Courtesy of the Times Colonist

Happiness is in vogue. It was the cover story in the November 2017 National Geographic. We have the annual World Happiness Report (launched on the International Day of Happiness, March 20), a Happy Cities initiative, an Economics of Happiness initiative, a country — Bhutan — that measures its Gross National Happiness, even World Happiness Summits and a Happy Planet Index. Indeed, we have one of the world’s leading experts on happiness right here in B.C.: John Helliwell, professor emeritus of economics at UBC and one of the co-editors of the World Happiness Report since its inception in 2012.

Clearly, happiness is serious business. But what does it have to do with health? Well, not surprisingly, quite a lot. In fact, the two are in many ways almost the same thing, and each helps to predict the other. Happier people live longer lives in good health, while good health is a key factor contributing to happiness; what makes us happy makes us healthy, and vice versa.

So what exactly is meant by “happiness”? Interestingly, that first report didn’t define it — after all, it is a subjective phenomenon, we each have our own idea of what it means to be happy. But it did note there are “two broad measurements of happiness: the ups and downs of daily emotions, and an individual’s overall evaluation of life,” how you feel about your place in society. The former is known as “affective happiness.” The latter — evaluative happiness — is the more important in public policy.

But while to some extent happiness is built into us — the 2012 report noted that it “depends crucially on personality [which is] strongly affected by your genetic makeup” — the 2017 edition notes that: “Happiness is increasingly considered the proper measure of social progress and the goal of public policy.” Indeed, the Organization for Economic Co-operation and Development committed itself in 2016 “to redefine the growth narrative to put people’s well-being at the centre of governments’ efforts.”

This, of course, is precisely what public health has been advocating for many years. So what areas should a government focus on if happiness (and thus, health) were the goal of public policy and the measure of social progress?

The 2017 report identifies six factors that between them explain three-quarters of the variability in happiness between countries: GDP per capita, healthy life expectancy, social support (having someone to count on in times of trouble), trust (measured in absence of perceived corruption), perceived freedom to make life decisions and generosity. In addition, having positive emotions — which as noted might be partly genetic, but can also be learned — and having a sense of life purpose are important.

And who does this best? Well, no surprises there: The 2012 report noted “the happiest countries in the world tend to be high-income countries that also have a high degree of social equality, trust and quality of governance.” Based on data from 2014-16, the top six are Norway, Denmark, Iceland, Switzerland, Finland and the Netherlands; Canada ranks seventh, the U.S. is 14th, the U.K. 19th.

Internationally, GDP per capita and healthy life expectancy explain about half the difference between countries, which is hardly surprising. We know that up to about $20,000 per capita, growth in GDP and increased life expectancy are closely linked; you need a certain level of wealth to fund clean water, sanitation, universal education and so on.

But much of the remainder flows from the other four social factors; of these, it seems, increased social support is almost as important as GDP per capita. Indeed, the report finds that on average, if a country were to increase the proportion of its population who had just one person to count on by 10 per cent, it would be “equivalent to that from a doubling of GDP per capita.”

Good mental health also has a significant impact. In examining the U.S., Australia and Britain, the 2017 report also found that “diagnosed mental illness emerges as more important than income, employment or physical illness” in explaining the differences in happiness among individuals.

So once we have enough wealth, it seems we should focus more on building social support and mental health if we want to improve happiness and health.

Dr. Trevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy.

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