Australian Health Promotion Association

15th National Conference

Building better thinking skills to foster wellbeing

Imagine it is 20 years from now - the year 2025. Some of us will be in the prime of life. Others will have moved on to grander places. Yet, there is a legacy. A legacy of deciding now to implement a National Agenda for Wellbeing.

What is life like as a result of this agenda? Here are some of the differences.

• Australia is leading the world in having significantly reduced the rates of suicide, depression, diabetes, obesity and deaths from lifestyle diseases.

• Australians choose to take responsibility for their wellbeing, supported by systems that foster resilience, including flexible thinking skills.

• Expenditure on hospitals and physical illness systems has declined, as have insurance premiums.

• Productivity has increased even though working hours have been reduced.

• Each quarter, along with announcements of GDP figures, the Consumer Sentiment Index, and Balance of Payments, much attention is given to the National Wellbeing Index.

• A Department of Wellbeing has been established. It is a key Cabinet player, ensuring a coordinated approach to fostering Australians' wellbeing.

• Levels of community involvement, including volunteering, have increased dramatically and people have established new confidence in participating locally.

So how did we achieve this state of wellbeing?

Let's come back to the present. I'd like to propose to you that health promotion practitioners continue to build better thinking skills and that we adopt a strong wellbeing advocacy role. This proposition has its origins in some of the work that I do.

I facilitate a Work/Life Wellbeing program. It's a one-day program, combining insights from sense-making processes, positive psychology and wellbeing research, guiding participants to a clearer sense of personal direction, increased mastery and greater resilience.

Wellbeing is defined broadly, as a state that allows someone to flourish. As well as feeling happy and satisfied, wellbeing means developing as a person, being fulfilled, and making a contribution to the community.

Recognising the importance of cognitions and their impact on emotions and behaviour, the program has a strong emphasis on mind and language practices that foster flexibility, adaptability and confidence. (1)

Participants design a three month action plan and are supported with a fortnightly wellbeing ezine. Some receive a call from me at the end of that time to chat about how they're going with their action plan.

I have offered this program for several years, primarily to public sector agencies. The results are mixed. Amongst those I call,

• Some have done nothing
• Some have thought about it and dabbled with their plan
• A few make significant changes to their wellbeing.

These people say things like:

"If I hadn't done the program I would have been a nut case."

"I've looked at the whole of my life. I keep in touch with friends and do more with the kids. It's made me stop and think. I don't have to prove anything anymore ."

The question in my mind now is - if Australians grew up with the cognitive and social skills that enabled them to easily make better thinking choices, and lived in a society that fostered wellbeing, what difference would this make? And how could this be achieved?

Research suggests that there are three main influences on wellbeing: (2)

• Genetics and upbringing - accounting for about 50% of the variation in people's happiness.

• Life circumstances, including income, material possessions and marital status, accounting for about 10%.

• Outlook and activities, like friendships, being involved in our community, sport and hobbies as well as cognitive activities such as appreciating life and optimism, accounting for about 40 %.

This arena is where we have the most opportunity to make a difference to our wellbeing.

Fostering better thinking choices across diverse contexts produces effective, long-term results. Evidence shows that happy people are more: sociable, active, altruistic, generous, tolerant, economically productive, creative, healthy and long living. Wouldn't it be useful to find ways to increase people's wellbeing so we could reap these benefits?

Developing personal skills: Sense-making skills vital to fostering wellbeing

Health promotion practitioners provide education and information about health and wellbeing, enhancing life skills so people can make informed healthy choices. These life skills include resilience, self-efficacy and health literacy. Such skills increase the options available to people to exercise more control over their wellbeing.

The beliefs people hold are central to many of the issues health promotion practitioners deal with - nutrition, being active, body image, smoking, driving, safe sex, drinking, oral health, to name a few.

Research is increasingly showing the critical role beliefs play in either contributing to or sabotaging our health and wellbeing. (3) The paradox is that many people know what they should do, but still choose to take the poorer option. The result is much of our wellbeing loss is self-inflicted.

This paradox is fuelled by the complexity of information available. Today's nutritional advice is contradicted by tomorrow's latest scientific finding. And too many choices means that people often make no choice at all. Plus a market ethos fuels decision-making that is not always in our best wellbeing interests.

