Alone: The Collapse and Revival of American Community. New York: Touchstone. Raz, J. (2004). The role of well-being. Philosophical Perspectives 18(1), 269--294. Sumner, W. (1996). Welfare, Happiness, and Ethics. Oxford: Clarendon Press. Taylor, C. (1989). Sources of the Self: The Making of the Modern Identity. Cambridge, MA: Harvard University Press. Williams, A. (ed.) (1999). Therapeutic Landscapes: The Dynamic between Place and Wellness. New York: University Press of America.
Relevant Websites http://biomapping.net BioMapping. http://www.gpiatlantic.org GPIAtlantic, Genuine Progress Index for Atlantic Canada. http://www.gpionline.net Gpionline. http://www.greenpeace.org Greenpeace International. http://rts.gn.apc.org Reclaim the Streets. http://www.atkinsonfoundation.ca The Atkinson Charitable Foundation: Canadian Index of Wellbeing (CIW). http://www.guerrillagardening.org The Guerilla Gardening. http://www.happyplanetindex.org The Happy Planet Index. http://www.worklifesupport.com Worklife Support.
Glossary Eudaimonia A concept first used by Aristotle to indicate human ‘happiness’ or ‘flourishing’. Stemming from the Greek ‘eu’ (happy, well, harmonious) and ‘daimon’ (the individual’s spirit). Health ‘‘A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’’ (World Health Organization (WHO) definition). Welfare Physical and mental health and happiness. A system of help given to support those who need financial, medical, or social assistance. Well-Being A good or satisfactory condition of existence; a state characterized by health, happiness, and prosperity. The state of feeling healthy and happy.
Introduction Well-being is a concept that permeates all aspects of contemporary society, from the individual to the workplace, the hospital to the national economy. To achieve personal well-being is one of Western society’s key aspirations. However, it is not a concept we can all agree upon – it is inherently subjective, relational, and contested – and must be understood within the context in which it emerges.
History of Understandings of Well-Being Historically the search for well-being was a central part of what it meant to be human. As is frequently the case, we can turn to Aristotle for an insight into the philosophical underpinnings to the holistic nature of wellbeing. Aristotle’s notion of ‘eudaimonia’ (best translated as ‘human flourishing’) represented the ultimate human good. However, contrary to key elements we might associate with contemporary understandings of ultimate human good, eudaimonia goes beyond the trappings of wealth, power, and knowledge, to focus on the virtues that underpin a life premised on spiritual, emotional, and material well-being. It highlights strength of character, including courage, honesty, and pride, together with mutually beneficial rationality. The underlying belief in the need to achieve ‘balance’ in the art of living continued to underpin philosophical and popular understandings of well-being, illustrated by
the continued popularity of sanctuaries of rest and relaxation such as spas, from the Roman times onward. With the advent of scientific medicine however, the advancement of the biomedical paradigm and the birth of the Enlightenment subject, this holistic notion of wellbeing was lost as the body became divorced from the mind. As biomedical belief took over from folklore, superstition, and religion as sources for the maintenance and promotion of health and well-being, disease of the ‘body’ became the primary focus and well-being of the ‘person’ was increasingly overlooked. Furthermore, anatomical specialisms subdivided the body and mind so that each instance of disease could be isolated, measured, and diagnosed. This was arguably further compounded in the latter part of the twentieth century with spiritual breakdown and falling formal religious participation, and well-being became increasingly something that could be bought at the counter or obtained from the doctor instead. Western societies had lost the art of locating well-being at the heart of human existence. As it is fundamentally this divorce in Western rational scientific thinking that has resulted in subsequent confusion about what well-being is and how to comprehend, measure, or enhance it, this discussion focuses mainly on developing understandings of well-being in Western societies; although as will become clear the relation to more holistic understandings of well-being rooted in Eastern philosophical and spiritual teachings has been an ongoing undercurrent. In Western society by the twentieth century, or ‘high modern’ period, well-being was predominantly understood, conceptualized, and produced through the institutions of national government; the British Welfare State being the ultimate embodiment of this. As the apparent success of the Welfare State took hold and the worst excesses of ‘illness, ignorance, disease, squalor, and want’ were eradicated, concerns over well-being were relocated to wider structures of nation and economy. Discussion grew in relation to the ‘economic well-being’ of countries alongside the individual right to financial security with the growth of market liberalism. At the root of this was the economic imperative that more wealth would lead to improved well-being, and that material well-being was therefore the solution to many of society’s wider issues and malaises. So much so that social, emotional, or virtuous understandings of well-being in a more holistic sense were almost completely lost, as illustrated by the successful US presidency campaign in the 1990s by Bill
235
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Wellbeing
