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Community Wellbeing in an Unwell World: Trends, Challenges, and Possibilities

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This essay explores the changing nature of the concept of community wellbeing and the richness of the concept for enhancing measurement of societal progress beyond the use of indicators focused more narrowly on economic growth. Beginning with the history of the concept of wellbeing in several disciplines, the authors pursue an integrated and ecological understanding of community wellbeing and present examples of recent developments and applications of community wellbeing indicators in international settings and in Australia.
Community Wellbeing in an Unwell World:
Trends, Challenges, and Possibilities
JOHN WISEMAN and KATHLEEN BRASHER
McCaughey Centre: VicHealth Centre for the Promotion of Mental Health and
Community Wellbeing, School of Population Health, The University of Melbourne,
Australia
Correspondence: John Wiseman, Director, McCaughey Centre: VicHealth Centre for
the Promotion of Mental Health and Community Wellbeing, School of Population Health,
The University of Melbourne, 3010 Australia. E-mail: jwiseman@unimelb.edu.au
ABSTRACT
This essay explores the changing nature of the concept of community wellbeing and
the richness of the concept for enhancing measurement of societal progress beyond
the use of indicators focused more narrowly on economic growth. Beginning with
the history of the concept of wellbeing in several disciplines, the authors pursue an
integrated and ecological understanding of community wellbeing and present
examples of recent developments and applications of community wellbeing
indicators in international settings and in Australia.
Journal of Public Health Policy (2008) 29, 353–366.
doi:10.1057/jphp.2008.16
Keywords: community, wellbeing, indicators, progress, mental health
promotion
INTRODUCTION
If we measure the health of our communities, our country, and our
world solely by growth in wealth and consumer spending, then many
of us are thriving. However, if our definition of wellbeing is
broadened to include the full range of social, economic, environ-
mental, cultural, and political concerns that matter most to citizens
and communities, then the diagnosis and prognosis are far more
mixed: half the world’s population lives on less than a dollar a day;
according to UNICEF, 30,000 children die each day due to poverty;
some 1.1 billion people have inadequate access to water; and 2.6
billion people lack basic sanitation. In Australia, the gaps in income,
employment opportunities, housing, and health outcomes continue
to grow. As in many affluent countries there is also a rising tide of
Journal of Public Health Policy 2008, 29, 353–366 r2008 Palgrave Macmillan Ltd 0197-5897/08
www.palgrave-journals.com/jphp
anxiety and depression, even among the richest and most fortunate.
And for all of us, rich and poor, our planetary environment is in
danger.
Internationally, and in Australia, there is growing interest in the
concept of community wellbeing as a more holistic and accurate
measure of societal progress than the dominant paradigm of
economic growth. We summarise the changing nature of the concept
of community wellbeing, commencing with the history of the
concept in different disciplines, then focusing on its application
to recent international and Australian developments in wellbeing
indicators. We address three questions: What is community well-
being? Why is community wellbeing important? What are the
most important international and Australian community wellbeing
trends?
WHAT IS COMMUNITY WELLBEING?
A sometimes sceptical response to the term ‘‘wellbeing’’ is under-
standable, given the way the word has been co-opted by the
marketers of day spas, aromatherapy, and lifestyle magazines.
However, there is also a more significant intellectual and political
dialogue about the nature of individual and community wellbeing,
informed by the long tradition of philosophical and scientific
discourses concerned with understanding the relationship between
the good life and the good society (1).
Differing assumptions about wellbeing are each underpinned by
their diverse and, at times, competing traditions of inquiry from the
behavioural, social, economic, and health sciences.
Wellbeing as ‘‘Hedonic’’ Pleasure or ‘‘Eudaimonic’’ Fulfilment
A brief survey of Western ideas about wellbeing usefully starts with
philosophical debates about the distinction between hedonic and
eudaimonic wellbeing – wellbeing as sensory pleasure vs. wellbeing
as the fulfilment of human potential.
