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ORIGINAL RESEARCH
published: 14 February 2022
doi: 10.3389/fpubh.2022.824960
Frontiers in Public Health | www.frontiersin.org 1February 2022 | Volume 10 | Article 824960
Edited by:
Rahul Shidhaye,
Pravara Institute of Medical
Sciences, India
Reviewed by:
Sebastiaan Rothmann,
North-West University, South Africa
Shun Wang,
KDI School of Public Policy and
Management, South Korea
Sarah Stewart-Brown,
University of Warwick,
United Kingdom
*Correspondence:
Koichiro Shiba
shiba_k@g.harvard.edu
Specialty section:
This article was submitted to
Public Mental Health,
a section of the journal
Frontiers in Public Health
Received: 29 November 2021
Accepted: 21 January 2022
Published: 14 February 2022
Citation:
Shiba K, Cowden RG, Gonzalez N,
Lee MT, Lomas T, Lai AY and
VanderWeele TJ (2022) Global Trends
of Mean and Inequality in
Multidimensional Wellbeing: Analysis
of 1.2 Million Individuals From 162
Countries, 2009–2019.
Front. Public Health 10:824960.
doi: 10.3389/fpubh.2022.824960
Global Trends of Mean and Inequality
in Multidimensional Wellbeing:
Analysis of 1.2 Million Individuals
From 162 Countries, 2009–2019
Koichiro Shiba 1,2
*, Richard G. Cowden 2, Natasha Gonzalez 3, Matthew T. Lee2,
Tim Lomas 2, Alden Yuanhong Lai 4and Tyler J. VanderWeele1, 2,5
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States, 2Human Flourishing
Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, United States, 3Independent Researcher,
Madrid, Spain, 4School of Global Public Health, New York University, New York, NY, United States, 5Department of
Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
Introduction: Human flourishing is a multidimensional concept characterized by a state
of complete wellbeing. However, much of the prior research on wellbeing has principally
focused on population averages assessed using a single item of wellbeing. This study
examined trends in population averages and inequalities for a multidimensional index
of wellbeing and compared emergent patterns with those found for Cantril’s ladder, a
measure of life satisfaction commonly used as a unidimensional index of wellbeing.
Methods: Data were from the Gallup World Poll from the years 2009 to 2019, a
repeated cross-sectional survey of nationally representative samples comprising ∼1.2
million individuals from 162 countries. We assessed five domains of flourishing: (1)
happiness, (2) health, (3) purpose, (4) character, and (5) social relationships. We used
the Gini Index to estimate inequalities in wellbeing within populations. We examined and
compared country ranking, global and region-specific trajectories of mean and inequality,
and relationships with age for flourishing and Cantril’s ladder.
Results: Although all trends were highly correlated across the two metrics of
wellbeing, we identified distinct patterns in flourishing concerning geography, time, and
age relationships that were not observed for Cantril’s ladder. Temporal trends and
age relationships were different across domains of flourishing. Evidence of changing
inequalities in wellbeing was also found, even when population averages were high or
stable over time.
Conclusion: Comprehensive measures of wellbeing are needed to capture the complex
and changing patterns of wellbeing both within and across populations.
Keywords: human flourishing, multidimensional wellbeing, life evaluation, inequality, epidemiology
INTRODUCTION
Humans have had a long-standing interest in identifying, understanding, and cultivating the key
ingredients of a flourishing life, a multidimensional concept reflecting a state of complete wellbeing
in which “all aspects of a person’s life are good” (1–3). The importance of flourishing is espoused
in principles of international agencies dedicated to improving global health (e.g., World Health
Shiba et al. Global Trends in Human Flourishing
Organization’s constitution) (4). Notions of flourishing are also
interwoven into global initiatives established to promote human
development throughout the world. For example, the United
Nations’ 2030 agenda for global transformation includes good
health and wellbeing as one of its 17 Sustainable Development
Goals (5). Similar priorities are reflected in the initiatives of
other international entities (e.g., Templeton World Charity
Foundation) invested in promoting wellbeing (6). A better
understanding of distributions and determinants of wellbeing
will provide valuable insight into progress toward many existing
global goals and initiatives.
To this end, there are two main limitations in existing
empirical research on wellbeing that need to be addressed
to support the promotion of wellbeing as a major public
health endeavor. First, most studies focus on a narrowly
defined (often unidimensional) conception of wellbeing (2,
7–10). This partial assessment of wellbeing is evident in
large-scale multi-nation reports, many of which influence
policies, strategic agendas, and resource allocation decisions
at local and international levels. For example, the World
Happiness Report provides an annual country-level comparison
of subjective wellbeing (11). This report relies primarily on
Cantril’s ladder, a single-item measure of self-reported life
satisfaction (sometimes referred to as life evaluation) (12). Life
satisfaction is commonly used as a measure of unidimensional
wellbeing and has some desirable properties (e.g., its conceptual
clarity and comparability across studies) (13). Despite the value
and potential impact of such analyses, such evidence provides
an incomplete picture of wellbeing, because life satisfaction
represents only one of a broader set of indicators for human
flourishing. A more holistic approach to assessing wellbeing
could identify areas of human life that have been over- or
underemphasized in policies and agendas, informing future
public health priorities (14).
Second, much of the existing research on wellbeing has
overlooked the distribution of wellbeing within populations
in favor of assessing trends in population averages. An
improved understanding of changing inequalities in
wellbeing could contribute to policy refinement and more
informed resource allocation decisions, which may help
address social inequities within and across countries.
In existing research on wellbeing inequalities, the focus
has usually been on specific aspects of wellbeing (e.g.,
health and life satisfaction) (15,16). To date, no study
has conducted a systematic global analysis of changing
population distributions of wellbeing based on a more
comprehensive measure.
Using a dataset with nationally representative sampling
consisting of more than one million individuals from 162
countries, the purpose of this study is to assess global
and region-specific trajectories of means and inequalities in
multidimensional wellbeing (assessed by the items that were
available in the data and best capture the multiple domains
of wellbeing) from 2009 to 2019 and compare the trends in
distributions of wellbeing with more a commonly-used metric
(i.e., Cantril’s ladder).