Clinton with the infamous slogan ‘‘It’s the economy stupid.’’ However, there emerged a growing recognition that GDP cannot alone stand for a measure of well-being. Although well-being appears to increase with increased wealth, this is only to a certain level, and it was progressively recognized that well-being and happiness do not correlate simply with material advancement. This led to the development of a number of ‘indexes’ to measure well-being, and by the end of the twentieth century, wellbeing in a wider sense was firmly on the political and social agenda. In 2005 Tony Blair, the then UK Prime Minister, turned Bill Clinton’s slogan on its head, vowing to find out how ‘happy’ his country was while espousing ‘‘It’s not just the economy stupid.’’ Even the leader of the opposition, David Cameron, spoke of the need to make people happier and to refocus from ‘GDP to GWB’ (general well-being). At the start of the twenty-first century, well-being is thus a central political challenge of our times, a sign of how used to continuous economic growth Western society has become, and how aware we now are of the sometimes hollow benefits that accompany it. Alongside this changing political climate alternative understandings of well-being were being promoted at the margins by the New Age Movement, urging us to leave behind the stresses of mainstream society and develop the mind, body, and spirit holistically in order to achieve well-being. This was essentially a Western reappropriation of Eastern traditions and Pagan histories, reapplied in a postcolonial, postmodern interpretation of well-being for groups finding themselves marginal to the central drives of Western capitalism. It heralded the changing conceptualization of well-being that was to come. The rise of reflexive individualization and self-help was beginning to elevate the individual, allowing the self to take center stage in discourses of well-being by the close of the twentieth century. Well-being from this perspective became firmly located in the individual body, with diet, exercise, and supplements being key components in the regime of the responsible individual who was to maintain his/her own well-being, no longer relying on state institutions. As understanding of well-being has become more sophisticated there has been a proliferation of studies and avenues for exploration and hence a significant variety of contexts within which discourses of well-being are being constructed. The well-being of ‘women’, for example, has come to be seen not just as an issue of dignity and human rights, but as an essential element in global development. Thus the Millennium Development Goals identify women’s well-being as a central component in the eradication of poverty. The well-being of ‘children’ is also of growing international concern, and ‘environmental’ well-being continues to be high on
international, national, and local agendas. Since the 1992 Rio Earth Summit it has been increasingly recognized that the well-being of the environment influences human well-being, and should therefore be of international political concern. At the ‘individual’ level, the turn of the twenty-first century has seen a renewed interest in the mind, body, spirit triadic conceptualization of wellbeing. With the advent of ‘risk society’ and increasing opportunity and necessity for self-reflexivity, the rise of ‘self-help’ literature and the expansion of therapeutic ‘experts’ can be seen as further evidence of the search for a meaningful, knowable focus in a disorientating world.
Elements of Well-Being: Happiness, Health, and Prosperity? The difficulty in defining well-being is in the nature of the factors it hinges upon. Well-being might be understood as ‘happiness, health, and prosperity’. However, ‘health’ itself is a term even the WHO has experienced difficulty in pinning down, and how do we define such relative concepts as ‘happiness’? Alternatively well-being can be conceptualized as a mixture of meeting basic needs and simple desires. Yet again we face the problem that need is a concept that has troubled academics and policymakers alike for centuries, and one person’s desires can impinge upon another’s well-being. It might be more helpful to think of well-being therefore as hinging upon some measurable notions of ‘welfare’ together with some self-ascribed understandings of ‘contentment’. However, a third element must be added to the equation, as without a sense of ‘dignity’ the procurement of the other two may prove to be a hollow victory. Thus well-being is a slippery concept which defies easy definition and varies in time and space. Dictionary definitions suggest it hinges on the state of being well, happy, or prosperous. However, an individual can certainly experience a profound sense of well-being without being prosperous, and health is not a prerequisite for well-being. ‘Subjective well-being’ is generally premised on three components: the presence of pleasant emotions, the relative absence of unpleasant emotions, and personal judgments about satisfaction. Subjective well-being and the judgments of satisfaction attached to it, can relate to specific conditions, such as marriage, home, or work, and can also involve explicit goals or values. Hence the inherent complexity across and within societies, and even within individuals over time and space. ‘General wellbeing’ may on the other hand relate to some assessment of attributes to be found within a society or institution that are taken as proxy measures of ‘satisfaction’. Without wanting to pass judgment on the relative value, weighting, or contribution of each element, Table 1 makes
Wellbeing
Table 1
Elemental table of well-being
Element
Key attributes
Physical
Health, illness, fitness, disability
Social
Economic
Political
Environmental
Emotional
Spiritual
237
Explanation