Incorporating strong sense-making skills in our programs enables people to reap the benefits of better thinking skills. A key issue is that people need to learn these skills from birth.

Which brings me to the implications for building public policy.

Building healthy public policy: What do we advocate for?

So what action do we now take to reach this vision of 2025? How would we create a political economy that allows people to thrive and flourish?

Fortunately there are people thinking about these issues. (4) Their ideas help us to identify what we could be advocating to start moving towards this 2025 vision. I offer five suggestions.

Identify a process for establishing a National Agenda for Wellbeing

This will mean:

• putting work into defining, promoting and measuring wellbeing.
• finding ways to put wellbeing on the national agenda. No easy task. A National Wellbeing Forum may be one option.
• fostering greater collaboration across sectors to share information and work cooperatively.

Establish credible measures of wellbeing

Work is already being done in this area, such as the Australian Unity Wellbeing Index and the Measure of Domestic Progress in the UK. (5)

We can, however, expect fierce opposition to such measures. Witness what happens whenever a report on poverty is released.

Create a wellbeing economy

The wellbeing literature shows that increasing economic growth does not necessarily improve our wellbeing once our basic needs are met. Economic and social policies can shape our culture and society. Placing wellbeing as central to public policy means changing how we think about the economy.

A UK example offers an option. In 2000 local authorities in England and Wales gained a new 'power of wellbeing' under the Local Government Act. This power entitles local authorities to do anything that might achieve the promotion or improvement of the economic, social or environmental wellbeing of their area. This means that local authorities consider how economic, social and environmental factors link with, and influence, people's personal wellbeing. (6)

Our working environment is increasingly organised in ways that undermine our wellbeing. Workcover compensation claims for psychological distress have increased four-fold since the mid 1990s. (7) Many people work in the type of organisation reflected in Dilbert cartoons.

Achieving work/life wellbeing in a global, 24-7 environment is complex and is more than childcare subsidies and flexible working hours, though these certainly help. In a recent discussion about issues affecting Australian women on Radio National's Australia Talks Back program commentators referred to broader social and economic factors that make it difficult for women and men, but moreso women, to balance all their commitments. (8) These factors include insufficient time, lack of male spouse support on the domestic front, casualisation of work with accompanying lower salaries, unequal pay, difficulties in finding suitable partners, and unhelpful mindsets about men as carers and breadwinners.

Which brings me to a core factor affecting our wellbeing - time. The New Economics Foundation in the UK suggests we need to reclaim our time, perhaps by taking productivity gains in the form of time. (9) The wellbeing literature supports the view that spending more time with our children, families, friends and communities is a key contributor to our wellbeing, both individually and collectively.

Employers stand to gain by paying attention to workplace factors that contribute to people's wellbeing. These factors include clear expectations, using strengths, receiving recognition and respect, being valued, building connections, and having opportunities to learn. (10) Certainly nothing too difficult there!

Encourage a whole of government approach to fostering wellbeing

This means working to develop a coordinated approach to fostering wellbeing across all portfolios - not just health, but employment, family services, housing, justice, finance, education, to name a few, Actions that foster everyone's wellbeing, and particularly in the early years, will pay big dividends down the track with reduced health and social costs. (11)

Build social capital

Here the time factor kicks in again. Many people would like to contribute to their community and be more active citizens, but the demands of work make this very difficult.

Promoting individual wellbeing is not just an important end in itself - it also has flow-on consequences for a flourishing society in all sorts of other ways.

Conclusion

With this paper I'm attempting to open a door on wellbeing and nudge us through it to realise this vision for 2025.

Our own perceptions of the health promotion profession will be critical to how far we move.

I'm proposing that we make sense of where health promotion is now heading by establishing a big agenda with a clear vision. Part of that sense making is to consider whether calling ourselves health promoters is still our primary focus. Perhaps it is time to be wellbeing promoters with a strong advocacy role.

My closing comment is this.

Let's not be bystanders in this matter of Australians' wellbeing. The issue is too important. Think what it would be like in 2025 to look back and say - we started this journey in Canberra, 2005.

To adapt the words of Richard Reeves, closing his paper 'The Politics of Happiness' (12):

"This [journey] is hard . But we have to start somewhere, sometime. And that might just as well be with ourselves, now."

Notes