What do we mean by wellness? I think there are four measures of wellness and recent research, as Professor Boden-Albala says, shows that we are getting less well by all of them.
“We are as a society becoming less well. By whichever index you care to judge the matter the result is the same.” NYU Prof. of Epidemiology Bernadette Boden-Albala
Let me first set out the ways in which, in my view, wellness should be judged.
- Physical health: This is not just the absence of biological disease, but also the challenges to our fitness and longevity brought on by lifestyle choices or circumstances.
- Mental health: This is more than not having a particular psychiatric disorder but also the amount of stress that we’re under which can have powerful negative effects on our psychic and physical immune system.
- Spiritual health: Perhaps the most neglected aspect of wellness. This is not just the decline of religion, but a whole range of aspects of our DNA and our neurophysiology which have to do with not just belief, but the ability to meditate, to be “mindful,” to switch off from the stress of the world — to lose ourselves in something other than ourselves. We have become a society of narcissists and materialists, which is the opposite of what we were designed to be.
- Social health: We are social beings, relationship-forming animals. Our genetics dictate that we must have certain kinds of relationships in order to be “well” in any sense of the word. We need to belong to a mutually supportive tribe in order to really feel safe. And without safety there can be no wellness for a human being.
I am a scientist and a psychologist. I study the biological and psychological underpinnings of human behaviour and I strive to take practical lessons from the vast body of research that has recently taken place in the fields of biological psychiatry, behavioural neurogenetics, neuroscience and other related fields. We know so much more about the kind of creatures we are now than we knew, say, 10 years ago and we literally find out more every day.
The interesting thing that almost all new research shows us is that the indices of wellness are pointing downward.
The major argument from those who say that we are becoming physically healthier has always been our increasing longevity. It’s a flawed argument because longevity doesn’t necessarily equal physical health. It’s true that over the past 100 years our life span has gone from an average of 48.4 years to almost 80 in the US and other Western countries. But this may now be reversing and in a number of them this metric is falling off — the longevity of the average American, for example, is actually declining. Much of this is due to the evils of increased opioid use, suicide among white middle class men and women, a rise in the rate of heart disease, and obesity, especially among the young.
Mental health is also declining. Since the 1980s, according to both the WHO and the NIH depression has been rapidly increasing. Much of this is due to the alarming increase in workplace stress. A study by the Hudson Institute — the futurist think-tank founded by Herman Kahn — has shown that between 2010 and 2020 work stress will have increased by 200 per cent. Autism is on the increase as are post-traumatic stress disorder, panic disorder and generalised anxiety disorder. Studies have shown that something like 80 per cent of all visits to doctors' surgeries and an almost equal number of hospital admissions can be put down to problems which have no biological origin.
Despite the popularity of meditation, mindfulness and other forms of spirituality, overall our spiritual health has been rapidly declining. We are hard-wired both in our genome and in our neurobiology for spirituality. In order to be mentally healthy we need to have a sense of the transcendent. This can take many forms from organised religion (many studies have shown that church or synagogue goers live longer and are healthier than non-attenders), meditation, tai chi or a vast number of other forms of spiritual exercise. The sad truth is that now perhaps a majority of us practice none of the above.
As to our social health — our ability to form meaningful, mutually supportive, relationships — this has suffered the worst decline of all and this exacerbates the problems in all of the other areas of wellness. Recent studies have shown that without a nexus of supportive people around us our system prepares to die. Part of the problem lies with social media and the disconnection that it has brought in terms of real rather than virtual and essentially meaningless “connections” and part is due to the decline of the church, workplace, neighbourhood and other “tribes” that humans used to belong to. It is also due to the decline in parenting skills as social psychologist Jean Twenge has observed. Gen M — or iGen as she calls it — has more anxiety and depression than other generations and is far less able to cope with the challenges of life. To cope you need supportive relationships and a tribe to belong to. Mostly iGen has neither.
This is not to say that all is lost, far from it. In all of the ways in which wellness can be measured, science is also providing us with answers — if we have the patience and the political and social will to make the changes needed.
My objective going forward is to point out the ways that we are dangerously exceeding our design specs and highlight the practical ways that science is showing us to regain our wellness — and our essential humanity.