Although health is only one possible, and not necessary, condition of well-being, the body nonetheless represents a key site for the enactment, performance, and securing of well-being. Hence, e.g., the notion of designing ‘therapeutic landscapes’ to enhance well-being and hasten recovery from ill-health and surgery. Nonetheless it is undoubtedly possible to experience a sense of wellbeing during periods of acute illness. People in the situation of long-term illness often end up with a profound sense of well-being on many levels because they have more to come to terms with and have been forced to develop ways of being which most people have never had to contemplate. Thus a subjectively assessed sense of well-being can transcend physiological state. This is also being acknowledged in studies of health and place which are seeking increasingly to move notions of ‘health’ beyond medicalized constructions. Relationships at personal, Social connectedness can lead to both individual well-being and community or community, and society level social well-being. This aspect is reflected in an increasing interest in interconnectedness, interdependence, and notions of ‘social capital’ which have pushed social well-being center-stage. Here the argument is that weakening of social relations has led to a degradation of social networks and the benefits they accrue. This discourse has also infiltrated educational agendas with national governments, local authorities, and individual schools and workplaces recognizing and acting upon the significance of well-being to the smooth running of institutions, communities, and families. Consumption, wealth, material Economic comfort and good health do not automatically equate with a sense of advancement, career, work well-being. Conversely, some who experience what has been identified as a quantifiably poor quality of life may still feel a sense of well-being. The idea of economic well-being can be tied to the national economy, or focus in upon the individual self, particularly in the context of the workplace. Increasingly in a Western context the workplace is being seen as a place where the individual should not have his/her well-being undermined-both for the employees’ dignity and for the economic success of the employer. Indeed measures to promote well-being in the workplace, from Tai Chi classes to the creation of therapeutic outdoor spaces, have been adopted as one strategy toward increased productivity in the workplace. Democracy, dignity, choice, The right to dignity, choice, and an opportunity to make change is a central part of influence well-being. The well-being agenda is now also a big part of political strategy. Politicians and think tanks in countries as far apart as England, Finland, and Australia are bringing well-being and happiness to the political arena, while others, e.g., Bhutan have always held it centrally. From implicitly addressing itthrough, e.g., health, wealth, and housing-to explicit use of the term ‘well-being’ and a wider sense of ‘happiness’ itself. Home, living, nature, global Living environment has long been seen as an issue for health and well-being, from the pioneering work of people like Edwin Chadwick. Although the negative effects of poor housing on well-being continue to be documented, even relatively good-quality housing is now being highlighted as potentially damaging to inhabitants well-being. New housing developments, e.g., have been shown to undermine the well-being of young families with lack of gardens, parks, and play areas. Wider reflections of the importance of environment to well-being are reflected in the development of such measures as NEF’s Happy Planet Index. Self-image, personal growth, self- The Western individual, emerging through the subjective turn and consolidated esteem through the reflexivity of contemporary society is at the heart of current conceptualizations of well-being. Here well-being implies a sense of agency and the ability to live a life that is experienced as meaningful. However the obsessive consumption driven individualization permeating Western society also means the widespread promotion of regimes of health, well-being, mind, and the body beautiful are frequently motivated by fear campaigns that create false needs and induce feelings of personal and emotional ineptitude, thereby undermining emotional well-being. Spirituality, faith, inner peace, life Historically spiritual awareness and development was a fundamental part of wellpath being, be this through self-exploration, holistic treatments for illness, or as part of organized institutional religion. However, with the rise of rationality and modernity, a practical drive to find well-being rooted in the empirically observable physical body lost this edge. To some extent however spiritual wellbeing is reemerging as an essential part of the overall mix. Western society now sees a mix of serious spiritual path finding, as well as an element of susceptibility to the latest consumer trend in the search for spiritual fulfilment.
NEF – New Economics Foundation.
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some attempt to pick apart the notion of well-being, so we can scrutinize each element in a little more detail.
How Do We Measure Well-Being? The history of well-being appears to be one of obsession with measuring the seemingly immeasurable. However, by employing a multimethod approach researchers are able to develop adequate empirical representations of well-being. At an individual level, the most common psychological tools available are self-report surveys, many of which have been developed for use in clinical assessments in a variety of contexts (such as the General Well-Being Index). At the collective level a number of models, indexes, or approaches have been developed to measure well-being. A selection of these are summarized in Figure 1.
