Measuring Wellbeing…or something like that

The epitome of wellbeing

So, the government wants to measure our wellbeing. Aside from making headlines that divert our attention away from the massive public sector axe that is falling heavily, this is a genuinely interesting proposition. Whilst some might question the wisdom of seeking to do this at a time of economic gloom and severe austerity measures, the recent move is the result of an idea that has been gaining political momentum over the past few years: the idea that economic prosperity alone does not constitute progress in a nation’s development. The wellbeing of the people is also important. A rich nation (measured by GDP) of thoroughly miserable people is not necessarily better off, all in all, than one with lower GDP but greater levels of “wellbeing”. Furthermore, Cameron’s idea is that it is the business of government to be interested in the nation’s wellbeing and to seek to promote and maximise it. Indeed, he wants to place wellbeing at the heart of policy-making: striking indeed coming from a Conservative Prime Minister. Tony Blair attempted the same feat, only to admit defeat and let it quietly slip off the policy agenda when the idea proved too complex to implement. Which brings us to the key question prompted by my vague description thus far: what on earth is wellbeing and how could or should we measure it?

Numerous indices of wellbeing have been developed, with increasing degrees of sophistication, reliability and statistical power. Broadly speaking, these indices take the form of questions about how a person feels about his/her life, answered on a rating scale. They cover areas including health, education, work or employment, family life, activities, community and social connectedness, political voice and governance, insecurity, environment and the rather ambiguous “subjective wellbeing”. The World Health Organization’s wellbeing questionnaire is somewhat simpler but taps into what we might consider is the essence of this last area, referring to positive mood, calmness, vitality and interest in daily life.

The difficulty with attempting to operationalize an abstract concept such as wellbeing through the development of quantitative measurements is the inherent subjectivity of those measures. To take but one example, pertinent to our work here at CHH. Let us suggest, quite plausibly, that health is considered to be a key component of wellbeing. A survey polls a group of people on their state of health and these statistics feed into a compiled wellbeing score. On this simple view, poor health would look like an inevitable detriment to wellbeing. However, several disparate research literatures point towards a more complex relation between health and wellbeing, or lack thereof. The recovery movement in psychiatry, for instance, promotes the idea of nurturing and enhancing subjective wellbeing in circumstances of chronic mental illness. Although ‘recovery’ is not a concept that can be captured in a soundbite, the kernel of the movement is about learning to cope with and manage one’s symptoms and distressing experiences, in order to regain control of one’s life and thus achieve a state of wellbeing. Havi Carel, a philosopher in Bristol, has written extensively on the idea that one can be ill, even terminally so, but happy and content with one’s life. Indeed, the narrative structure of many survivor accounts of various illnesses demonstrate a journey towards reconciliation between a prolonged state of poor health and a sense of personal wellbeing. This is not to suggest that health and wellbeing aren’t related, only that health status shouldn’t be assumed to map on to wellbeing in such a straightforward manner. This example is just the tip of the iceberg in terms of the conceptual complexity any measure of wellbeing will have to deal with, and it will be interesting to see what the statisticians come up with. I hope to post more on this topic as the measures are developed and reported on.

It's all a bit complicated....
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2 comments

  1. Another very interesting post Natalie – I think the complex and intricate relationship between wellbeing and health does need more nuanced debate and analysis; as you hint, it’s partly the media-headline culture which tries to foist equationism upon us.

    Reading the piece made me think of a third element – happiness – as it somehow seems to sit alongside both health and wellbeing. I also noticed a couple of blogs on the BMJ website about this, based around Philip Roth’s conjectural hypothesis in a fictionalised Journal of Medical Ethics that “happiness be classified as a psychiatric disorder and be included in future editions of the major diagnostic manuals under the new name: major affective disorder, pleasant type.” This does give pause for thought, and links back to some of your earlier posts on whether sadness is a part of normal human experience, and whether our expectations of happiness are somehow relatively recent arrivals on the scene (along with individualism, self-fulfilment, and the other promises of modern capitalist consumer culture).

    The blogs are here:
    http://blogs.bmj.com/bmj/2010/11/11/julian-sheather-is-happiness-a-mental-disorder/
    http://blogs.bmj.com/bmj/2010/11/08/richard-smith-now-happiness-is-declared-a-disease/

  2. Hi Natalie

    No doubt you’ve already seen this seminar at King’s, but I thought readers of this post might also be interested in the details:

    Measuring well-being: A need or a political strategy?
    When: 19 January 2011, 17.00
    Where: Harris Lecture Theatre (Guy’s Campus)
    Speakers: Paul Allin (deputy director of Measuring National Well-being, Office for National Statistics), Prof Sarah Stewart- Brown (University of Warwick) and Dr Sam Thompson (new economics foundation) andLucy Smith (Lambeth First).

    More info: http://www.kcl.ac.uk/research/groups/khsc/events/seminars.html

    It will be fascinating to hear your thoughts if you are able to make it!

    Best, Angela

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