Plato, through Protagoras, argues that wellbeing is simply the
balance of pleasure over pain (2). The philosophical lineage building
on this foundation includes Thomas Hobbes and Jeremy Bentham.
Bentham’s utilitarian recommendations rest on the view that:
JOURNAL OF PUBLIC HEALTH POLICY .VOL.29,NO.3354
‘nature has placed mankind under the governance of two sovereign
masters, pain and pleasure. It is for them alone to point out what we
ought to do’’ (3). This hedonic assumption, that human nature is
driven by the maximisation of individual pleasure, is also at the core
of the dominant political paradigm of our time: neo-classical
economics with its associated view that the only reliable way to
assess pleasure is through the ways individuals exchange money for
goods and services in the marketplace.
For Aristotle, the sources of human wellbeing are deeper and
broader than the achievement of pleasure or the avoidance of pain.
‘Eudaimonic wellbeing’’ defines the ways in which we are able to
flourish, find meaning, and fulfil our potential (4). Our capacity
to realise our potential is deeply affected by collective and
social relationships. The wellbeing of communities is, therefore, an
essential precondition for the wellbeing of individuals. In economics,
this eudaimonic tradition is reflected in the work of the Nobel
Laureate economist Amartya Sen, who famously defined the purpose
of economic development as expanding the capability, and therefore
the ‘‘freedom’’, of individuals to fulfil their potential; to live lives of
meaning and value (5).
Many voices and traditions outside the Western philosophical
canon also share the Aristotelian viewpoint of an understanding of
wellbeing extending beyond the sum of personal pleasures.
For Buddhists, happiness refers to the search for contentment and
‘real value’’. The first step is for the individual to understand
chandha or real value, which is most likely to be found through
fulfilling individual desires, and through compassion and work with
others. Individual happiness is dependent on compassion, which, in
turn, is the precondition for collective wellbeing. A recent dialogue
between Western psychology and Buddhism noted:
Wellbeing yis not simply stimulus driven pleasure emerging
occasionally on the hedonic treadmill of lifeyBuddhism
promotes an ideal state of well-being that results fromy
realising ones fullest potential in terms of holistic compassion
and creativity (6).
Islamic views on wellbeing commonly begin by emphasising the
importance of living in accordance with the will of God, and in
following the moral and religious principles of the Koran. There is a
WISEMAN AND BRASHER .COMMUNITY WELLBEING 355
particularly strong focus on the idea of balance. Islamic scholar
Izmar Muhir comments:
Well-being is a state of integration and balance of all the
different components of the human being: body, mind and soul.
Only when these components are balanced and harmonized is it
possible to be transformed into a full human being able to
realize one’s own potentialities (7).
The vocabularies of Indigenous Australian languages do not
include a word that translates wellbeing in any simple way. Judy
Atkinson, in her work with the Ngaringman of the Northern
Territory, has noted:
Punyu yencompasses person and country, and is associated
with being strong, happy, knowledgeable, socially responsible
(to take care), beautiful, clean and safe – both in the sense of
being within the law and in the sense of being cared for (8).
This helps explain the preference among many Indigenous
communities and researchers for the phrase ‘‘social, emotional and
spiritual wellbeing’’ over the more constrained, Western idea of
‘mental health’’.
Subjective and Objective Wellbeing
Within the human sciences, subjective wellbeing research has
focused on the ways in which individuals evaluate their lives.
For psychologists, subjective wellbeing differs from concepts of
happiness, life satisfaction, or self-assessed health. It is part of
a broader construct called ‘‘quality of life’’ (9,10). An extensive
body of psychological research literature has evolved investigat-
ing the relationships between subjective wellbeing, personality
traits, emotional states, life course stages, and external
stresses (11).
Subjective wellbeing is measured by how satisfied people are with
their lives. The International Wellbeing Groups’ Personal Wellbeing
Index asks ‘‘how satisfied are you in your y’’ for each of eight life
domains: standard of living, personal health, achieving in life,
personal relationships, personal safety, community-connectedness,
future security, and spirituality – religion (12).
