5 wellbeing and health

Question 1

What are the APA definitions of wellbeing, happiness and QoL?

Answer 1

W = a state of happiness and contentment, with low levels of distress, overall good physical and mental health, or good QoL

H = an emotion of joy, gladness, satisfaction, and wellbeing

QoL = the extend to which a person obtains satisfaction from life. the following are important: emotional, material and physical wellbeing, …

-> no clear definitions, all the same thing

Question 2

How can wellbeing otherwise be conceptualised?

Answer 2

objective wellbeing: societal perceptions
(education attainment, SES)

subjective wellbeing: individual perception
(how do u feel/think about your life)

WHO (2013) ‘well-being exists in two dimensions, subjective and objective. It comprises an individual’s experience of their life as well as a comparison of life circumstances with social norms and values’.

hedonic vs eudaimonic wellbeing

maximize pleasure vs. reach full potential

Question 3

What is Seligmans PERMA model of wellbeing?

Answer 3

positive emotion
engagement
relationships
meaning
achievement

Question 4

what role does wellbeing play for health?

Answer 4

high subjective wellbeing can increase life expectancy for 4 to 10 years

the quality of patient care experience can be as crucial as medical treatments

staff wellbeing is vital for improving patient experience and health outcomes

Question 5

What are differences in wellbeing concepts across cultures (US/Japan comparison)?

Answer 5

social hierarchy and wellbeing

US: subjective social status more strongly predicted life satisfaction, sense of purpose, …

Japan: objective social status more strongly predicted life satisfaction, self acceptance, …

=> at the top: more optimistic, more positive emotions, less adversity

local status versus global status
interdependence versus independence

japan: well-managed relationships with others
us: individuals personal feelings and emotions

Question 6

What does wellbeing actually mean?

Answer 6

Oxford: the state of being comfortable, healthy or happy

Aristotle - Eudaimonia - contented state, feeling happy

multidimensional
physical
emotional/psychological
social
spiritual
intellectual
economic

Question 7

What seven types of evidence have indicated that high subjective wellbeing causes better health and longevity?

Answer 7

1. long-term prospective studies
2. natural levels of SWB are related to specific physiological processes that can affect health
3. experimental manipulation of emotions -> relation to physiological variables
4. animal studies: SWB -> health (groups differ in baseline levels of SWB)
5. quasi-experimental studies where natural events are examined on their effects on health outcomes
6. intervention for SWB -> does that change physiological measures
7. how are QoL factors related to SWB

Question 8

What evidence exists for 1. long-term prospective studies

Answer 8

mortality, controlling for initial health

depression and anxiety predicts disease progression

.18
.15 effect size for longevity

positive affect is associated with reduced death rates

swb is predictive of cancer incidence

can it also improve ppls chances of surviving an existing illness?

time specificity?

results are consistent in indicating that SWB predicts
disease, although the findings are much clearer and complete for cardiovascular disease than other illnesses

Question 9

What evidence exists for 2. natural levels of SWB are related to specific physiological processes that can affect health

Answer 9

shortterm and longterm negative affect are associated with physiological indicators

pessimists have higher blood pressure levels

fibrinogen response to stress was smaller in happier individuals

Brummett, Boyle, Kuhn, Siegler, and Williams (2009) found that positive feelings were associated with lower blood pressure reactivity during sadness recall but not during anger recall, and were related to more epinephrine, as well as lower cortisol rise after waking

various forms of negative affect (stress, anxiety, depression) are related to deleterious changes in cardiovascular system

hostility and trait negative affect were predictive of inflammatory markers
which is linked to AD, osteoporosis, arthritis, frailty, cardiovascular disease

delayed wound healthing and infection

immune functioning
angry individuals had weaker immune response to vaccine
high optimism has stronger response

stress - lower values of immune parameters
objective stress is better predictor than self-reported stress

only long-term positive emotion traits predict greater immune competence independently of negative affect

effect of low SWB on telomere shortening. Shorter telomeres resulting from negative emotions could cause health issues in a variety of different bodily systems because of the greater probability that new cells will contain replication mistakes.

