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Fixin' Healthcare

Monday, November 21, 2005

A Sense of Happiness

Lately, I have been struggling with the concept of happiness. It is not so much a personal consideration as it is about the conditions in society and the community that influence happiness. Because happiness and health are related there is reason to be concerned about conditions, attitudes, public policies and laws that influence happiness.

A growing body of knowledge links stress, happiness and health status. The biochemical and physiologic basis for this linkage was considered previously in the post on 11/05/05. This consideration is about those aspects of life in the community that promote or interfere with happiness.

Health care is undergoing a major shift of focus that expands the boundaries beyond the diagnosis and treatment of illness and disease to include achieving and maintaining optimum health status. The basis for this shift is the growing body of evidence that lifestyle is the major cause of many chronic diseases, and changing lifestyle can prevent and reverse chronic diseases.

How this transformation will progress and where it will lead cannot be determined at the present. However, many considerations will be included that were not previously mainstream medical thought. Greater personal responsibility for health and increased community commitment to healthy lifestyle are examples. These are not simple issues and there is much to be learned. Not the least of the possibilities is that personal health is more dependent upon community health than personal medical care.

The Declaration of Independence proposed the pursuit of happiness as a basic human right. There were no definitions or guarantees of happiness, just the right to pursue happiness. It is doubtful the founding fathers could have envisioned the complexity of modern society or the struggle for expression by the individual. Some would say the proposed pursuit of happiness has been forgotten but others would say it has been taken to the extreme.

The theory of government includes a balance between individual and community welfare. In all likelihood the Declaration of Independence expressed a view of the pursuit of happiness based upon freedom from oppression. Even today happiness as a personal emotion would not be a consideration for a community or the country. Yet, it is the community and community life that determine the background from which a sense of security, expression, accomplishment and well-being are derived.

Happiness is often equated with money and the well-being of a nation is most often measured by the gross domestic product. But around the world a growing body of thought is trying to develop measures that take into account not just the flow of money. The small Himalayan kingdom of Bhutan wants to ensure that prosperity is shared across society while preserving cultural traditions, protecting the environment and maintaining a responsive government.

Recently, 400 people from a dozen countries gathered at St. Francis Xavier University in Nova Scotia to consider new ways to define and assess prosperity. There were many thoughts relating to the observation that economic growth does not always equate with happiness, a sense of well-being or improved health status. Several countries, including the United States, Canada and Great Britian, have launched studies to determine whether a better understanding of well-being and happiness can be achieved.

What is happiness? Is happiness solely a personal matter or does it involve the community? Does happiness make a difference? Are the prosperous happier than the poor? To what extent is happiness dependent upon a sense of purpose, accomplishment, the community, social structure, security, justice and the environment? Is the United States a happy country?

So many questions, but life does not seem to wait around. Life moves on and it is continuously giving answers. Understanding the answers is dependent upon the nature of the questions. Do I know what makes me happy or unhappy? Am I prepared to do something about it? Are my actions contributing to continued happiness? Am I alone in this quest?

The recent study from King County, Seattle, Washington indicates how county planning for land use and transportation can influence physical activity and health status (see post from 10/31/05). It was accomplished by making health status a basis for county planning. And, if health status is improved, would the sense of happiness be elevated and could the economy be strengthened? And/or, if there is an increased sense of happiness, would health status be improved?

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