The Rise of Well-being in Public Health
GHH seminar at WHO Regional Office for Europe, Copenhagen
Report on the event from 7th November, 2014
Dr. Claudia Stein is the Director of the Division for Information, Evidence, Research and Innovation at the World Health Organisation’s Regional Office for Europe and she is a director with a passion for well-being. The WHO’s own definition of health, enshrined in the constitution of 1948, emphasised a positive understanding: ‘a state of complete physical, mental and social well-being and not merely the absence of disease’. Despite this holistic conception and the declarations of Alma Ata on primary health care and of Ottawa on health promotion, sustaining such a vision of health has proved difficult. However, recent years have witnessed a re-assertion of this vision and a re-invigoration of the concept of well-being. From the World Health Assembly’s endorsement of well-being as a key outcome through the work of Dr. Stein’s Division in examining indicators and the cultural determinants of well-being to the experiences and practices of its member states, the WHO is renewing its commitment to health as being well rather than simply not being ill.
As part of this renewed engagement with well-being, Dr. Stein’s Division at the WHO Regional Office for Europe hosted a dedicated Global Health Histories Seminar to well-being in November. The seminar comprised four presentations: two by academics; two by WHO staff. The seminar was live-streamed and accessed by over 135,000 ‘accounts’ and is now accessible here.
Mark Jackson is professor of history at the University of Exeter. His presentation drew on his historical study of stress in the Twentieth Century which provides insights into how wellbeing is similarly conceived. In particular, the historical trajectory in understanding stress discloses a move towards an emphasis on the individual and illustrates the contingent nature of both understanding and experiencing stress.
Sarah Atkinson is professor of geography and medical humanities at Durham University. Her presentation unpicked the assumptions underpinning the dominant approach to wellbeing and how this informs policy. Drawing on social theory, other approaches are also possible that suggest different approaches to how to enhance wellbeing with a greater emphasis on the relational processes through which wellbeing emerges as a situated effect.
Claudia Stein summarised the work that the WHO has achieved through consultation with member states whilst also describing the distance still to be travelled to make well-being an outcome of primary concern across the region. Her division are reviewing existing schema, the potential of a life-course approach and the importance of cultural factors in understanding and determining well-being.
Agis Tsouros, the Director of the Division of Policy and Governance for Health and Well-being at the WHO Regional Office for Europe, drew attention back to the different member state countries as the starting point for brokering ideas. The challenge for those working for WHO with the member states is to capture what is new and promising from the different deliberations on well-being and develop those approaches that can make real differences to real lives.
Questions from the floor and by twitter from those watching the live-stream and the discussions they provoked addressed a range of critical contemporary challenges in developing a well-being agenda. These included questions such as: How can any assessment of well-being deal with the invisibility of those who are most vulnerable, that is those outside of any formal system, such as trafficked sex workers? What are the relations between various forms of social media and well-being or happiness? What are the relations between well-being and ageing and how might this vary across different settings?