Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Correspondence

A theory of public wellbeing

Author: Matthew Fisher

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

Wellbeing is seen as a matter of concern for governments and public policy. However, current theories on wellbeing are not well placed to inform this concern, because they fail to take account of and explain evidence on social determinants of mental health.

Discussion

This article proposes a new theory of public wellbeing which does takes account of such evidence, by explaining the role of stress within three basic functions of social cognition. Building on this description, the article then proposes that wellbeing consists in seven basic abilities, which are always developed and exercised (or not) through constant processes of interaction between individual and environment. The article explains why contemporary theories on wellbeing are poorly placed to inform public policy for wellbeing. It also positions the proposed theory in relation to evidence on social determinants of health (SDH) and the associated public policy agenda. It is argued the proposed theory of wellbeing extends on and challenges the SDH policy agenda in relation to the normative target of policy proposals, factors identified as determinants, impacts of determinants on populations, and proposals for political and social change.

Conclusion

Improved theory on public wellbeing can inform policy for wellbeing because it explains the contingent nature of wellbeing within contemporary social environments, and extends understanding of social determinants of wellbeing.
Literature
1.
Department of Health. Men's health and wellbeing policy. Perth, WA: Government of Western Australia; 2018.
2.
Department of Health England. Wellbeing: why it matters to health policy. London: Department of Health England; 2013.
3.
Government of Victoria. Victorian public health and wellbeing plan 2015–2019. Melbourne, Victoria: Government of Victoria; 2015.
4.
Forgeard MJC, Jayawickreme E, Kern M, Seligman MEP. Doing the right thing: measuring wellbeing for public policy. Int J Wellbeing. 2011;1(1):79–106.
5.
Stiglitz J, Sen A, Fitoussi JP. Report by the commission on the measurement of economic performance and social Progress. Paris: CMEPSP; 2009.
6.
Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry. 2016;3(2):171–8.CrossRefPubMed
7.
Foresight Mental Capital and Wellbeing Project. Final project report. London: The Government Office for Science; 2008.
8.
Dodge R, Daly A, Huyton J, Sanders L. The challenge of defining wellbeing. Int J Wellbeing. 2012;2(3):222–35.CrossRef
9.
Deci EL, Ryan RM. Hedonia, eudaimonia, and well-being: an introduction. J Happiness Stud. 2008;9(1):1–11.CrossRef
10.
Baum F. The new public health (4th Ed.). Melbourne: Oxford University Press; 2016.
11.
Faculty of Public Health and Mental Health Foundation. Better Mental Health for All: A Public Health Approach to Mental Health Improvement. London: Faculty of Public Health and Mental Health Foundation; 2016.
12.
13.
Huppert FA, Baylis N. Well-being: towards an integration of psychology, neurobiology and social science. Philos Trans R Soc Lond. 2004;359:1447–51.CrossRef
14.
First International Conference on Health Promotion. Ottawa charter for health promotion. Ottowa, Canada: World Health Organization; 1986.
15.
Friedli L. Mental health, resilience and inequalities. Copenhagen: World Health Organization; 2009.
16.
Fryers T, Melzer D, Jenkins R. Social inequalities and the common mental disorders: a systematic review of the evidence. Soc Psychiatry Psychiatr Epidemiol. 2003;38:229–37.CrossRefPubMed
17.
Australian Bureau of Statistics. National survey of mental health and wellbeing: summary of results. Canberra: ABS; 2007.
18.
Fisher M, Baum F. The social determinants of mental health: implications for research and health promotion. Aust N Z J Psychiatry. 2010;44:1057–63.PubMedCrossRef
19.
Brunner E. Socioeconomic determinants of health: stress and the biology of inequality. Br Med J. 1997;314:1472–6.CrossRef
20.
Kristenson M, Eriksen HR, Sluiter JK, Starke D, Ursin H. Psychobiological mechanisms of socioeconomic differences in health. Soc Sci Med. 2004;58(8):1511–22.PubMedCrossRef
21.
22.
Deaton A. Policy implications of the gradient of health and wealth. Health Aff. 2002;21(2):13–30.CrossRef
23.
Bowen S, Zwi AB, Sainsbury P, Whitehead M. Killer facts, politics and other influences: what evidence triggered early childhood intervention policies in Australia? Evidence & policy: A journal of research, debate and practice. 2009;5(1):5–32.