JOURNAL OF PUBLIC HEALTH POLICY .VOL.29,NO.3356
Researchers of objective wellbeing are more concerned with
measuring and analysing the empirically observable material
conditions affecting the lives of individuals. These include life
expectancy, income, nutrition, employment, education, or demo-
cratic participation.
A fruitful dialogue is now emerging, recognising that a fully
rounded picture of wellbeing requires a thoughtful mix of subjective
and objective indicators and measures (13).
Towards an Integrated, Ecological Understanding of
Community Wellbeing
A third important area to explore moves beyond individual and
collective wellbeing to linking human and environmental wellbeing.
As the Organization for Economic Cooperation and Development
(OECD) ‘‘Society at a Glance’’ observes: ‘‘People’s happiness depends
to a large extent on the circumstances of the broader community they
are part of and their relationship to it’’ (14).
The World Health Organization (WHO) Millennium EcoSystem
Assessment Report also provides a compelling case for a far more
informed understanding of the relationships between natural and
built environments, and the physical, mental, and social wellbeing
of individuals and communities. Former Director-General Lee
Jong-Wook noted:
Nature’s goods and services are the ultimate foundations of life
and health y. Health risks are no longer merely a result of
localised exposures to traditional forms of pollution. They are
also a result of broader pressures on ecosystems, from depletion
and degradation of freshwater resources to the impacts of
climate change. Like more traditional risks, the harmful effects
of the degradation of ecosystems are being borne disproportio-
nately by the poor (15).
Towards a Definition of Community Wellbeing
Any definition of wellbeing needs to be contextualised within
communities of population and interest, as well as of place.
WISEMAN AND BRASHER .COMMUNITY WELLBEING 357
We propose the following definition of community wellbeing:
Community wellbeing is the combination of social, economic,
environmental, cultural, and political conditions identified
by individuals and their communities as essential for them
to flourish and fulfil their potential.
WHY IS COMMUNITY WELLBEING IMPORTANT?
There is compelling evidence that promoting community wellbeing
can play a key role in improving individual mental health outcomes.
Also, community wellbeing provides a useful starting point for
rethinking our definition of progress.
Improving Mental Health
Community wellbeing is essential to the wellbeing of the individual.
As the 1986 Ottawa Charter for Health Promotion makes clear:
to reach a state of complete physical, mental and social
wellbeing, an individual or group must be able to identify and
to realise aspiration, to satisfy needs, and to change or cope
with the environment. yTherefore, health promotion is not
just the responsibility of the health sector, but goes beyond
healthy lifestyles to wellbeing (16).
The WHO and World Bank estimate that, by 2020, depression
will constitute the second largest cause of disease burden worldwide
(17) with enormous social and economic costs. The promotion of
positive mental health and wellbeing at the population level provides
an effective mechanism to modify the broad influences of community
wellbeing. The Victorian Health Promotion Foundation (VicHealth)
understands this connection, noting that:
Mental health is not merely the absence of mental illness.
Mental health is the embodiment of social, emotional, and
spiritual wellbeing. Mental health provides individuals with
the vitality necessary for active living, to achieve goals and to
interact with one another in ways that are respectful and
just (17).
JOURNAL OF PUBLIC HEALTH POLICY .VOL.29,NO.3358
Informed by an extensive review of available evidence, VicHealth
identified four key potentially modifiable social and economic
determinants crucial to the mental health of individuals: freedom
from violence, freedom from discrimination, social inclusion and
connectedness, and economic participation and security (17). These
determinants reflect and articulate the intrinsic relationships between
mental health, social and economic factors, and community well-
being.