MATERIALS AND METHODS
Data
Data came from the Gallup World Poll (GWP), a repeated
cross-sectional study of nationally representative samples of
non-institutionalized residents aged 15 years or older from 168
countries (see Figure 1), covering more than 98 percent of the
world’s population (17). GWP began in 2005 and collected data
from ∼1,000 respondents per country annually through 2019
(country-year specific sample size: mean =1,169, SD =775,
min =500, max =13,408). Data were collected via face-to-face
interviews in low-income countries and via random-digit-dialing
telephone interviews in high-income countries with 80% or
higher telephone coverage of the population. For countries with
face-to-face interviews, the samples were obtained using multi-
stage sampling, in which GWP sampled clusters of households as
Primary Sampling Units (PSUs), followed by households within
the PSUs, and then members in each household.
This study used data from 2009 to 2019 because some GWP
wellbeing items were not measured in prior years. We excluded
six countries (i.e., Saudi Arabia, Jordan, Cuba, Guyana, Oman,
and the Maldives) where at least one of the wellbeing measures
was completely missing throughout the 11-year period. The
final study sample consisted of 1,193,134 observations from 162
countries. Because this study involved secondary analysis of
de-identified data, its ethical review was exempted.
Measurement
Using VanderWeele’s (2) multidimensional conception of
flourishing as a framework, we assessed five domains of
wellbeing that are universally desired and ends in themselves: (1)
happiness, (2) health, (3) purpose, (4) character, and (5) social
relationships (2). Unlike other theorizing and other existing
measures of multidimensional wellbeing, this framework
suggests that flourishing consists of something more than one’s
psychological state and thus covers other dimensions of human
wellbeing such as character and physical health as well. We
selected three items that corresponded to each domain among
the items available in the GWP. Specifically, we first selected
candidate items based on their theoretical fit with the domains
of interest and then examined between-item correlations to
choose three items for each domain. Only two items had discrete
responses ranging from 0 to 10. All other items were binary. The
full list of items is available in Table 1. Between-item correlations
are shown in Supplementary Table 1.
The composite scores for flourishing were calculated as
follows. First, binary items were coded such that positive
responses (i.e., responses indicating higher levels of wellbeing)
were assigned a value of 1, and negative responses were set to
0. Second, we rescaled the two items with responses ranging
from 0 to 10 to range from 0 to 1. Third, we took an average
of the three items for each domain to obtain domain-specific
scores. Fourth, we took an average of the domain-specific scores
to obtain a composite index of flourishing. Lastly, we rescaled
the composite index by multiplying values by 10. Final scores
on the composite flourishing index range from 0 to 10, with
Frontiers in Public Health | www.frontiersin.org 2February 2022 | Volume 10 | Article 824960
Shiba et al. Global Trends in Human Flourishing
FIGURE 1 | Data availability. Countries are colored by regions. Countries that did not participate in the Gallup World Poll are showed as NA.
greater values indicating higher flourishing levels. Our goal was
not to establish flourishing index scores that can be used in future
studies but rather to take advantage of the available items in the
GWP to roughly quantify multidimensional wellbeing.
We also compared trends for the index of flourishing to those
found for Cantril’s ladder, a widely used single-item measure of
current life satisfaction (12). Cantril’s ladder asks respondents to
evaluate their current life on a ladder scale ranging from 0 (worst
possible life) to 10 (best possible life). Current life satisfaction is
one of the three items that formed the happiness domain in our
composite flourishing index.
Statistical Analysis
To assess trends in the distribution of wellbeing, we calculated
national average and within-country inequality in flourishing
and life satisfaction. We measured inequality in wellbeing using
the Gini Index, which summarizes the distribution of wellbeing
within the population (18). The Gini Index ranges from 0 (no
inequality) to 1 (greatest inequality). Although the Gini Index
is often used to assess income inequality, it has also been used
in the health disparity literature (19). Other measures of health
disparity (e.g., standard deviations) could be used; however, we
decided to use the Gini Index because it does not depend on
the scale and range of the variable being investigated, which will
facilitate comparisons with future studies.
We performed the following analyses. First, we pooled data
across years and ranked the 162 participating countries based
on mean and Gini Index of flourishing. For the top and bottom
25 countries in both rankings, we compared trends in mean
and inequality in composite flourishing and Cantril’s ladder life
satisfaction. We also compared mean scores for each domain of
flourishing across the top and bottom 25 countries. Second, we
used the most recent GWP wave (i.e., 2019) to plot and evaluate
the relationship between country-specific mean and inequality
in composite flourishing and life satisfaction. We also calculated
Pearson’s correlation of mean and inequality for both wellbeing
measures. Third, we examined global trajectories of the mean and
inequality for Cantril’s ladder, composite flourishing, and each
domain of flourishing from 2009 to 2019. We calculated country-
and year-specific mean and inequality values for each metric
and used their averages as global trends. Fourth, we compared
trajectories of mean and inequality in composite flourishing
with those in life satisfaction from 2009 to 2019 by geographic
regions. Countries were grouped into 11 regions: Africa (Sub-
Saharan), Middle East and North Africa, Australia-New Zealand,
Commonwealth of Independent States, East Asia, South Asia,
Southeast Asia, European Union, Europe (Other), Northern
America, and Latin America and the Caribbean. Figure 1 shows
countries included in each category. Lastly, to further investigate
differential trends across the wellbeing metrics, we pooled the
data across years and countries to examine the relationship
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Shiba et al. Global Trends in Human Flourishing
TABLE 1 | List of items for the composite flourishing score.
Domain Item Code
Happiness (Happiness 1) On which step of the ladder would you say you personally feel you
stand at this time?
Original responses (0 (the worst possible life) to 10 (the best
possible life) were rescaled to range from 0 to 1.
Happiness (Happiness 2) Just your best guess, on which step do you think you will stand in
the future, say about 5 years from now?
Original responses (0 (the worst possible life) to 10 (the best
possible life) were rescaled to range from 0 to 1.
Happiness (Happiness 3) Did you experience the following feelings during a lot of the day
yesterday? How about enjoyment?
Yes =1 and No =0
Health (Health 1) Do you have any health problems that prevent you from doing any of
the things people your age normally can do?