24.
Cummins RA, Eckersley R, Pallant J, Van Vugt J, Misajon R. Developing a national index of subjective wellbeing: the Australian Unity wellbeing index. Soc Indic Res. 2003;64(2):159–90.CrossRef
25.
Bradburn N. The structure of psychological well-being. Chicago: Aldine; 1969.
26.
Kahneman D, Diener E, Schwarz N. Well-being: foundations of hedonic psychology: Russell Sage Foundation; 1999.
27.
Cummins RA, Lau AL, Davern MT. Subjective wellbeing homeostasis. Handbook of social indicators and quality of life research. Springer. 2012:79–98.
28.
Kahneman D, Krueger AB. Developments in the measurement of subjective well-being. J Econ Perspect. 2006;20(1):3–24.CrossRef
29.
Seligman MEP. Authentic happiness: using the new positive psychology to realize your potential for lasting fulfilment. London: Nicholas Brealey Publishing; 2002.
30.
Ryff C, Singer B. Know thyself and become what you are: A eudaimonic approach to psychological wellbeing. J Happiness Stud. 2008;9:13–39.CrossRef
31.
Baum F, Fisher M. Why behavioural health promotion endures despite its failure to reduce health inequities. Sociol Health Illness. 2014;36(2):213–25.CrossRef
32.
Becker D, Marecek J. Dreaming the American dream: individualism and positive psychology. Soc Personal Psychol Compass. 2008;2(5):1767–80.CrossRef
33.
Evans RG, Barer ML, Marmor TR, editors. Why are some people healthy and others not? The determinants of health of populations. New York: Walter de Gruyter; 1994.
34.
O'Dea K, Daniel M. How social factors affect health: neuroendocrine interactions. In: Eckersley R, Dixon J, Douglas B, editors. The social origins of health and well-being. Melbourne: Cambridge University Press; 2001.
35.
World Health Organization. Constitution of the World Health Organization. Geneva: WHO; 1948.
36.
Commission on the Social Determinants of Health. Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva: WHO; 2008.
37.
Richter M. It does take two to tango! On the need for theory in research on the social determinants of health. Int J Public Health. 2010;55:457–8.PubMedCrossRef
38.
Marmot M, Friel S, Bell R, Houweling TAJ, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):1661–9.CrossRefPubMed
39.
Fisher M. The science of social reasoning and decision making: foundations of a new social-Liberal theory. Adelaide: University of Adelaide; 2009.
40.
41.
Panksepp J. Affective neuroscience: the foundations of human and animal emotions. New York: Oxford University Press; 1998.
42.
Ledoux JE. The emotional brain: the mysterious underpinnings of emotional life. New York: Simon & Schuster; 1996. 384 p.
43.
44.
Koechlin E, Summerfield C. An information theoretical approach to prefrontal executive function. Trends Cogn Sci. 2007;11(6):229–35.PubMedCrossRef
45.
46.
Fuster J. M. Upper processing stages of the perception-action cycle. Trends Cogn Sci. 2004;8(4):143–5.PubMedCrossRef
47.
48.
49.
Gallese V, Keysers C, Rizzolatti G. A unifying view of the basis of social cognition. Trends Cogn Sci. 2004;8(9):396–403.PubMedCrossRef
50.
51.
52.
Davidson R. J. Anxiety and affective style: role of prefrontal cortex and amygdala. Biol Psychiatry. 2002;51:68–80.PubMedCrossRef
53.
Bechara A, Damasio H, Damasio AR. Emotion, decision making and the orbitofrontal cortex. Cereb Cortex. 2000;10:295–307.PubMedCrossRef
54.
Berretta S. Cortico-amygdala circuits: role in the conditioned stress response. Stress. 2005;8(4):221–32.PubMedCrossRef
55.
Dickerson SS, Kemeny ME. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychol Bull. 2004;130(3):355–91.PubMedCrossRef
56.
de Kloet ER, Joels M, Holsboer F. Stress and the brain: from adaptaion to disease. Nat Rev Neurosci. 2005;6:463–75.CrossRefPubMed
57.
McEwen B, Wingfield JC. The concept of allostasis in biology and biomedicine. Horm Behav. 2003;43:2–15.PubMedCrossRef
58.
Antonovsky A. Health, stress and coping. San Francisco: Jossey Bass; 1980.
59.
Phillips AG, Ahn S, Howland JG. Amygdalar control of the mesocorticolimbic dopamine system: parallel pathways to motivated behaviour. Neurosci Biobehav Rev. 2003;27:543–54.PubMedCrossRef
60.
Botvinick MM, Cohen JD, Carter CS. Conflict monitoring and the anterior cingulate cortex. Trends Cogn Sci. 2004;8(12):539–46.PubMedCrossRef
61.
Damasio AR, Damasio H, Christen Y. Neurobiology of decision-making. Berlin. New York: Springer; 1996.CrossRef
62.
Chrousos GP, Gold PW. The concepts of stress and stress system disorders: overview of physical and behavioral homeostasis. J Am Med Assoc. 1992;267(9):1244–52.CrossRef