Rethinking Progress
At a broader political and policy level, the key elements of
community wellbeing are employed to provide a more comprehen-
sive framework for measuring and understanding the ‘‘progress’’ of
societies. There is acknowledegment that one thread of wellbeing –
particularly one stemming from economics – is insufficient for
sustainable policy development. As the OECD Secretary-General
noted:
Around the worldya consensus is growing about the need to
develop a more comprehensive view of progress – one that takes
account of social, environmental and economic concerns –
rather than focussing mainly on economic indicators like Gross
Domestic Product (18).
This opening up of debate about meaningful measures of societal
progress and wellbeing is expressed by a growing body of literature
regarding the full costs of a culture driven by consumerism. The
term ‘‘affluenza’’ has now entered the language to describe the
symptoms of ‘‘a painful, contagious, socially transmitted condition
of overload, debt, anxiety and waste resulting from the dogged
pursuit of more’’ (19).
WHAT ARE THE KEY INTERNATIONAL AND AUSTRALIAN
COMMUNITY WELLBEING TRENDS?
We draw on this broader definition of community wellbeing to
examine key global, and Australian indicator development and
wellbeing trends. International and Australian interest in community
wellbeing indicators is fuelled by the recognition of their potential
WISEMAN AND BRASHER .COMMUNITY WELLBEING 359
for stimulating discussions on community, regional, and national
goals, and priorities among citizens and policy-makers, as well as for
monitoring and understanding wellbeing trends and outcomes.
Indicator development has occurred in two ways: as a single
composite index or as a suite of indicators.
Composite wellbeing or ‘‘quality of life’’ indexes include the
United Nations Development Programme’s (UNDP) Human Devel-
opment Index (HDI). The HDI is based on a weighted composite of
gross domestic product (GDP) per capita, life expectancy, and years
of education (20). Included in the Human Development Reports
from the UNDP is the Gendered Development Index. This aims to
capture the way in which gender differences intersect with and
influence wellbeing outcomes. The Government of Bhutan, drawing
on Buddhist traditions, developed a ‘‘Gross National Happiness
Index’’ as a more balanced measure of progress than GDP (21).
An alternative approach is to construct a suite of indicators
providing a comprehensive picture of wellbeing in a particular nation
or region. Examples include The United Nations Millennium
Development Goals and Indicators (22), European Union’s Social
Indicator Framework (23), Canada Wellbeing Measurement Act
(24), and the UK Sustainability Indicators (25).
If wellbeing indicators, whether as an index or as a suite, are to be
effective tools for understanding and shaping policy priorities, the
critical task is to identify key elements in the story they tell about
the ways in which life and wellbeing are getting better or worse
for citizens, communities, and societies. While this involves some
inevitable over-simplification, it is essential for separating the core
messages from the swirling noise of data. In global wellbeing trends,
these core messages relate to disparities in economic growth, the
presence of extreme poverty, and the impact of climate change.
Global Community Wellbeing Trends
Global economic growth (measured in terms of GDP per capita)
continues to rise across most continents with the exception of
Eastern Europe and Africa. There is also strong evidence of the
unequal global distribution of economic production related closely
to the unequal distribution of the consequences of poverty (26). Even
using the World Bank’s notoriously parsimonious extreme poverty
JOURNAL OF PUBLIC HEALTH POLICY .VOL.29,NO.3360
measure of purchasing power of $1 a day, over one billion people
continue to live in extreme poverty. If we use the more widely
supported measure of $2 per day, over three billion of the world’s
citizens continue to live in extreme poverty.
In order to give meaning to these dry statistics, we need to
remember their consequences for individual human lives (27):
!Every year six million children die from malnutrition before their
fifth birthday.
!Every day HIV/AIDS kills 6,000 people.
!Each year over 300 million people are infected with malaria. Every
30 seconds an African child dies of malaria.
!More than 2.6 billion people do not have basic sanitation. More
than one billion people have unsafe sources of drinking water.