No =1 and Yes =0
Health (Health 2) Did you experience the following feelings during a lot of the day
yesterday? How about physical pain?
No =1 and Yes =0
Health (Health 3) Now, please think about yesterday, from the morning until the end of
the day. Think about where you were, what you were doing, who you were with,
and how you felt: Did you feel well-rested yesterday?
Yes =1 and No =0
Purpose (Purpose 1) In (this country), are you satisfied or dissatisfied with… Your freedom
to choose what you do with your life?
Yes =1 and No =0
Purpose (Purpose 2) Did you learn or do something interesting yesterday? Yes =1 and No =0
Purpose (Purpose 3) Employment status and religious importance (“Is religion an
important part of your daily life?”)
Employment: employed full/part time =1, out of
workforce/unemployed =0; Religious Importance: yes =1,
no =0; if either of employment or religious importance =1, then
Purpose 3 =1
Character (Character 1) Have you done any of the following in the past month?…
Volunteered your time to an organization
Yes =1 and No =0
Character (Character 2) Have you done any of the following in the past month?… Donated
money to a charity
Yes =1 and No =0
Character (Character 3) Have you done any of the following in the past month?… Helped a
stranger or someone you didn’t know who needed help
Yes =1 and No =0
Social (Social 1) If you were in trouble, do you have relatives or friends you can count on
to help you whenever you need them, or not?
Yes =1 and No =0
Social (Social 2) Are you satisfied or dissatisfied with the city or area where you live? Satisfied =1 and Dissatisfied =0
Social (Social 3) Were you treated with respect all day yesterday? Yes =1 and No =0
Respondents were classified into six categories of employment status (employed full time for an employer, employed full time for self, employed part time and do not want to work full
time, employed part time and want to work full time, out of workforce, unemployed) by Gallup based on answers to a series of questions about employment.
between age and life satisfaction, composite flourishing, and each
domain of flourishing.
We also conducted a series of supplemental analyses. First, we
assessed the relationship between flourishing and life satisfaction
by producing a scatter plot of country-specific mean values
for each wellbeing metric and calculated Pearson’s correlation.
Second, to delineate more nuanced patterns, we examined trends
in mean, inequality, and age relationship in the wellbeing
measures by geographic regions. We applied survey weights to all
responses to ensure the representativeness of the GWP sample.
The survey weights were calculated to adjust for oversampling
based on geographic regions, differential survey modes (e.g.,
landline vs. cellphone), and household size and to standardize the
distributions of demographic characteristics (i.e., age, gender, and
education) to the 15+population of each country. All analyses
were performed using R, version 3.6.0.
RESULTS
Country Ranking
Table 2 shows the top and bottom 25 of 162 countries
according to mean composite flourishing scores (see
Supplementary Table 2 for the rankings of all countries).
Generally, countries ranked highly for mean flourishing
also tended to have high mean scores on Cantril’s ladder
(Pearson’s correlation =0.75 and p<0.01 as shown in
Supplementary Figure 1). However, there were some differential
trends across the wellbeing metrics. For example, the three
countries with the highest mean scores on Cantril’s ladder
(Denmark, Finland, and Switzerland) were not ranked as highly
in terms of flourishing (13th, 22nd, and 12th, respectively). New
Zealand, Ireland, and Australia were the three highest-ranked
countries in terms of flourishing. The countries with the highest
Cantril’s ladder values tended to score highest in the happiness
domain (e.g., Denmark: 0.83). However, they did not perform
as well in other domains compared to the countries with the
highest flourishing values (e.g., Denmark vs. New Zealand:
0.77 vs. 0.81 for the purpose domain and 0.44 vs. 0.56 for the
character domain).
Some countries had an even larger discrepancy between
flourishing and Cantril’s ladder (e.g., Indonesia: 10th on mean
flourishing vs. 89th on mean Cantril’s ladder; Greece: 140th
on mean flourishing vs. 74th on mean Cantril’s ladder),
often pertaining to differences in the purpose and character
