By Siobhan Farmer and Barbara Hanratty
In case you hadn’t noticed, well-being is what you need. From companies promoting food supplements to lifestyle magazines, think-tanks to government departments, well-being is on everyone’s agenda. Happiness, quality of life, life satisfaction — it doesn’t seem to matter that we don’t know exactly what it is — we definitely want some.
Well-being hit the headlines in 2010 when UK Prime Minister David Cameron announced that a new well-being measure, developed by the Office for National Statistics (ONS), would be used to better understand the state of the nation. He suggested that a measure of the country’s well-being would be a better reflection of how people are doing than economic measures like Gross Domestic Product (GDP). This was soon reported in the media as the PM’s happiness index — with much scorn over both the cost and the concept.
But behind the headlines, the ONS have undertaken an extensive, rigorous piece of work to define well-being and propose appropriate measures. Their concept encompasses objective prerequisites for achieving well-being, such as education, health, housing and income. Combined with these, are more subjective measures of well-being which include a person’s sense of purpose, happiness, and life satisfaction.
In February 2012, ONS released the first analysis of Experimental Subjective Well-being data from the 2011 Annual Population Survey. This reported on the well-being of adults, but there are also data available, to contribute to the measurement of children’s well-being. One example is the Tellus survey, which ran in English schools between 2006 and 2009. This study investigated children’s opinions of their school and local area; gathered information on their health behaviours, such as eating, drinking alcohol, smoking, drug use and physical activity; and also asked whether the pupils were happy, had friends and could talk to their parents. Over 250,000 schoolchildren aged between 10 and 15 took part in 2009.
This month, the Journal of Public Health publishes an analysis of Tellus 4 data from two local authorities in the north west of England. It focuses on smoking, drinking and substance use amongst school pupils, and relates these behaviours to wellbeing and low income, using the proxy of eligibility for free school meals. Unsurprisingly, older age was the most important factor related to use of substances, but there were some interesting differences between girls and boys. Overall more boys than girls had experimented with drugs, but by the fourth year of secondary school, girls were significantly more likely to have been drunk. Being eligible for free school meals was associated with substance use, taking into account subjective well-being and age. And children who reported being happy or able to talk to their family, were less likely to be regular users. These findings reinforce the need to target health promotion messages to the right age group, and the importance of addressing social determinants of health behaviour. An emphasis on individual responsibility or an individualised approach to prevention, without consideration of the health and social consequences of living on low incomes, is never likely to be completely successful.
So far from being woolly, well-being in our analysis was a useful concept with a real world application. What we need to know more about, of course, is precisely how to enhance well-being, so children do not become regular drinkers or drug takers. Readers of a certain age might remember the 1994 Blur song, ‘Parklife,’ in which the actor Phil Daniels achieved his sense of well-being by feeding the pigeons. Tackling well-being in the real world is likely to prove more challenging.
Dr Barbara Hanratty is an NIHR Career Development Fellow and GP trained in public health, based in the Department of Health Sciences, University of York and Hull York Medical School. She previously worked in the Department of Public Health and Policy at Liverpool University. Her research interests encompass inequalities, older adults and end of life care.
Siobhan Farmer is a Specialty Registrar in Public Health and a NICE Scholar currently based with the Cheshire and Merseyside Health Protection Unit. She completed her MPH in 2010. Prior to this she led on Drugs Education in St Helens Healthy Schools Programme, after several years in the North East working in young people’s health promotion.
The Journal of Public Health has made their co-authored paper, The relationship between subjective wellbeing, low income and substance use among schoolchildren in the north west of England: a cross-sectional study, free for a limited time.