And, as the Stern report identifies, climate change brings with
it stark and compelling social, economic, and environmental
consequences that are experienced disproportionately by the most
vulnerable in society (28):
Climate change threatens the basic elements of life for people
around the world – access to water, food, health, and use of
land and the environment. On current trends, average global
temperatures could rise by 2–31C within the next fifty years or
so, leading to many severe impacts, often mediated by water,
including more frequent droughts and floods.
Australian Community Wellbeing Trends
Australian work on measuring and understanding community
wellbeing has paralleled and at times led global work. The
Australian Bureau of Statistics’ (ABS) ‘‘Measuring Australia’s
Progress’’ sets an international benchmark for a national approach
in identifying and communicating data on wellbeing (29).
The overall Australian community wellbeing story is in many
ways a microcosm of the global picture. Australia, too, has
experienced a period of strong economic and employment growth
over the past decade (29). However, this is associated with a rising
level of casualised and precarious employment: 48.8% of employment
growth during the period 1982–2004 was casual of workers (30).
WISEMAN AND BRASHER .COMMUNITY WELLBEING 361
In the year March 2006 to March 2007, bankruptcies rose by 8.9%
and insolvencies by 16% (31).
It is clear that severe poverty is still real and pernicious in
Australia. The figures range between Centre for Independent Studies’
data at 5% (32) and Australian Council of Social Service data at
11%. (33)
The consequences of poverty continue to be most severe for
Indigenous Australians: babies born to Indigenous mothers are twice
as likely to be of low birth weight and twice as likely to die at birth
compared with other babies; and Indigenous Australians have higher
rates of deaths due to circulatory and respiratory diseases, injury,
cancer, diabetes, depression, self harm, and substance abuse than
non-Indigenous people (34,35).
In relation to climate change, the latest findings from CSIRO
indicate that by 2070 the impact of climate change will radically
shape our continent with significant impacts on health and
wellbeing (36).
The Role of Community Indicators Victoria as a Tool for
Understanding and Improving Community Wellbeing
Around the world, at the local level, community wellbeing indicator
frameworks are being developed as tools for informed, engaged, and
integrated community planning and policy making. One example is
Community Indicators Victoria (CIV). Developed as a collaborative
project to provide a long-term platform for the development and
use of local community wellbeing indicators, and hosted by the
McCaughey Centre in Victoria, CIV indicators are grouped in five
domains to reflect the broad definition of wellbeing (37):
!Healthy, safe, and inclusive communities
!Dynamic, resilient economies
!Sustainable built and natural environment
!Culturally rich and vibrant communities
!Democratic and engaged communities.
The choice of indicators was informed by a set of ‘‘filtering’
criteria, including a review of international and Australian literature,
a comprehensive review of Victorian local government community
plans, and an extensive consultation process with local governments,
JOURNAL OF PUBLIC HEALTH POLICY .VOL.29,NO.3362
state government agencies, and the community sector. Data to
measure these indicators, both subjective and objective, are drawn
from the ABS, administrative data sources, and a new statewide
CIV Survey.
A public access, user-friendly website (www.communityindicators.
net.au) provides two key functions. It summarises wellbeing
indicators for each Local Government Area. It allows citizens and
policy makers to explore and analyse trends of particular interest in
one or more local communities. Over time, the website enables users
to generate evidence relative to population group variables such as
gender, age, ethnicity, and disability, and it produces local wellbeing
maps based on the indicators for particular regions and localities.
CONCLUSION
The importance of an integrated and ecological understanding of
community wellbeing for policy making and citizen engagement is
increasing. CIV provides an example of one such approach where
local citizens and policy makers can come together with shared
information on all aspects of community wellbeing in order to set
priorities for future work. This approach may have broader
applications in national and international, regional or statewide
planning processes.
In looking to the future, it is clear that such a multifaceted,
ecological understanding of the nature and sources of community
wellbeing depends on respecting and bringing together a wide range
of disciplines and sources of knowledge. Turning this knowledge into
action and change requires a high level of commitment to working
closely and effectively with citizens and policy makers. Our challenge
is to create and share knowledge about actions that build healthy,
just, and sustainable communities and societies in which all citizens
can flourish, thrive, and fulfil their full human potential.