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Shiba et al. Global Trends in Human Flourishing
TABLE 2 | Mean composite flourishing, Cantril’s ladder score, and each domain of flourishing among top and bottom 25 out of 162 countries according to country
ranking for composite flourishing.
Country Flourishing Cantril’s ladder Domain of flourishing, mean (SD)
Mean (SD) Rank Mean (SD) Rank Happiness Health Purpose Character Social
Top 25 in flourishing rank
New Zealand 7.71 (1.32) 1 7.31 (1.67) 9 0.80 (0.17) 0.75 (0.29) 0.81 (0.23) 0.56 (0.31) 0.93 (0.16)
Ireland 7.67 (1.33) 2 7.07 (1.77) 15 0.77 (0.18) 0.80 (0.27) 0.78 (0.24) 0.55 (0.32) 0.93 (0.15)
Australia 7.59 (1.37) 3 7.29 (1.71) 10 0.78 (0.18) 0.74 (0.30) 0.77 (0.24) 0.56 (0.30) 0.93 (0.16)
Canada 7.59 (1.37) 4 7.40 (1.67) 7 0.80 (0.17) 0.74 (0.30) 0.81 (0.22) 0.54 (0.31) 0.92 (0.17)
Uzbekistan 7.58 (1.31) 5 5.80 (2.14) 59 0.76 (0.18) 0.78 (0.29) 0.79 (0.22) 0.39 (0.33) 0.94 (0.15)
Iceland 7.55 (1.24) 6 7.45 (1.63) 6 0.81 (0.16) 0.69 (0.32) 0.83 (0.21) 0.48 (0.29) 0.93 (0.15)
Norway 7.52 (1.31) 7 7.53 (1.57) 4 0.81 (0.16) 0.73 (0.30) 0.80 (0.24) 0.46 (0.31) 0.95 (0.13)
United States 7.50 (1.49) 8 7.10 (1.93) 14 0.78 (0.19) 0.73 (0.31) 0.79 (0.23) 0.58 (0.31) 0.88 (0.19)
Netherlands 7.50 (1.34) 9 7.45 (1.30) 5 0.80 (0.15) 0.75 (0.31) 0.74 (0.25) 0.52 (0.29) 0.94 (0.15)
Indonesia 7.50 (1.33) 10 5.25 (1.92) 89 0.70 (0.17) 0.81 (0.25) 0.79 (0.22) 0.50 (0.35) 0.87 (0.21)
Qatar 7.49 (1.23) 11 6.55 (2.03) 27 0.74 (0.20) 0.77 (0.27) 0.83 (0.19) 0.48 (0.29) 0.91 (0.17)
Switzerland 7.46 (1.31) 12 7.55 (1.57) 3 0.78 (0.18) 0.76 (0.29) 0.80 (0.23) 0.44 (0.31) 0.94 (0.14)
Denmark 7.45 (1.26) 13 7.68 (1.58) 1 0.83 (0.15) 0.73 (0.30) 0.77 (0.24) 0.44 (0.29) 0.95 (0.13)
Thailand 7.39 (1.26) 14 6.10 (1.96) 45 0.73 (0.19) 0.77 (0.28) 0.85 (0.20) 0.42 (0.30) 0.87 (0.20)
United Kingdom 7.38 (1.45) 15 6.89 (1.82) 18 0.76 (0.19) 0.76 (0.29) 0.73 (0.26) 0.53 (0.31) 0.91 (0.18)
Austria 7.38 (1.39) 16 7.23 (1.71) 11 0.76 (0.19) 0.78 (0.28) 0.77 (0.24) 0.45 (0.31) 0.93 (0.17)
United Arab Emirates 7.36 (1.30) 17 6.85 (2.01) 20 0.75 (0.20) 0.80 (0.26) 0.82 (0.21) 0.45 (0.32) 0.91 (0.17)
Costa Rica 7.34 (1.33) 18 7.18 (2.16) 13 0.79 (0.19) 0.75 (0.30) 0.85 (0.21) 0.38 (0.32) 0.90 (0.18)
Panama 7.33 (1.34) 19 6.68 (2.46) 24 0.76 (0.20) 0.79 (0.28) 0.85 (0.21) 0.35 (0.35) 0.90 (0.19)
Trinidad and Tobago 7.31 (1.44) 20 6.28 (2.25) 38 0.76 (0.20) 0.73 (0.30) 0.80 (0.22) 0.47 (0.34) 0.86 (0.22)
Sweden 7.30 (1.29) 21 7.36 (1.63) 8 0.80 (0.17) 0.74 (0.30) 0.76 (0.25) 0.39 (0.29) 0.94 (0.15)
Finland 7.28 (1.36) 22 7.56 (1.52) 2 0.77 (0.19) 0.74 (0.30) 0.78 (0.24) 0.40 (0.31) 0.94 (0.15)
Paraguay 7.24 (1.30) 23 5.57 (2.15) 71 0.72 (0.19) 0.79 (0.28) 0.83 (0.22) 0.33 (0.35) 0.92 (0.17)
Puerto Rico 7.24 (1.63) 24 6.82 (2.68) 21 0.76 (0.23) 0.68 (0.32) 0.79 (0.25) 0.40 (0.33) 0.90 (0.18)
Guatemala 7.23 (1.40) 25 6.25 (2.63) 41 0.72 (0.22) 0.75 (0.29) 0.85 (0.21) 0.40 (0.35) 0.88 (0.20)
Bottom 25 in flourishing rank
Gabon 5.80 (1.57) 138 4.43 (2.17) 133 0.55 (0.22) 0.64 (0.32) 0.72 (0.25) 0.27 (0.26) 0.69 (0.28)
Congo Kinshasa 5.79 (1.53) 139 4.35 (1.76) 140 0.58 (0.2) 0.70 (0.31) 0.68 (0.25) 0.21 (0.28) 0.70 (0.27)
Greece 5.76 (1.52) 140 5.53 (2.27) 74 0.60 (0.25) 0.71 (0.30) 0.57 (0.26) 0.17 (0.24) 0.84 (0.24)
Syria 5.74 (1.09) 141 4.10 (2.47) 148 0.48 (0.23) 0.72 (0.26) 0.62 (0.25) 0.38 (0.27) 0.67 (0.29)
Montenegro 5.73 (1.78) 142 5.28 (2.21) 85 0.59 (0.25) 0.67 (0.32) 0.60 (0.29) 0.21 (0.27) 0.79 (0.26)
Iraq 5.73 (1.61) 143 4.71 (2.25) 119 0.52 (0.24) 0.55 (0.33) 0.62 (0.26) 0.33 (0.29) 0.75 (0.27)
Madagascar 5.71 (1.44) 144 3.98 (1.80) 158 0.56 (0.20) 0.65 (0.30) 0.66 (0.25) 0.21 (0.30) 0.77 (0.25)
Palestine 5.71 (1.66) 145 4.62 (2.29) 122 0.55 (0.25) 0.63 (0.34) 0.65 (0.25) 0.20 (0.27) 0.80 (0.25)
Albania 5.70 (1.74) 146 4.99 (2.36) 100 0.60 (0.25) 0.64 (0.34) 0.61 (0.27) 0.23 (0.28) 0.75 (0.27)
Bosnia Herzegovina 5.68 (1.80) 147 5.15 (2.22) 96 0.56 (0.25) 0.64 (0.34) 0.59 (0.28) 0.25 (0.28) 0.76 (0.27)
Egypt 5.67 (1.58) 148 4.45 (2.20) 130 0.52 (0.24) 0.66 (0.33) 0.63 (0.23) 0.24 (0.27) 0.80 (0.24)
Serbia 5.65 (1.82) 149 5.17 (2.25) 94 0.56 (0.26) 0.65 (0.34) 0.60 (0.29) 0.18 (0.26) 0.79 (0.26)
Tunisia 5.63 (1.65) 150 4.78 (2.04) 114 0.56 (0.24) 0.66 (0.32) 0.65 (0.25) 0.25 (0.26) 0.75 (0.28)
Georgia 5.61 (1.80) 151 4.23 (2.01) 146 0.53 (0.25) 0.60 (0.37) 0.61 (0.25) 0.21 (0.26) 0.74 (0.26)
Nagorno Karabakh 5.55 (1.69) 152 4.86 (1.70) 110 0.54 (0.23) 0.58 (0.34) 0.68 (0.24) 0.23 (0.25) 0.74 (0.26)