MDD and age predicts that
AD as well
chronic stress

premature aging in diverse bodily systems

positive affect - protective psychosocial and behavioural factors
social connectedness, perceived social support, optimism, preference for adaptive coping responses

high life satisfaction was associated with not smoking, physical exercise,
a healthier diet, and using sun protection

optimism is strong predictor for depression and less antisocial behaviour and lower heavy drug use

Question 10

What evidence exists for 3. experimental manipulation of emotions -> relation to physiological variables

Answer 10

stress induction
skin-recovery time after tape-stripping was measured
trait positive emoitons predicted quicker barrier recovery in stress induced group

positive mood induction - quicker cardiovascular recovery

follwoing marital conflict condition, participants had slower wound healing
levels of high hostility

strongest effect size they reviewed was between transient positive emotions and sIgA antibody production.

Question 11

What evidence exists for 4. animal studies: SWB -> health (groups differ in baseline levels of SWB)

Answer 11

conditions likely to cause stress have a negative impact on health

socially stressed monkeys developed more extensive coronary artery atherosclerosis

isolation - shorter survival in SIV-infected monkeys

influences blood coagulation

Enteric bacteria may grow more rapidly in stressed animals
Tethered pigs show greater basal metabolism than group-housed
pigs. Both housing systems and threatening human behavior can elevate
plasma-free corticosteroids, with negative results for pregnancy, growth, and
immune strength.

social interaction among mice post-stroke helped decrease stroke-induced neuronal death

Question 12

What evidence exists for 5. quasi-experimental studies where natural events are examined on their effects on health outcomes

Answer 12

emotional events and disasters are associated with cardiovascular and immune changes, can trigger deaths in those who are psychologcially affected by a disaster, probably in vulnerable populations

death spikes during the first month after bereavement, with greater than a
twofold increase in mortality for men and a threefold increase for women,
and then returns to normal levels.

spike in deaths in Israel on the first day of missile strikes during the Gulf War
of 1991, unrelated to direct deaths from the strikes

even observing exciting sports events seems to be able to trigger
cardiac deaths

blood samples were taken from hypertensive patients before and after an earthquake. The quake induced transient elevations in blood pressure and viscosity, and these parameters returned to baseline after 4 to 6 months

wound healing time in dental students during the summer vacation and again during the first examinations of the year. Students took on average three days longer to heal a small, standardised wound during the examinations, and interleukin messenger RNA was 68 per cent lower during the tests

work stress has been related to systematic differences in cortisol
weekend-weekday differences in cortisol response

Berthier and Boulay (2003) found deaths dropped in France when they won
the World Cup, a study by Katz et al. (2005) found an increase in cardiac
arrests in Switzerland during the World Cup

Question 13

What evidence exists for 6. intervention for SWB -> does that change physiological measures

Answer 13

increased positive affect and left-sided anterior brain activation in meditators compared to wait-list controls, and these were accompanied by increases in antibodies to flu vaccine

hostility-reduction intervention in men with cardiovascular disease led to lower diastolic blood pressure compared to control group participants
.47 reduction

who wrote about positive topics had fewer health center visits for illness during the following 3 months

undergoing cholecystectomy to one of two treatments, either a control condition or a relaxation with guided imagery condition. Those in the treatment condition exhibited less wound inflammation
and redness than the control participants.

myocardinal infarction
type-A counselling

palliative care - metastatic lung cancer
early-care patients had fewer depressive symptoms and lived almost 3
months longer than the 9-month average survival time in the control group.

Question 14

What evidence exists for 7. how are QoL factors related to SWB

Answer 14

positive emotions were related to lower pain and greater tolerance for pain

fibromyalgia patients had higher levels of pain thresholds for mild and moderate pain with higher levels of trait positive affect.

women reported less pain to heat stimuli when looking at pictures of their partner

Positive emotions predicted recovery of greater functional status
among stroke patients

Question 15

What is the lifecourse approach in ageing?

