SECOND OPINION:IRISH PEOPLE are a happy lot and eight out of 10 adults report feeling happy all or most of the time, according to a recent report from the Central Statistics Office. The happiness finding was part of an overall set of questions on subjective wellbeing (SWB), which included feeling worn out and having a lot of energy.
Asking these questions in State surveys is part of a growing international trend to measure SWB as well as gross national product (GDP). Britain will publish its first happiness index in 2012 and France and Canada are well on the way. The idea of happiness economics is old hat in Bhutan where, in 1972, the king decided gross national happiness would be measured instead of GDP. New policies must pass a wellbeing impact test before being implemented. Happy days.
The study of happiness is not new. Philosophers such as Socrates and Epicurus spent a lot of time thinking about what makes people happy. The Consolations of Philosophyby Alain de Botton notes that friendship and freedom are among the things that are essential for happiness, whereas big houses and fame are not.
In 1967, Robert Kennedy suggested a move away from measuring GDP as an indicator of a country's success towards a system of measuring wellbeing. He pointed out that GDP includes products that impair health such as junk food, cigarette advertising, pollution and "special locks for our doors and jails for people who break them". A recent Bulletin of the World Health Organisationnotes that happiness economics is now becoming mainstream and this is a positive development for the health of citizens.
The evidence linking health and SWB is vast and unequivocal. A just published review by US researchers concludes that the influence of SWB on health and all-cause mortality is clear and compelling. They note that the “effect sizes are not trivial, they are large” and worthy of national attention by policymakers. The review recommends adding interventions to improve SWB to a nation’s list of public health programmes.
Longitudinal studies, where people are tracked over time, show that depression and anxiety predict heart disease and clinical depression predicts worse heart health than depressed mood. Unpleasant emotions play a major role in heart disease once disease is present and we should not be surprised that the expression “a broken heart” has a literal and metaphorical meaning.
One 29-year study of 7,000 adults in the US showed that SWB reduced the risk of all-cause mortality. Positive feelings had the strongest effect. A 2008 Australian study of 10,000 adults showed that happiness predicted better physical health and absence of chronic illness. A 2009 study in 21 countries showed that positive emotions are associated with healthy behaviours such as eating well, being physically active and not smoking. In sum, a strong case can be made that SWB influences health and longevity and all the studies converge to form a compelling picture that feelings matter.
No one is happy all the time and people who are mostly happy frequently experience unpleasant emotions such as anger, fear and sadness. The trick seems to be to deal with these feelings in a healthy way when they occur, which means expressing them assertively and verbally in an open and honest way as in, I feel hurt, disappointed, angry . . . and so on. The disclosure has to be accurate and there is a big difference between saying “I am a bit upset” when what we want to say is “I am absolutely furious”. You can be certain that unexpressed feelings will leak out non-verbally as they are impossible to disguise. Feelings, whether pleasant or unpleasant, will reveal themselves in the short term through body language and in the long term affect our future health.
Most people do not deal with their feelings assertively. Instead, they become aggressive, let other people walk all over them, blame others for what they feel, or expect them to be mind-readers. While working for the Irish health services, I ran assertiveness courses for thousands of people including teachers, health professionals, men and women's groups, in urban and rural areas, even with The Gay Byrne Showon RTÉ Radio 1. Most participants on these courses were unable to express their feelings assertively. Naming and owning feelings is a powerful way to contribute to our future health. Perhaps the excellent CSO will include a full set of subjective wellbeing indicators in future surveys and we will know how Ireland is doing in terms of what really matters.
Dr Jacky Jones is a former regional manager of health promotion with the HSE