Haiti 5.54 (1.73) 153 3.96 (2.16) 159 0.48 (0.22) 0.63 (0.33) 0.63 (0.27) 0.42 (0.34) 0.60 (0.31)
Benin 5.53 (1.58) 154 4.00 (2.37) 155 0.55 (0.22) 0.60 (0.32) 0.74 (0.24) 0.24 (0.29) 0.62 (0·30)
Chad 5.52 (1.60) 155 4.04 (2.12) 153 0.53 (0.21) 0.61 (0.33) 0.67 (0.24) 0.26 (0.30) 0.68 (0.30)
Yemen 5.50 (1.66) 156 4.00 (2.31) 156 0.51 (0.26) 0.66 (0.33) 0.64 (0.23) 0.19 (0.25) 0.76 (0.27)
Afghanistan 5.45 (1.85) 157 3.66 (1.85) 164 0.47 (0.23) 0.69 (0.32) 0.62 (0.25) 0.31 (0.30) 0.63 (0.30)
Armenia 5.40 (1.77) 158 4.52 (2.16) 125 0.51 (0.26) 0.57 (0.35) 0.61 (0.27) 0.23 (0.25) 0.75 (0.26)
Central African Republic 5.33 (1.55) 159 3.52 (2.10) 167 0.50 (0.22) 0.57 (0.34) 0.71 (0.23) 0.30 (0.31) 0.62 (0.28)
Togo 5.31 (1.62) 160 3.56 (2.31) 165 0.51 (0.22) 0.58 (0.32) 0.72 (0.25) 0.24 (0.29) 0.57 (0.31)
Burundi 5.26 (1.63) 161 3.55 (2.04) 166 0.52 (0.22) 0.69 (0.32) 0.66 (0.26) 0.14 (0.25) 0.58 (0.31)
South Sudan 5.22 (1.80) 162 3.40 (3.08) 168 0.45 (0.26) 0.51 (0.33) 0.66 (0.26) 0.37 (0.34) 0.60 (0.30)
Data were pooled across all waves (2009–2019). Scores for composite flourishing and Cantril’s Ladder ranged from 0 to 10. Scores for each domain of flourishing ranged from 0 to 1.
Higher scores indicate better wellbeing.
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Shiba et al. Global Trends in Human Flourishing
TABLE 3 | Gini index of composite flourishing, Cantril’s ladder score, and each domain of flourishing among top and bottom 25 out of 162 countries according to country
ranking for composite flourishing.
Country Flourishing Cantril’s ladder Domain of flourishing (Gini index)
Gini index Rank Gini index Rank Happiness Health Purpose Character Social
Top 25 in flourishing rank
Qatar 0.09 1 0.17 32 0.15 0.18 0.12 0.32 0.07
Iceland 0.09 2 0.12 8 0.10 0.24 0.12 0.33 0.06
Denmark 0.09 3 0.11 3 0.09 0.22 0.16 0.34 0.05
New Zealand 0.09 4 0.12 11 0.11 0.20 0.15 0.30 0.06
Thailand 0.10 5 0.17 37 0.14 0.19 0.12 0.38 0.11
Ireland 0.10 6 0.14 17 0.12 0.17 0.15 0.31 0.06
Norway 0.10 7 0.11 4 0.10 0.21 0.15 0.36 0.04
United Arab Emirates 0.10 8 0.16 25 0.14 0.16 0.13 0.37 0.07
Sweden 0.10 9 0.12 9 0.11 0.21 0.17 0.38 0.06
Uzbekistan 0.10 10 0.20 65 0.13 0.20 0.14 0.47 0.06
Switzerland 0.10 11 0.11 5 0.12 0.19 0.14 0.37 0.05
Netherlands 0.10 12 0.09 1 0.09 0.20 0.17 0.30 0.06
Indonesia 0.10 13 0.20 60 0.13 0.15 0.14 0.38 0.11
Canada 0.10 14 0.12 10 0.11 0.21 0.14 0.31 0.07
Australia 0.10 15 0.12 12 0.12 0.21 0.16 0.29 0.06
Luxembourg 0.10 16 0.11 6 0.13 0.19 0.17 0.42 0.06
Paraguay 0.10 17 0.22 82 0.15 0.19 0.13 0.56 0.08
Bhutan 0.10 18 0.12 13 0.12 0.17 0.13 0.37 0.14
Costa Rica 0.10 19 0.17 30 0.13 0.21 0.12 0.47 0.09
Panama 0.10 20 0.20 73 0.14 0.18 0.12 0.54 0.09
Austria 0.10 21 0.13 15 0.14 0.18 0.16 0.37 0.07
Malta 0.10 22 0.17 31 0.19 0.20 0.13 0.34 0.08
Finland 0.10 23 0.10 2 0.13 0.21 0.16 0.43 0.05
Philippines 0.11 24 0.26 127 0.18 0.22 0.10 0.47 0.10
Turkmenistan 0.11 25 0.17 36 0.16 0.20 0.18 0.40 0.08
Bottom 25 in flourishing rank
Chad 0.16 138 0.28 139 0.22 0.28 0.19 0.56 0.23
Lebanon 0.16 139 0.25 113 0.28 0.23 0.21 0.52 0.15
Lithuania 0.16 140 0.19 57 0.22 0.25 0.25 0.65 0.13
Benin 0.16 141 0.31 153 0.22 0.29 0.17 0.60 0.26
Algeria 0.16 142 0.19 51 0.21 0.23 0.21 0.59 0.17
Central African Republic 0.16 143 0.32 155 0.25 0.32 0.17 0.54 0.24
Ukraine 0.16 144 0.24 101 0.24 0.30 0.25 0.63 0.13
Tunisia 0.16 145 0.23 95 0.24 0.26 0.21 0.52 0.19
Palestine 0.17 146 0.27 131 0.26 0.30 0.21 0.62 0.15
North Macedonia 0.17 147 0.25 111 0.25 0.26 0.21 0.61 0.16
Croatia 0.17 148 0.19 52 0.23 0.25 0.22 0.66 0.16
Nagorno Karabakh 0.17 149 0.18 44 0.24 0.32 0.18 0.53 0.18
Togo 0.17 150 0.34 161 0.24 0.29 0.18 0.60 0.29
Yemen 0.17 151 0.32 157 0.29 0.27 0.19 0.60 0.18
Bulgaria 0.17 152 0.26 119 0.28 0.27 0.27 0.65 0.12
Montenegro 0.17 153 0.23 94 0.24 0.25 0.25 0.62 0.16
Albania 0.17 154 0·26 124 0.23 0.30 0.23 0.61 0.18
Burundi 0.17 155 0.31 151 0.25 0.24 0.21 0.75 0.29
Haiti 0.18 156 0.30 148 0.27 0.29 0.23 0.44 0.28
Bosnia Herzegovina 0.18 157 0.24 99 0.25 0.28 0.25 0.58 0.18
Serbia 0.18 158 0.25 109 0.27 0.28 0.26 0.68 0.17
Georgia 0.19 159 0.27 130 0.28 0.35 0.22 0.62 0.18
South Sudan 0.19 160 0.48 168 0.33 0.35 0.21 0.46 0.27
Afghanistan 0.19 161 0.28 138 0.27 0.24 0.21 0.51 0.26
Armenia 0.19 162 0.27 133 0.30 0.36 0.24 0.58 0.18
Data were pooled across all waves (2009–2019). A higher rank for the Gini Index indicates less inequality in wellbeing.
