I recently listened to a radio show that got me thinking about something, which, to my knowledge, has never been explored.
We all know the famous phrase from the United States Declaration of Independence about the ‘inalienable’ rights of man; “Life, liberty and the pursuit of happiness”. However, some new research highlighted in the aforementioned radio programme argued that the act of constantly pursuing happiness can actually make us less happy! The UK government is now pushing the ‘happiness’ issue more than ever. As many a health economist has argued (Dolan, Gandjour, Brazier), the line between happiness and good health is extremely blurry. This made me think…
In the pursuit of good health, do we become any healthier?
Now, in this question I am referring only to the pursuit of good health on an individual level; I am not questioning the value of promoting public health. In eating healthily, doing more exercise, brushing our teeth and generally trying to get a flat stomach, is the average person likely to gain anything? I believe the ‘blur’ between good health and happiness to be largely made up of mental health. Do we actively pursue good mental health? I think not – many of our day-to-day activities are very stressful, tiring, and leave us little time for dealing with our emotions. It seems possible (maybe probable) that the pursuit of good (physical) health could actually be damaging to our mental health. Failure to achieve goals and expectations, for example, could be very damaging to an individual’s self-esteem.
I believe that this is something which could be tested quite easily (I may do it myself one day). The British Household Panel Survey, for example, includes a question on satisfaction with health. It seems safe to assume that if one is dissatisfied with their health then they will be seeking to become satisfied with it. This could then be compared with measures of health and well-being and examined longitudinally to see if those who go from being dissatisfied with their health to being satisfied actually have any significant gain in health over and above those who remain dissatisfied. Data on physical activity and diet could also be incorporated. I’m sure that, with extra thought, more robust methods could be figured out; I am just floating the idea.
If this is the case then surely it would have serious implications for health economics and public health more generally.
Please share your knowledge on this topic in the comments box below. If you know of any relevant literature then please discuss.
I would disagree, as far as I’m concerned you can never be too healthy and am always seeking to improve it whether by exercising or eating better or brushing ones teeth. So in answer to your question, am I satisified with my health? I would probably answer ‘yes’ because i compare it to those around me and know it could be worse, does this mean i don’t want to be healthier, no it doesn’t.
I think my worry is the conclusions that you may try and draw from such a study and their validity. It would be all too easy to conclude (if what you described showed it) that exercise etc leads to a reduction in mental health, however by excluding people like myself you would be excluding a vast amount of individuals who have exactly the opposite effect and as consequently distorts the results. I.e. Poor conclusion validity.
Fair enough, but this is only a criticism of the suggested methodology – not the actual point of the argument. So, the question remains: in your pursuit of better health, do you get any healthier?
I think possibly not. And even if you do I don’t think we can assume that the same applies to everybody. In attempting to convince everybody that they can improve their health, public health bodies (and society in general) DO make this assumption. I don’t think it’s a safe assumption. For the reasons expressed above.
As a side note – I think you miss the point about people like yourself dropping out of the analysis. We wouldn’t be looking for the average effect of exercise, we would be investigating whether the pursuit of good health CAN be damaging to one’s health. Therefore we wouldn’t be that interested in people like you. Though if anything, the fact that you are satisfied with your health and yet you still seek to improve your health (with no hope of increasing your satisfaction further), demonstrates one example of how striving for better health may not be worthwhile. The consensus in health economics is that there is such a thing as ‘full health’. By definition those in full health cannot get any healthier – no matter how much effort they exert.
I’ve just had a quick read of this and would like to make a couple of points. Firslty, hirnic has raised some very good methodological points and I think identifying what exactly you are trying to measure and defining the research question would be critical for such an analysis and I’m not sure if the BHPS would be able to satisfactorily do this. On a more personal level as someone who does ‘enjoy’ exercise, I would argue that the lines are once again blurred. I generally think you get two types of people who exercise, those who exercise for health and enjoyment, and those who exercise for health. For example, personally I love exercise, not only does it improve my health but at the end of a hard day it acts as a great stress relief and clears the brain. We all have heard about endorphins and “runner’s highs” etc. Hence I enjoy exercise and I enjoy getting healthier. The other type is the person who exercises not because they enjoy it, but they know they should (or wants to lose weight etc) and every exercise session takes an enormous amount of motivational effort. You could argue that these people are the ones you’re interested in as they want to get healthy, but I assure you I also have the side goal of maximising health. So how does this fit into your blog post, well for the first type of people like myself I think it is very beneficial for my mental health, anything that relieves stress (which exercise is shown time and time again to do) has got to be a good thing for mental health. For the second non-enjoy exercise types you may well see worsening mental health due to lack of motivation and stress as a result of not meeting targets or not losing enough weight etc. However I’d guess this would be offset by the endorphins released when exercising leaving no overall effect. Whatever the results of such a study I think it would be very difficult to generalise due to the inherent differing preferences of individuals and many caveats would be needed. E.g. for those who don’t enjoy exercise, exercising can reduce mental health etc. All in all I’m not sure how you could differentiate between these two different groups using the BHPS.
Apologies for the convoluted comment, that’s what happens if you don’t plan what you’re going to write!
I think differentiation between the two groups would be quite easy.
Those like yourself who “enjoy” exercise, and thus by definition gain from it, I would expect to already be satisfied with their health (or at least already have a good level of health). They may be seeking to improve it further but I believe this is more about maintaining a good state of health than improving it.
An analysis of satisfaction with health would therefore cause people like yourself to drop out of the group of interest. We would only be looking at those who enter the analysis with a low satisfaction with their health, or those who go from doing no exercise to doing some – it seems the average regular exerciser would not fall in to this category.
I agree, but defining mental health and the activities that constitute ‘healthy mental behaviour’ is a real challenge here.
‘Healthy eating’ – everyone (generally) knows what that means. But what is healthy thinking? or Mental care?
Add to this the stigma (from some people’s perspective) associated with yoga/meditation/spiritual/soul activities.
What is an evidence based, somewhat simple, criteria that defines healthy mental behaviours (or should it be mental fitness?)