Transcript Thinking drinking: the question of culture

Patterns and trends in quality of life:
A ‘synthesis’ approach
Richard Eckersley
National Centre for Epidemiology and Population Health
The Australian National University
[email protected]
http://nceph.anu.edu.au
‘The central purpose of a nation should be to
improve the quality of life of its people. It follows
that the primary function of public policy should
be to improve quality of life; it is an important
means to that end.’
Source: Eckersley 2005
Two views of progress
 Material progress:
• Economic growth is paramount.
• Aims to increase standard of living.
• Wealth increases personal freedom and choice, and
provides resources to meet social goals.
 Sustainable development:
• Economic growth is not paramount.
• Aims to improve and maintain quality of life.
• Seeks balance and integration of social, economic and
environmental goals.
Bjorn Lomborg:
The Skeptical Environmentalist
‘…mankind’s lot has improved vastly in every
significant measurable field and it is likely to continue to
do so…children born today – in both the industrialised
world and developing countries – will live longer and be
healthier, they will get more food, a better education, a
higher standard of living, more leisure time and far more
possibilities – without the global environment being
destroyed.’
Lomborg, 2001, p 351-2
Synthesis
Synthesis is the drawing together and critical analysis,
by individuals or groups, of knowledge from different
fields, disciplines and sciences (and the humanities
and arts) to address social and scientific questions.
Conceptual issues
 Research seeks to improve understanding of the
world by creating new knowledge; synthesis
creates new understanding by combining existing
knowledge.
 Research seeks precision in the detail; synthesis
strives for coherence in overall picture.
Conceptual issues
 Challenges Occam’s Razor: ‘entities must not be
unnecessarily multiplied’.
 Questions concept of single reality: imposing story on world
distorts its reality.
 Dispenses with scientific certainty or ‘proof’; all positions
provisional.
 Replaces notions of simple cause-and-effect relationships
with more complex patterns of interaction.
Strengths - synthesis:
Adds value to existing specialised knowledge.
Reduces disciplinary biases.
Transcends interdisciplinary tensions.
Improves researchers’ knowledge outside
specialisation.
 Generates new research questions.
 Is especially useful in examining complex systems.
 Enhances application of knowledge.




Applications – synthesis:
 Improves fit between research and policy.
 Strengthens links between research and advocacy.
 Is appropriate for the increasing scale and
magnitude of social problems, and hence of the
necessary responses.
 Suits the complex, diffuse processes of social
change.
Systems thinking
 If you optimise one aspect of a system without
paying attention to the rest, you will sub-optimise
overall.
 Tampering without understanding in systems often
produces unanticipated side-effects.
 All systems are determined by the central purpose
they are designed to serve; change the purpose,
and the whole system changes.
Theoretical basis: biological
Evolutionary health principle:
‘…if an animal is removed from its natural habitat, or if the
environment changes…it is likely the animal will be less
adapted to the new conditions and will show signs of
physiological or behavioural maladjustment.’
Source: Boyden 2004
Theoretical basis: social
‘[Critical social science] says that people are constrained by
the material conditions, cultural context, and historical
conditions in which they find themselves .…[and which]
limit their options and shape their beliefs and behaviour.…
[But] people are not locked into an inevitable set of
structures, relationships and laws. People can develop new
meanings or ways of seeing that enable them to change
these….people do shape their destiny but not under
conditions of their own choosing.’
Source: Neuman 1994
Spanning disciplinary cultures
In current multidisciplinary project on young people’s
potential and wellbeing, we could not agree on:
 Whether trends in wellbeing can be generalised.
 Extent to which different findings can be reconciled.
 If potential and wellbeing are linked, or separate.
 The relative importance of social influences and
individual capacities.
 The relative influence of social and biological factors in
shaping wellbeing.
Source: Eckersley, Wierenga, Wyn (in press)
Is life getting better – or worse?
Streams of evidence:





Patterns and trends in health, happiness
Trends in mental health and wellbeing
Public attitudes on QoL
Effects of cultural factors
Winds of change?
Life expectancy by income
Source: Inglehart, 2000
Subjective wellbeing by income
Source: Inglehart, 2000
Income and happiness
USA, 1956-98
Source: Myers and Diener, 1996
Satisfaction with life and finances,
by income
90
85
80
75
70
65
60
55
50
45
40
<$15K
$15-30K
$30-60K
$60-90K
$90-120K
>$120K
Personal
wellbeing
Standard
of living
Financial Savings &
security investment
Health-related QoL in USA
‘…during 1993-2001, the perceived physical
and mental health of US adults
worsened….Older adults reported more
physically unhealthy days and activity
limitation days, whereas younger adults
reported more mentally unhealthy days.’
MMWR, 28 Oct 2005
Growing generation gap in malaise
USA, 1975-1999
Source: Putnam 2000
Lifetime prevalence of depression,
by birth cohort, USA
Source: Kessler et al 2003
Trends in conduct problems:
age 15-16, UK, 1974-99
mean conduct score
1.5
1.25
1
Boys
Girls
0.75
0.5
0.25
1974
Source: Collishaw et al 2004
1986
1999
Mental health in America
Survey of mental disorders, >9,000 Americans, aged
18 and over, 2001-2003, found:
 Lifetime prevalence: 46%
 12-month prevalence: 26%
 Those aged 18-29 have lifetime risk 4 times that of
those 60 and over.
Source: Kessler et al 2005
Flourishing or languishing in the
US?
1995 survey of >3,000 Americans, aged 25-74.
 Mental health as a continuum, ‘syndrome of symptoms
of positive feelings and positive functioning’.
 26% ‘languishing’ or depressed, or both.
 57% neither mentally ill nor fully healthy.
 17% ‘flourishing’.
 Younger people more likely to be languishing.
Source: Keyes 2002
Satisfaction vs health: ATS
Large, longitudinal study of Victorian children. At age
19-20:
 Over 80% satisfied with their lives – including lifestyle,
work or study, relationships with parents and friends,
accomplishments and self-perceptions.
 50% experiencing one or more problems associated
with depression, anxiety, anti-social behaviour and
alcohol use.
Source: Smart & Sanson 2005
Declining quality of life
 Average satisfaction with national conditions rates at about
60 per cent, 15 percentage points below personal
satisfaction.
 Twice as many think QoL is getting worse as think it is
getting better.
 Reasons for decline (in order):
•
•
•
•
•
Too much greed and consumerism
Breakdown in community and social life
Too much pressure on families, parents and marriages
Falling living standards
Employers demanding too much
Source: Eckersley 2000; Pusey 1998
Perceptions of QoL - 1
‘Against (a) background of general anxiety about ‘the
state of the world’ and the relentlessness of ‘bad
news’…we are disturbed by the many signs of
‘degeneration’ in the Australian way of life.’
‘…We are “tending our own patch” and becoming
absorbed in our own concerns….our focus has narrowed
to an extent that allows us to exclude some of the “nasty
stuff” which has become too unpalatable to think about.’
Hugh Mackay
Mind & Mood, 1998, 2003
Perceptions of QoL - 2
‘Personal aspirations and aspirations for the nation appeared
to be largely unrelated….Few participants believed that
Australia would become their ideal society (and) they had
distanced themselves from this goal….they manage, or
control, their reactions to social issues so they can maintain a
comfortable and self-focused life.’
Values and Civic Behaviour in Australia
Brotherhood of St Laurence, 2002.
Perceptions of QoL - 3
‘…we seem to be lurching from one difficulty to another
with the prospect of a serious crisis emerging…Who to
blame? Repeatedly, the finger is pointed at politicians
who seem to have…neglected investment in Australia’s
future. “Short-term thinking” is one of the most common
accusations levelled at political leaders.’
Mind & Mood
Ipsos Mackay Report
June 2005
And the future?
‘If the mood is a bit depressed at present, then it
turns even bleaker when Australians contemplate
the future. They fear further degradation in our
quality of life – through excessive development,
excessive materialism, excessive reliance on
technology, excessive speed.’
Hugh Mackay
Mind & Mood, 2001
Materialism and wellbeing
 Materialism:
• correlated with dissatisfaction, depression, anxiety,
anger, social alienation and poorer personal
relationships.
• ‘extrinsic goals’ such as fame, fortune, glamour
associated with lower overall wellbeing, compared to
‘intrinsic goals’ of intimacy, personal growth,
contributing to community.
• The more materialistic our values, the poorer our
quality of life.
Individualism and wellbeing
 Individualism:
•
•
•
•
•
•
Increased risk, uncertainty, insecurity.
Lack of clear frames of reference.
Higher expectations.
Onus of success rests with individual.
‘Tyranny’ of excessive choice.
Reduced social support and personal control
Meaning or money?
The goals of US college students
Source: Myers 2004
‘The gap between “what I believe in” and “how I live” is
uncomfortably wide for many of us and we are looking
for ways to narrow it….We want to express our values
more clearly and live in ways that make us feel better
about ourselves….to feel that our lives express who we
are and that we are living in harmony with the values we
claim to espouse.’
Hugh Mackay
The Wrap: Understanding where we are
now and where we’ve come from, 2003
‘In my work, I meet more and more business people who
secretly despise the system they are part of, who deplore the
lack of corporate values, who know their products and
services are of little consequence, and who would love to be
out of it and do something more meaningful.’
…But they feel trapped in their expensive lifestyles. ‘So they
don their suit and tie and serve the system, but they glance
more often out of the window. The spirit is stirring in such
people, and they are increasingly asking themselves tough
questions.’
Sir John Whitmore
Resurgence, 2005
Sustainability and health:
a new bottom line?
…understanding the social basis of health and wellbeing
contributes to working towards sustainability. It allows us
to integrate different priorities by measuring them against a
common goal or benchmark – improving human health and
wellbeing.
…making health, not wealth, the bottom line of progress
takes us deeper into questions of quality of life: how well
societies provide the conditions that are conducive to total
wellbeing – physical, mental, social, spiritual.