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Shiba et al. Global Trends in Human Flourishing
domains. Moreover, countries with similar levels of mean
composite flourishing performed differently across the domains
of flourishing.
Table 3 shows the top and bottom 25 countries according
to inequalities (Gini Index) in composite flourishing (see
Supplementary Table 3 for the rankings of all countries). The
inequality ranking was largely comparable with the ranking for
mean flourishing. As shown in Figure 2, countries with higher
mean scores tended to have lower inequalities in wellbeing
(Pearson’s correlations between country mean scores and Gini
Indexes: −0.91, p=0.01 for flourishing; −0.87, p=0.01 for
Cantril’s ladder). However, some countries ranked highly in mean
flourishing (e.g., Australia, 3rd; the United States, 8th) ranked
lower on the Gini Index (15th and 29th, respectively).
Temporal Trends in Wellbeing
Figure 3 shows the global trajectories of mean scores and Gini
Indexes for composite flourishing and Cantril’s ladder. Mean
scores for composite flourishing and Cantril’s ladder were both
stable over time. Regarding inequality of wellbeing, the Gini
Indexes for Cantril’s ladder showed a monotonic increase (0.20
in 2009 to 0.25 in 2019) but remained somewhat more constant
for composite flourishing. For domains of flourishing, we found
increasing population average scores and decreasing inequality
in the purpose domain (Average: 0.71 in 2009 to 0.74 in 2019;
Gini Index: 0.18 in 2009 to 0.17 in 2019). In contrast, we found
decreasing population average scores and increasing inequality
in the health domain (Average: 0.72 in 2009 to 0.69 in 2019; Gini
Index: 0.23–0.24).
Figure 4 shows region-specific trajectories of mean scores and
Gini Indexes of composite flourishing and Cantril’s ladder. For
both flourishing and Cantril’s ladder, mean scores were relatively
stable over time across regions and highest in Australia-New
Zealand and Northern America. The Gini Index for flourishing
was relatively stable and lowest in Australia-New Zealand and
Northern America. However, when assessing Cantril’s ladder,
there was a monotonic increase in the Gini Indexes in Sub-
Saharan Africa (0.21 in 2009 to 0.36 in 2019), Middle East and
North Africa (0.19 in 2009 to 0.25 in 2019), South Asia (0.22
in 2009 to 0.35 in 2019), and Latin America and the Caribbean
(0.20 in 2009 to 0.24 in 2019). In other regions, the Gini Indexes
for Cantril’s ladder remained constant or even decreased. Region-
specific trajectories for each domain of flourishing are presented
in Supplementary Figures 2, 3. Overall, the temporal trends
were relatively similar across regions but differed across domains.
Age and Wellbeing
Figure 5 shows the relationship between age and mean scores
for each wellbeing metric. We found that the mean for
Cantril’s ladder decreased with age until early adulthood,
increased with age after early adulthood, and declined
again in very late life (after age 80). Conversely, the mean
FIGURE 2 | Correlations Between Country-specific Mean Scores and Gini Indices in 2019. Pearson’s correlation coefficients were calculated. Points were colored by
regions. Size of each point represents the country’s population size.
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Shiba et al. Global Trends in Human Flourishing
FIGURE 3 | Global Trend of (A) Mean and (B) Inequality for the Composite Flourishing and Each Domain of Flourishing from 2009 to 2019. To facilitate comparison
with the domain-specific scores, the mean composite flourishing scores and Cantril’s Ladder scale scores were re-scaled to range from 0 to 1. We computed mean
scores and Gini indices of all the wellbeing measures for each country and year and then plotted smoothed curves for global trajectories.
composite flourishing score monotonically decreased across
the life-course. Region-specific age trends are shown in
Supplementary Figure 4. For both composite flourishing and
Cantril’s ladder, relationships with age varied to some extent
across regions. Regarding specific domains of flourishing,
mean scores for the health domain and happiness domain
(which included life satisfaction and affect) decreased with
age. In contrast, scores for the social wellbeing domain
increased with age. Mean values of the purpose and character
domains peaked in middle age (around 40–50s) but declined in
later life.
DISCUSSION
This study investigated global trends in wellbeing from 2009 to
2019. Prior work in the field has primarily focused on population
averages in wellbeing based on a unidimensional metric, such as
Cantril’s ladder as an index of life satisfaction. This study adds to
the existing evidence by examining multidimensional wellbeing
(i.e., flourishing) and assessing both population averages and
inequalities in wellbeing. To do so, we leveraged data from
the GWP, a nationally representative sample of 1.2 million
individuals from 162 countries with a wide range of wellbeing
measures. Our study has three main findings:
1. We observed a positive correlation between the mean
composite flourishing scores and mean Cantril’s ladder scores
and a negative correlation between mean scores and the degree
of inequality assessed by the Gini Index for both flourishing
and Cantril’s ladder.