Relevance and Significance of WellBeing: Why Does Well-Being Matter? Since the days of Charles Booth mapping of poverty, health and other objective indicators of quality of life have had clear applications for policymakers and practitioners. However, these measures may miss the varying degrees of resilience and emotional thriving that individuals demonstrate. It is often this individual response to and judgment of circumstances which influence the degree to which any one individual copes with the same environmental factors – even in crisis situations. Hence objective measurements should not be taken alone in quality of life assessments and this is where the notion of well-being adds substantially to the quality of life debate. While the obvious benefits of adequate income, good health, and solid social relationships might be clear, research suggests that a sense of subjective well-being can
Gross National Happiness •
A term coined and developed in Bhutan from the 1970s to reflect the importance of spiritual development alongside material development in order to secure human well-being. Based on four principles: Equitable and sustainable socioeconomic development Preservation and promotion of cultural values Conservation of the natural environment Good governance
The Ottawa Charter •
In 1986 an international health promotion conference identified three key components to securing physical, mental, and social well-being. The ability to: Identify and realize aspirations Satisfy needs Cope with or change the environment
Capabilities Approach • An emerging approach to poverty in the1990s which emphasizes the importance of: Practical choice and agency Beyond simple notions of availability or access to resources or utilities Human Development Index • Developed in Pakistan in 1990 measuring average achievements in a country based on: Life expectancy Literacy rates and education enrolment Standard of living Genuine Progress Indicators (GPIs) • Idea first developed in California in 1995, and now taken on board in a number of different contexts (e.g., the Canadian Index of Well-being, GPI Atlantic, GPI Online Australia). Originally based on 26 social, economic, and environmental variables covering: Indicators and measures of progress Assessment of economic value of nonmarket social and environmental assets Happy Planet Index • Developed by the UK New Economics Foundation (NEF) in 2006, linking environmental well-being explicitly with social well-being. NEF assessed the ecological efficiency with which human well-being was being achieved. This combines a measurement of: Ecological footprint Measures of life satisfaction Life expectancy
Figure 1 Well-being indexes.
Wellbeing
in itself influence well-being and success in other areas. Someone who is happy most of the time is likely to have more self-confidence, perform better economically, and may even live longer. So what is the wider significance of well-being? In relation to this it is worth expanding a little upon three main areas.
Individuals and the ‘Well-Being Industry’ In contemporary interpretations, self-responsibility and self-actualization emerge as key ideals in the procurement of well-being, and there is a growing social structure and commercial network emerging to accommodate that. Lash and Urry describe the rise of ‘reflexivity enhancers’ – personal trainers, personal shoppers, stylists, dieticians, Tai-Chi instructors, health spas; all those who offer the promise of luxurious self-improvement and an enhanced sense of well-being with the swipe of a credit card. The self is very much a project to be worked on and these individuals and institutions provide the promise of achieving soul satisfaction. The pinnacle perhaps being the ‘life coach’ – the expert charged with the total physical, mental, and spiritual rescue of the failing individual. In short, a thriving well-being industry has been born in response to the modern search for our very own eudaimonia.
Politics: A New Development Agenda? Beyond a certain level, an increase in material wealth does not lead to an equal rise in overall well-being. Thus, economic prosperity does not always impact positively on the subjective well-being of a nation. Progress and economic opportunity for some may lead to misery in other aspects of their lives and social or environmental degradation more generally. For example, the rise of private car use although ensuring freedom of movement in privacy and comfort for large sections of the world’s population, has also led to parental paranoia and childhood obesity as the street became transformed into a car-dominated space of fear. At global levels it has contributed to damaging the Earth’s atmosphere and is a factor in increasingly polarized wealth. In recognition of such trends, a wider ‘well-being agenda’ is progressively underpinning government policy drives in wealthy industrialized countries and political discourse around well-being has grown. From health and education to work–life balance and responsible consumption patterns, political rhetoric and structures are opening up to facilitate choices and actions aimed at enhancing individual well-being. Politically understandings of well-being are also therefore hinged upon individual agency and responsibility, and the number of areas where we might exercise that responsibility is growing.
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Moral Imperatives: Individual Choices in a Global World The British political system invented the Welfare State and in some senses may therefore consider itself to have the moral upper hand in terms of enhancing individual and national well-being. Yet, it continues to contribute to international humanitarian atrocities, including war, arms trading, and environmental degradation, with apparent scant regard for well-being beyond its own borders. Thus, there are inevitably times where one person’s well-being may hinder that of another. Britain is far from alone in setting such double standards. Nonetheless, a growing exploration of well-being and heightened political awareness can only serve to raise the profile of such inconsistencies and offer opportunities for individuals and civil society to respond. The rise of movements such as Reclaim the Streets, Guerrilla Gardening, and Greenpeace all offer opportunities to highlight social and environmental issues affecting well-being, together with suggesting avenues for action. Thus, the ‘responsible individual’ does not relate solely to self-focused choices, but can also involve choices made through a moral sense of responsibility to others, and can therefore act as an agent of change.