Answer 15

• cumulative impact on ageing of all life experiences

health promotion needs to adopt a “whole life approach”

focusing on integrated interventions and interconnected theory

Question 16

What is the WHOs definition of health promotion?

Answer 16

The process of enabling people to increase control over, and to improve, their healthHealth promotion … covers a wide range of social and environmental interventions that are designed to benefit and protect individual people’s health and quality of life by addressing and preventing the root causes of ill health, not just focusing on treatment and cure.

Question 17

What are some facts for positive wellbeing across the lifecourse?

Answer 17

• starting well
  Children’s experiences in their first five years of life have lasting impacts on their wellbeing.
  Child wellbeing in the early years is strongly associated with the mental health of their parents.
• developing well
  childrens rating of their wellbeing appear to be most strongly influenced by relationships, with family members and peers
  wellbeing in adolescence suggests a “u-shaped” curve, reaching its lowest at 14-15. this decline seems to be sharper for girls.
  health is important for young peoples wellbeing, but they receive it as less important for their wellbeing than adults do
• living well
  self-reported health is one of the factors most closely related to wellbeing
  frequency of contact with family and friends, and quality of those personal relationships, are crucial determinants of peoples wellbeing
  caring responsibilities for someone with a disability or in poor health is associated with lower happiness ratings, and more depressive symptoms
• working well
  unemployed people tend to experience lower levels of wellbeing
  having a good job is important, job quality and security are important for greater wellbeing
  evidence that unemployment of a parent may cause a child to have reduced levels of wellbeing in longterm
• ageing well
  advancing age is associated with physical and cognitive decline, wellbeing is consistently found to be higher in later life than among young or middle aged adults
  but declines in the oldest old

Question 18

What role do social relationships play in wellbeing?

Answer 18

social relationships are key to wellbeing

• Family relationships are very important for young people’s wellbeing.
• Young people’s experiences of bullying have a strong negative effect on their
  wellbeing.
• The influence of social relationships on the risk of death are comparable to
  other established mortality risk factors such as smoking and alcohol
  consumption, and actually exceed the influence of physical activity and
  obesity.
• Good quality relationships with partners have been found to be a strong
  correlate of happiness.

Question 19

Why is wellbeing part of the public health agenda?

Answer 19

• Health is one of the top things people say matter to their wellbeing. There is a
  two way relationship between wellbeing and health: health influences
  wellbeing and wellbeing itself influences health.
• Subjective wellbeing influences health and longevity in healthy populations. It
  is estimated that high levels of subjective wellbeing can increase life by 4 to
  10 years.
• Smoking is associated with lower levels of wellbeing, with some evidence
  demonstrating a causal link.
• An increase in the number of portions of fruit and vegetables consumed; a
  normal body weight; and meeting guidelines for physical activity are all
  associated with high levels of wellbeing.

Question 20

Why can wellbeing of staff in health care affect service delivery?

Answer 20

• There is a strong relationship between staff wellbeing and performance
  outcomes, with evidence demonstrating a causal link.
• How patients experience care can be just as important as the actual medical
  treatment they receive.
• Staff wellbeing is important in its own right (for example in relation to stress,
  bullying, and harassment) and it can improve the quality of both patient
  experience and their health outcomes.

Question 21

Where does the UK rank on international wellbeing indicator surveys?

Answer 21

• the UK ranks mid-table for many subjective and objective wellbeing indicators
  used in international surveys
• the UK ranks above average for self-reported health among adults, below
  average on the same indicator for children
• recent poor performance on mental wellbeing index
  20th out of 27 EU countries

Question 22

How can interventions improve wellbeing?

Answer 22

• increased levels of variables associated with greater wellbeing, like physical activity, social relationships, …
  -> indirect increase in wellbeing

-> often only hypothesized effect cus there’s a lack of evidence om exact effect on wellbeing