2. Despite the correlation between the two metrics of wellbeing,
there were distinct patterns in the multidimensional
flourishing concerning time, geography, and age that were not
evident when wellbeing was assessed using Cantril’s ladder as
a unidimensional measure of wellbeing.
3. Despite the correlation between the mean scores and Gini
Indexes, we identified non-trivial trends in inequalities
of wellbeing that were not detected when analyzing
average wellbeing.
Flourishing vs. Cantril’s Ladder
The comparison of trends in the multidimensional flourishing
with those in the Cantril’s ladder scores gave us at least two
major insights. First, assessing wellbeing using Cantril’s ladder
did not appear to sufficiently capture the multidimensional
nature of flourishing. The positive correlation between composite
flourishing and Cantril’s ladder suggests value in using Cantril’s
ladder as a simple approach to capture wellbeing trends.
However, there were notable differences between trends in
composite flourishing and Cantril’s ladder for many countries.
Some countries had higher mean levels of Cantril’s ladder
relative to composite flourishing (e.g., Scandinavian countries
and Greece). Many of those countries scored highly on the
happiness domain, for which current life satisfaction constituted
one item of the index but did not score as highly in
other flourishing domains (e.g., purpose and character). We
speculate that this trend may reflect the relatively lower levels
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Shiba et al. Global Trends in Human Flourishing
FIGURE 4 | Trajectories of (A) Mean Score and (B) Gini Index for Flourishing and Cantril’s Ladder from 2009 to 2019 by Regions. We computed mean scores and
Gini indices of the composite flourishing and Cantril’s ladder for each country and year and then plotted smoothed curves for trajectories in each region.
of individualism in those countries (20). Similarly, countries
with higher levels of composite flourishing levels relative to
Cantril’s ladder (e.g., Indonesia) scored lower in the happiness
domain but higher in other domains (e.g., health, purpose,
and character). The relationships with age were remarkably
different between Cantril’s ladder and composite flourishing and
across the flourishing domains, suggesting wellbeing is not a
unidimensional construct. Our finding is consistent with the
prior work by Huppert and So (21) that analyzed a representative
sample of 43,000 Europeans and examined the relationship
between their flourishing measure and life evaluation. They
found a relatively low correlation between flourishing and life
evaluation, although their flourishing measure differs from ours
in that their measure more extensively covered aspects of
psychological wellbeing (e.g., optimism and vitality) but omitted
some domains that we examined (health and character). Taken
together, the findings imply that a unidimensional Cantril’s
ladder may adequately assess one dimension of flourishing
(i.e., happiness) but fails to identify differential trends in other
essential domains of flourishing.
Second, even the composite flourishing appeared inadequate
and needed to be complemented with independent evaluations of
each domain to obtain a full picture of flourishing. Countries with
similar mean composite flourishing levels had different domain-
specific wellbeing levels, suggesting they require different
interventions to promote flourishing. Further, although the
global mean level of composite flourishing has remained constant
over time, wellbeing increased in the purpose domain and
decreased in the health domain during the same period.
Collectively, these findings suggest that the specific domains
of flourishing to be prioritized for the promotion of complete
wellbeing did change over time. For interventions to be more
targeted at the changing needs of wellbeing globally, it is therefore
important to assess flourishing as a composite as well as with each
of the domains.
Previous research focused on Cantril’s ladder has resulted
in insufficient attention to how the interrelationships between
purpose, character, and health shape global wellbeing. We found
that scores on these three domains decline with age, suggesting
that interventions might be particularly helpful for older adults
in rapidly aging societies (22). Accumulating evidence suggests
that some of the items we used to measure purpose and character
have important effects on population health. For example, self-
reported purpose is associated with lower risk of mortality and
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Shiba et al. Global Trends in Human Flourishing
FIGURE 5 | Associations of (A) Composite Flourishing/Cantril’s Ladder and (B) Each Domain of Flourishing with Age. Data was pooled across countries and years.
increased likelihood of engaging in preventive behaviors (23–
26). Similarly, volunteering, one of our character items, has been
found to predict lower risk of mortality, higher physical activity,
and a range of wellbeing outcomes, including greater purpose
(27). More research is warranted to better understand how these
three domains impact global wellbeing.
Population Average vs. Inequality
Although population average scores and Gini index were
negatively correlated, some countries (e.g., Australia and the
United States) with high population average flourishing had
relatively large inequality. We also identified rapidly rising
inequalities in life satisfaction in Africa, South Asia, Latin
America, and the Caribbean, which might be explained partly
by the unequal distributions of life satisfaction drivers (e.g.,
income) in these countries. Our findings indicate that wellbeing
inequalities can arise even when the population average wellbeing
appears high or stable over time. Notably, the analysis of average
population wellbeing did not provide these insights.
To inform policies for reducing wellbeing inequalities, it
is important to identify the drivers of such inequalities and
how they differ across populations. The wellbeing inequalities
observed in this study might reflect increasing social inequalities
within some countries. While socioeconomic conditions have
been documented to affect multiple domains of wellbeing
in many studies, the relationship might be heterogeneous
across populations. For instance, studies based on European
populations demonstrated that socioeconomic factors (e.g.,
education) were associated with mental illness but did not
predict mental wellbeing (28,29). Because our measure of
inequality (Gini Index) summarized overall inequalities within
populations, future studies are warranted to assess inequalities
based on specific social groups (e.g., does flourishing differ across
income groups?).
While it is informative to study determinants of flourishing
that can be altered via interventions targeting individuals,
future studies should also examine more social and structural
determinants of population wellbeing (e.g., policies and
neighborhood environment). Interventions that aim to shift the
distribution of flourishing within the whole population may be
a more effective public health strategy than intervening among
“high-risk” people at the individual level, although the two
approaches are not mutually exclusive (30). Such population-
level approaches may also narrow existing inequalities in
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Shiba et al. Global Trends in Human Flourishing
wellbeing (31), as indicated by the observed negative correlations
between population averages and inequalities in this study.