The Future of Well-Being? Well-being as a concept and goal has been with us since the earliest philosophical and moral debates, and continues to transform through political appropriations and changing social aspirations. As the world changes, so will our requirements, expectations, and measurements of well-being. Perhaps we will become more in tune with the likes of the Bhutanese in realizing that with advances in modernization comes the threat of loss of other fundamental components of well-being, such as tranquility, happiness, and spirituality. Around the world most studies report an element of subjective well-being among populations regardless of, and often in spite of, economic or environmental circumstances. Thus, out of all the elements of well-being discussed it is perhaps the subjective one, and ultimately the one most difficult to measure satisfactorily, which should be our key concern. Continued advances in information technology, biogenetics, and the automation of society are likely to raise new questions, in particular around our understanding of relative and experiential rather than absolute notions of well-being. With the use of new technologies, maps of physical and emotional well-being are already being produced in a variety of inventive ways. Physiological measurements of heartbeat, skin response, and neurological activity have been mapped to plot the ‘well-being’ of people-places. Such work has the potential to tell us a lot more about what well-being ‘really’ looks like and
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offers hope for innovative and useful understanding in the future. The likelihood of well-being emerging as something we can conceptualize simply and definitively remains unlikely, but the growth of political interest in the concept means it is likely to be increasingly central in both economic and social analysis. At the time of writing, major contemporary texts in human geography omit well-being from the index completely. It is unlikely such an omission can continue. Geographical variations in interpretations, cultural experiential factors, and the uniqueness of individual subjectivity all ensure that the difficult task of nailing this nebulous concept will continue for sometime yet, and geographers should be playing a key part in that undertaking. The growth of academic work on reenchantment and spirituality, the continued popularity of grassroots activism addressing global imbalances, and a vastly expanding and thriving well-being industry, are all indicative that well-being is set to remain on the agenda and continue to raise interest. It is now more than ever a concept pushing at the doors not only of the philosophers, but of world leaders, policymakers, and academics alike. See also: Affect; Emotional Geographies; Health Geography; Therapeutic Landscapes.
Further Reading Adam, B., Beck, U. and van Loon, J. (eds.) (2000). The Risk Society and Beyond Critical Issues for Social Theory. London: Sage. Alkire, S. (2005). Valuing Freedoms: Sen’s Capability Approach and Poverty Reduction. Oxford: Oxford University Press. Crossley, N. (2001). The Social Body: Habit, Identity and Desire. London: Sage. Deneulin, S. (2006). The Capability Approach and the Praxis of Development. Basingtoke: Palgrave. Diener, E. and Eunkook, M. S. (eds.) (2000). Culture and Subjective Well-being. London: MIT Press.
Gaston, J. and Vogl, L. (2005). Psychometric properties of the General Well-Being Index. Quality of Life Research 14(1), 71--75. Giddens, A. (1991). Modernity and Self Identity: Self and Society in the Late Modern Age. Cambridge: Polity Press. Griffin, J. (2002). Well-being: Its Meaning, Measurement and Moral Importance. Oxford: Clarendon. Lash, S. and Friedman, J. (1992). Modernity and Identity. London: Blackwell. Lash, S. and Urry, J. (1994). Economies of Signs and Space. London: Sage. McCready, S. (ed.) (2001). The Discovery of Happiness. Naperville, IL: Sourcebooks. Putnam, R. (2000). Bowling Alone: The Collapse and Revival of American Community. New York: Touchstone. Raz, J. (2004). The role of well-being. Philosophical Perspectives 18(1), 269--294. Sumner, W. (1996). Welfare, Happiness, and Ethics. Oxford: Clarendon Press. Taylor, C. (1989). Sources of the Self: The Making of the Modern Identity. Cambridge, MA: Harvard University Press. Williams, A. (ed.) (1999). Therapeutic Landscapes: The Dynamic between Place and Wellness. New York: University Press of America.
Relevant Websites http://biomapping.net BioMapping. http://www.gpiatlantic.org GPIAtlantic, Genuine Progress Index for Atlantic Canada. http://www.gpionline.net Gpionline. http://www.greenpeace.org Greenpeace International. http://rts.gn.apc.org Reclaim the Streets. http://www.atkinsonfoundation.ca The Atkinson Charitable Foundation: Canadian Index of Wellbeing (CIW). http://www.guerrillagardening.org The Guerilla Gardening. http://www.happyplanetindex.org The Happy Planet Index. http://www.worklifesupport.com Worklife Support.