What influences wellbeing?
Webinar 2: Serious about wellbeing: what works?
The primary influences on wellbeing are the social determinants of health - the conditions in which people are born, grow, live, work and age - set out in the
Marmot Review Fair Society, Healthy Lives
Local government plays a crucial role in addressing the social determinants of health and there is growing awareness among elected members and officers of the relationship between persistent health inequalities and income, employment, housing, education and skills and the quality of the built and natural environment.
The social determinants of health and the role of local government
The research evidence on the social determinants demonstrates both the impact of the material circumstances of people's lives (e.g. living in poverty, struggling on a low income, fuel poverty) and the impact of inequalities in income and wealth i.e. the gap between rich and poor.
What the wellbeing literature adds is a deeper understanding of other factors that make up a valued life for individuals, families and communities. These include a sense of meaning and purpose, opportunities to contribute, respect and dignity, feeling valued, family life and relationships, security, political voice, sense of belonging and affiliation.
People living in poverty, as well as other vulnerable or excluded groups, consistently describe the pain of being made to feel of no account, which is often experienced as more damaging to wellbeing than material hardship. From this perspective, inequalities (the lived experience of injustice) are both stressful in themselves and greatly exacerbate the stress of coping with material deprivation
This focus on the importance of values and relationships is part of a wider view that ‘wellbeing does not depend solely upon economic assets' outlined in the ‘capability approach' of Amartya Sen and Martha Nussbaum.
Martha Nussbaum on the Capabilities Approach to Human Development
The focus on social relationships ‘what happens when people come together' is also central to assets based approaches
A glass half-full: how an asset approach can improve community health and wellbeing
The significance of social values and social relationships to wellbeing is inspiring many councils to think in new and creative ways and to include factors like ‘social return on investment' and ‘mental wellbeing impact assessment' in their strategic thinking. [link] Case Studies
A guide to social return on investment
Mental Wellbeing Impact Assessment
The revival of food and farmers' markets is a good example, where social value enhances the economic, health and environmental benefits of access to local produce and fresh fruit and vegetables. Local markets provide opportunities for social contact, the exchange of information, knowledge and expertise, informal and formal employment opportunities and contribute to a sense of place and belonging - all of which enhance wellbeing.
Other examples include greater awareness of the link between planning, management of traffic, parks, open spaces, play spaces and opportunities for people to come together, to ‘stop and chat' and to participate in the day to day life of the community.
Driven to excess: impacts of motor vehicle traffic on residential quality of life
Social prescribing or community referral is also based on the strength of the evidence for the importance of social connections, someone to turn to and sources of support within the community. Social prescribing involves connecting people (usually via primary care but sometimes through voluntary agencies or healthy living centres) with non clinical sources of support within the community e.g. arts, leisure, exercise, welfare or debt advice, learning, self help and volunteering.
Social relationships? Everything you ever needed to know...
Be inspired by Forgotten Spaces
These calls for ‘a return to the social' are important to ongoing debates about ‘big society' and ‘broken society' and have a special resonance where local government is responding to the aftermath of the riots.
Influences on wellbeing - What matters most?
There is considerable debate about the relative contribution to overall wellbeing of:
- Individual skills and attributes
(behaviour, attitudes and feelings)
- Family, relationships, support andnetworks
(people in our lives)
- Material resources
(income ,financial security, environment)
- Inequalities in distribution of resources
(what we have in relation to others)
It is likely that these factors are interlinked in complex ways and that they all make a contribution. However, the social gradient (inequality across social groups at every step on the ladder) in both mental illness and levels of mental wellbeing shows the strong relationship between psychological distress and the material circumstances of people's lives. At a population level, loneliness, isolation, lack of support and feelings of anxiety and depression are much more common among those in the poorest deciles. The mental wellbeing of children is particularly strongly influenced by household income.
North West Mental Wellbeing Survey Manchester
Adult Psychiatric Morbidity in England, 2007: results of a household survey
The evidence on the impact of inequalities is set out in The Spirit Level
Some of the debates about the issues are included in a review by Joseph Rowntree Foundation:
Does income inequality cause health and social problems Influences on wellbeing: Everything you ever needed to know....
Be inspired by
1 January 2012