Future Directions of Wellbeing Research
Our study has three implications for future global research on
wellbeing. First, a multidimensional approach to assessing
wellbeing is likely to better inform policies aimed at
enhancing human wellbeing more holistically. We showed
that unidimensional life satisfaction wellbeing assessment -a
common approach in the literature- may overlook important
trends in other critical flourishing domains. Because trends
can vary substantially across domains of flourishing, future
efforts dedicated to tracking wellbeing are encouraged to assess
composite flourishing as well as domain-specific wellbeing.
In studying determinants or impacts of policies on population
wellbeing, assessing domain-specific wellbeing using multiple
items is helpful because a specific exposure/treatment can
promote wellbeing in one domain and deteriorate wellbeing in
other domains. For instance, evidence suggests that taking care
of children as an expression of the self may improve a sense of
meaning but can decrease happiness (32). We also need a better
understanding of the determinants of the domains of wellbeing
for which empirical research is scarce (e.g., purpose or character).
Research in this area could provide some explanations about
the distinct trends in Cantril’s ladder and flourishing that we
observed in this study. One useful approach for such a study is
to conduct an outcome-wide analysis, which examines the effects
of a single factor on a wide range of outcomes simultaneously
(33). This approach has several methodological advantages (e.g.,
preventing p-hacking and publication bias) and provides a
holistic view of the relationships between the exposure/treatment
and subsequent wellbeing.
Second, more comprehensive measurements for the
flourishing domains and inclusion of those items during
data collection are warranted. Most datasets used in public
health and social science research do not contain a full set
of items to assess flourishing. Thus, a feasible approach has
been to use available items as a proxy to characterize the
flourishing domain of interest, as we did in this study. Given
the theoretical advantage of using multidimensional measures
to more comprehensively capture relevant domains of human
wellbeing, the quality of future research in this area will rest on
the development, evaluation, and refinement of psychometrically
sound measures of multidimensional wellbeing that are validated
for use within and across different cultural contexts.
Lastly, future research should go beyond assessing only
average population wellbeing and also pay attention to
inequalities of wellbeing within populations. Tracking
population averages may not be particularly informative
for a more equitable promotion of wellbeing because, as we
demonstrated, existing and widening inequalities may be masked
in such an analysis. Although we used Gini Index as a simple
measure of total inequality in a population, future studies
are encouraged to conduct more comprehensive assessment
that considers (a) inequality across specific social groups (e.g.,
inequality in wellbeing across levels of income) and (b) the scale
of inequality measure (i.e., relative vs. absolute inequality) (19).
Study Limitations
Three limitations should be noted. First, our flourishing measures
were admittedly crude. Because of the limited data availability
of GWP items, some items were, as noted above, a proxy of
the flourishing domain of interest at best. For example, we
assessed the character domain by measuring whether subjects
engaged in volunteering, donating money, and helping others
in the past month. These arguably do not constitute character
itself but rather are its consequences. Although we may expect
these measures to reflect one’s character well, other facilitators
of and barriers to these behaviors may exist, such as social
norms, transportation, physical health, and financial conditions.
In assessing the purpose domain, we used one’s employment
status and religious importance, but some individuals may not
derive purpose from these conditions. The items for the purpose
domain and the character domain showed weak within-domain
correlations. Furthermore, other important theorizing around
multidimensional wellbeing exists [e.g., works by (3,34–39)].
Although we calculated continuous composite scores for each
domain, the domain-specific scores were based exclusively on
three individual binary items (except for the happiness domain),
which do not capture the nuanced levels of wellbeing. Moreover,
the scores were calculated as simple averages of the individual
items, thereby assigning equal weight to each item. However, this
study’s purpose was not to establish a comprehensive measure of
flourishing but rather to use the GWP data as best as possible.
We did not intend to be prescriptive of what constitutes a
“good” life by choosing the specific items (e.g., working and
religion) either. We aimed to compare trends in wellbeing
assessed multidimensionally with those from a unidimensional
wellbeing measure, hoping to create a foundation that facilitates
future research with more rigorous multidimensional wellbeing
measures. Our finding also warrants future studies using other
existing data sources that examine wellbeing globally using
different items (e.g., World Values Survey). Second, differences in
culture and language may alter people’s perceptions of the world
(40–42). International comparisons involving metrics such as
life satisfaction rely on equivalence among translations. Despite
scholars’ best efforts, there are often at least subtle differences
between translated terms. Moreover, cultural variation affects
how people respond to surveys; participants in individualistic
contexts tend to emphasize their positive feelings, whereas
respondents in more collectivist locales may be more likely
to downplay these in a self-effacing manner (43). Third, the
regional grouping we used to categorize countries may be crude.
Other approaches to categorize countries (e.g., eastern vs. western
vs. southern Europe for countries in Europe) exist, although
any grouping of countries, including ours, can be arbitrary
and imperfect.
CONCLUSIONS
In conclusion, the current study demonstrated that the standard
approach to monitoring wellbeing that assesses population
averages using a unidimensional measure might not fully capture
complex and changing patterns in wellbeing. Achieving complete
wellbeing (i.e., human flourishing) is the ultimate goal of many
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Shiba et al. Global Trends in Human Flourishing
international organizations and global initiatives. We propose
that future research on wellbeing needs to establish and use
more comprehensive multidimensional wellbeing measures and
assess population distributions of wellbeing. Such research
would inform a more effective and equitable promotion of
human flourishing.
DATA AVAILABILITY STATEMENT
De-identified data that underlie the results reported in this article
will be available upon request to and permission by the Gallup
Inc. Programming code to replicate the study findings will be
available upon request to Koichiro Shiba. Requests to access these
datasets should be directed to shiba_k@g.harvard.edu.
AUTHOR CONTRIBUTIONS
KS was responsible for conceptualization, data curation, formal
analysis, funding acquisition, investigation, methodology, project
administration, and writing an original draft. RC, ML, and TV
were responsible for methodology, reviewing, and editing the
draft. NG, TL, and AL conducted literature review and reviewing
and editing of the draft. All authors contributed to the article and
approved the submitted version.
FUNDING
This study was supported by the Wellbeing for Planet Earth
Foundation. TV was funded by the John Templeton Foundation
(Grant Number 61075).
SUPPLEMENTARY MATERIAL
The Supplementary Material for this article can be found
online at: https://www.frontiersin.org/articles/10.3389/fpubh.
2022.824960/full#supplementary-material
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