ABOUT THE AUTHORS
John Wiseman is Director of The McCaughey Centre, VicHealth
Centre for the Promotion of Mental Health and Community
Wellbeing,School of Population Health, University of Melbourne.
He presented the core of this paper first at the Faculty of
WISEMAN AND BRASHER .COMMUNITY WELLBEING 363
Medicine, Dentistry and Health Science Dean’s Lecture at The
University of Melbourne, Australia, on 3 July 2007. Previously,
he was Professor of Public Policy at Victoria University and Assistant
Director, Policy Development and Research in the Victorian
Department of Premier and Cabinet.
Kathleen Brasher is a Research Fellow in the McCaughey Centre,
VicHealth Centre for the Promotion of Mental Health and
Community Wellbeing, The University of Melbourne. She is also a
clinician who has worked extensively in academic and community
settings, most recently on broader determinants of social inclusion.
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Minimalism and essentialism in Manila looks at examples of Thomasian Architects on design and urban architecture (through built projects and photography). This study catalogues approaches to austerity, financial considerations such as frugal innovation, adaptive reuse, and new forms of minimalism in the material and spaces of contemporary Manila (since the 2008 Global Financial Crisis). Findings show that prioritizing natural wind flow in interior and urban spaces are a common attribute that in the selected works discussed of Thomasian Architects post GFC, which is an essential consideration in addressing pandemics in the built environment.
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Nowadays, when there are a lot of problems to solve and we are constantly caught up in daily tasks, it is more and more difficult to organize ourselves and make the ideal choices for our lives. We choose to smoke or not, to eat at fast food or not, to lead a sedentary or active life, etc. All these choices and behaviors can affect us to a greater or lesser extent our health. Free time is the biggest problem of modern people and the main reason why it does not move. However, the solution is relatively simple. If you can’t train at home, you can find at least one fitness gym in each neighborhood. So, the offer of gyms is generous, because the demand is starting to increase. Maintaining a permanent state of health is a difficult test that each of us must pass daily. Perhaps the most important aspect of this equation is responsibility. When we succeed to become aware about the responsibility for maintaining physical, mental and social well-being, as defined health by WHO, belongs to us and to no one else (family, doctors, teachers, coaches), then we can make the right choices for our lives. “Numerous studies have shown that a person’s life expectancy is directly influenced (positively) by seemingly commonplace aspects, such as maintaining a normal weight, quitting smoking, moderate or no alcohol consumption, sleep lasting 7 - 8 hours, diversified diet and rationally distributed, and last but not least, physical exercise practiced independently and regularly” (http://www.doctor.info.ro)
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The affective content of Subjective Wellbeing (SWB) was investigated in two separate studies. Study 1 involved a representative sample of 478 participants from across Australia aged between 18 and 72 years. This study tested the circumplex model of affect and then determined the minimum set of affects that explain variance in SWB. The model was supported, with most affects congregated around the valence axis. Overall, 64% of the variance in SWB was explained by six Core Affects, indicating that SWB is a highly affective construct. Study 2 tested the relative strength of Core Affect (content, happy and excited), in three separate models of SWB incorporating cognition (seven discrepancies) and all five factors of personality. Using a sample of 854 participants aged been 18–86 years, structural equation modeling was used to compare an affective-cognitive driven model of SWB, with a personality driven model of SWB and a discrepancy driven model of SWB. The results provide support for an affective-cognitive model which explained 90 percent of the variance in SWB. All models confirm that the relationship between SWB, Core Affect and Discrepancies is far stronger than the relationship between personality and SWB. It is proposed that Core Affect and Discrepancies comprise the essence of SWB. Moreover, Core Affect is the driving force behind individual set-point levels in SWB homeostasis.
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