Ben Harris-Roxas, a Croakey contributor, prolific Tweeter and health equity expert, has been reading a new report that looks at evidence-based recommendations for improving health and wellbeing.
The findings are not only likely to be useful for those with a concern for personal health, but present a significant challenge to traditional approaches to health social marketing campaigns.
He writes:
“Can you think of five things you can do to improve your health and wellbeing? If your list looks something like mine, it will involve exercising more, eating better, sleeping longer, spending more time with friends and family, and being less stressed. Laudable goals, but are they achievable?
As health professionals we rely on evidence when coming up with interventions to improve wellbeing. What would an evidence-based list look like?
The New Economics Foundation (NEF) in the UK has tackled this task. Their list includes:
- Connect…
With the people around you. With family, friends, colleagues and neighbours. At home, work, school or in your local community. Think of these as the cornerstones of your life and invest time in developing them. Building these connections will support and enrich you every day. - Be active…
Go for a walk or run. Step outside. Cycle. Play a game. Garden. Dance. Exercising makes you feel good. Most importantly, discover a physical activity you enjoy; one that suits your level of mobility and fitness. - Take notice…
Be curious. Catch sight of the beautiful. Remark on the unusual. Notice the changing seasons. Savour the moment, whether you are on a train, eating lunch or talking to friends. Be aware of the world around you and what you are feeling. Reflecting on your experiences will help you appreciate what matters to you. - Keep Learning…
Try something new. Rediscover an old interest. Sign up for that course. Take on a different responsibility at work. Fix a bike. Learn to play an instrument or how to cook your favourite food. Set a challenge you will enjoy achieving. Learning new things will make you more confident, as well as being fun to do. - Give…
Do something nice for a friend, or a stranger. Thank someone. Smile. Volunteer your time. Join a community group. Look out, as well as in. Seeing yourself, and your happiness, linked to the wider community can be incredibly rewarding and will create connections with the people around you.
This isn’t some Sunday newspaper mind-body-spirit liftout list.
All of the NEF report’s actions are underpinned by a solid evidence base. The actions were each selected because they could be acted upon, they act as a buffer for mental ill-health, and they enhance well-being.
What’s striking about the list developed by NEF is that it goes beyond the health messages most of us hear and that governments promote. How many of the NEF list’s actions do we encounter in health social marketing campaigns? The “be active” message is reasonably well understood, but what about the others?
The other thing that’s striking about the list is that the actions don’t just benefit individuals. There would be substantial benefits to families and communities if we connected more with each other, volunteered more, and kept learning.
The NEF report has a number of limitations and the authors, Jody Aked, Nic Marks, Corrina Cordon and Sam Thompson, recognise these.
It doesn’t include important factors that can be beyond individuals’ control, such as work environments, nutrition, access to green space, and where people live. As such it’s not a comprehensive list of actions that are required to promote well-being, or an exhaustive list of the things that the health and social service sectors need to do.
If we took promoting well-being seriously, our health social marketing campaigns would look quite different. This list of five simple, practical actions provides a different vision of how we can promote wellbeing.
We can do more than bashing people over the head with negative messages about what they’re not doing.”
May I add the most important?
No 1 – Make sure you are born into a family with money and education.
@ Dr Whom: You’re spot on. Re-reading the piece I realise I haven’t emphasised the importance of social and structural factors enough – the social determinants, in other words. I think it’s still interesting to note that even if we restrict ourselves to promoting actions that individuals can take, we could do things differently.
Ben – I just finished Barbara Ehrenreich’s Smile or Die, [sometimes titled – Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America] and I’m a bit more oversensitive than usual to positivity.
I suppose we should add that your family should also have a gene pool that isn’t too prone to a few illnesses. But even then money and education will help.
Too some extent this list works as a subset of the Social Inclusion model. I was thinking the other day that these days – it may have been different a while back – smoking is a loner’s habit. The more socially included one is the less chances there are to smoke.
I was struck when in IRE, UK and EU lat last year how much people still smoke inside compared to here in Oz. I can’t think of any smoker I know here who smokes even in
their own house. I know even those who live alone smoke outside even at night.
It might be that social inclusion works against continuing smoking these days in some practical ways.
It reads a bit like a Sunday newspaper Mind Body Spirit lift out. I agree that these things contribute to good health and well being and they are all good suggestions but to someone suffering chronic stress, pain, mental illness or restricted by a disability they may seem somewhat simplistic. But there seems to be a lot of that around now, simplistic solutions to complex problems – take a look at the Biggest Loser on television. In our rushed society no-one seems to have the time or inclination to sit and listen or analyse, and then help. That takes time and we must rush on to the next thing, or the next person, or the next dollar.
@Doctor Whom I haven’t read that one of Ehrenreich’s, though I thought her earlier one “Nickel and Dimed” was a devastating indictment on American working conditions. I’ll take a look.
This discussion reminds me a little of David Gordon’s alternate health tips from Dennis Raphael’s paper on “Health Inequities in the USA”:
1. Don’t be poor. If you can, stop. If you can’t, try not to be poor for long.
2. Don’t have poor parents.
3. Own a car.
4. Don’t work in a stressful, low paid manual job.
5. Don’t live in damp, low quality housing.
6. Be able to afford to go on a foreign holiday and sunbathe.
7. Practice not losing your job and don’t become unemployed.
8. Take up all benefits you are entitled to, if you become unemployed, retired or sick and disabled.
9. Don;t live next to a busy road or near a polluting factory.
10. Learn how to fill in the complex housing benefit/asylum application forms before you become homeless and destitute.
@Jenny Haines Fair points.
Jenny and Ben – I highly recommend Barbara Ehrenreich’s Smile or Die. I got mine from Book Depository – doesn’t everyone – landed on my doorstep for about 50% of what it would cost here.
She talks about how when she got breast cancer she was overwhelmed with positive thinking advice from all directions. And that when she went seeking support etc she was again bumping into the oppressive cult of positivity. She then goes on to look at the cult of positive thinking in USA and then the evidence for positive thinking in illness in particular (no evidence – or weak correlation at best) – with side tracks into religion, sales, spruikers and corporate culture.
She spends a fair bit of time on Martin Seligman and the Positive Psychology movement. She writes well and its a good read.
The work of Wilkinson and Pickett appear to indicate that income inequality across a first world society is pivotal and correlates very strongly with most indicators of health and well being. (google Spirit Level for impressive slide data). This can be demonstrated eg in the USA and in individual states of the USA. Thus, although individual factors as suggested can clearly help individuals, and may perhaps explain some of the variation in the data from Wilkinson et al, the main factors contributing to the overall health and well being of a particular society through all socio-economic classes are not in the control of the individual.
tim woodruff
doctors reform society