63.
Marmot M. Status syndrome: how your social standing directly affects your health and life expectancy. London: Bloomsbury; 2004.CrossRef
64.
Epel ES, Blackburn EH, Lin J, Dhabhar FS, Adler NE, Morrow JD, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci U S A. 2004;101(49):17312–5.PubMedPubMedCentralCrossRef
65.
66.
Thoits PA. Stress and health: major findings and policy implications. J Health Soc Behav. 2010;51:S41.CrossRefPubMed
67.
Joëls M, Karst H, Krugers HJ, Lucassen PJ. Chronic stress: implications for neuronal morphology, function and neurogenesis. Front Neuroendocrinol. 2007;28:72–96.PubMedCrossRef
68.
Ehlert U, Gaab J, Heinrichs M. Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: the role of the hypothalamus-pituitary-adrenal axis. Biol Psychol. 2001;57:141–52.PubMedCrossRef
69.
Baum A, Garofalo JP, Yali AM. Socioeconomic status and chronic stress: does stress account for SES effects on health? Ann N Y Acad Sci. 1999;869:131–44.CrossRef
70.
Wilkinson R, Pickett K. The spirit level: why more equal societies almost always do better. London: Penguin Books; 2009.
71.
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–78.PubMedCrossRef
72.
Stansfeld SA, Fuhrer R, Shipley MJ, Marmot MG. Work characteristics predict psychiatric disorder: prospective results from the Whitehall II study. Occup Environ Med. 1999;56:302–7.PubMedPubMedCentralCrossRef
73.
Damasio AR. Descartes error: emotion, reason and the human brain. London: Picador; 1994.
74.
Bosma H, Marmot MG, Hemingway H, Nicholson AC, Brunner E, Stansfeld SA. Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. Br Med J. 1997;314.PubMedPubMedCentralCrossRef
75.
76.
Luks A, Payne P. The healing power of doing good: the health and spiritual benefits of helping others: iUniverse; 2001.
77.
Phongsavan P, Chey T, Bauman A, et al. Social capital, socio-economic status and psychological distress among Australian adults. Soc Sci Med. 2006;63:2546–61.PubMedCrossRef
78.
Maller C, Townsend M, Pryor A, Brown P, St Leger L. Healthy nature healthy people:‘contact with nature’as an upstream health promotion intervention for populations. Health Promot Int. 2006;21(1):45–54.PubMedCrossRef
79.
Peterson LG, Pbert L. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149(7):936–43.PubMedCrossRef
80.
Durie M. Indigenous knoweldge within a global knowledge system. Higher Educ Policy. 2005;18:301–12.CrossRef
81.
Alkire S. Human development: Definitions, critiques and related concepts. New York: United Nations Development Programme; 2010.
82.
Ochsner KN, Ray RD, Cooper JC, Robertson ER, Chopra S, Gabrieli JDE, et al. For better or worse: neural systems supporting the cognitive down- and up-regulation of negative emotion. Neuroimage. 2004;23:483–99.PubMedCrossRef
83.
Maslach C, Jackson SE, Leiter MP, Schaufeli WB, Schwab RL. Maslach burnout inventory. Palo Alto, CA: Consulting Psychologists Press; 1986.
84.
Fisher M, Baum F, MacDougall C, Newman L, McDermott D. To what extent do Australian health policy documents address social determinants of health and health equity? J Soc Policy. 2016;45(3):545–64.CrossRef
85.
Antonovsky A. The salutogenic model as a theory to guide health promotion. Health Promot Int. 1996;1(1):11–8.CrossRef
86.
Stewart-Brown S. Resilience and well-being. In: Bhugra D, Bhui K, Wong S, Gilman S, editors. Oxford textbook of public mental health. Oxford: Oxford University Press; 2018.
Metadata
Title
A theory of public wellbeing
Author
Matthew Fisher
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7626-z

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue

Research article

Evaluating changes in electronic gambling machine policy on user losses in an Australian jurisdiction

Study protocol

Active women over 50: study protocol for RCT of a low-dose information and support program to promote physical activity behaviour change

Research article

Factors affecting dental service utilisation among older Singaporeans eligible for subsidized dental care – a qualitative study

Research article

A discourse network analysis of UK newspaper coverage of the “sugar tax” debate before and after the announcement of the Soft Drinks Industry Levy

Research article

Randomised controlled trial and economic evaluation of a task-based weight management group programme

Research article

Timing of treatment interruption among latently infected tuberculosis cases treated with a nine-month course of daily isoniazid: findings from a time to event analysis