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Quality of Life
Author: Dr Michael Ellis 2006
More and more quality of life is judged in terms of wealth rather than
in terms of such immeasurable faculties such as happiness, creativity,
well being, generosity of spirit and a sense of compassion and
connectedness. Even the education system is focused on the needs of big
business and children are narrowly focused on aims which do not enhance
their health or create a wider knowledge of their understanding of
their place in society or the nature of life itself.
The basic needs of freedom of poverty expressed by such people as
Galtung, Rawls, Max-Neef and Lasswell and Maslow are not addressed for
people even in higher socio-economic groups ion the developed world.
Such needs would address the needs specifically for affection,
understanding, participation, leisure, creation, identity and freedom.
The society is so stressed that by 2010, one in three people will be
suffering from depression which psychiatrists consider needs medical
treatment by drugs. So we come to the brave new world of Aldous Huxley
where the workers are placed on soma to blunt their conception of what
freedom or real quality of life is.
Poverty and Culture
According to the UN Development Report, Australia is second only to
Norway as the most desirable country in the world in which to live.
This report of the UN Development program measures 162 countries
according to a range of factors such as life expectancy, education
levels, healthcare and income.
However, in this picture there is obviously no room for complacency.
According to research by the National Centre for Social and Economic
Modelling, University of Canberra for the Smith Family welfare
organisation in 1999, 1 in 7 Australians were living in poverty.
Those most likely to live in poverty were those on welfare, those with
three or more children, sole parents or the unemployed. The researchers
warned that the risk of poverty is greater for children than adults.
NATSEM estimated that 752,000 dependant Australians or 14.9% lived in
poverty in May 1999. Also, 12.9% of Australian adults lived in poverty
in May 1999.
Some of the things that cannot be measured by statistics is the concept
of culture. Culture is also dependent on quality of life and quality of
life is also dependent on health as well as education.
The Key To Culture
Often, the key to culture is found, not so much primarily in the early
experience of the child. It is dependent on pre-natal items as to the
kind of nutrition the mother has, the kind of experience she has
experienced during her pregnancy, the kind of relationships she has,
whether it is integral and stable or unharmonious. After birth, the
forms of child rearing, social stimulation, love and care are very much
significant as to the future child's happiness.
Our children are currently being born into a world which is threatened
by many, many factors, including those with adverse effects. The
factors the global community has to deal with in the next hundred years
are famine, global spread of disease, civil war, international wars,
competition for scarce resources, civil disorder amongst the haves and
have nots, housing shortages, and the highly materialistic ethos of the
possibility of human extinction.
Human beings have already changed the environment of the planet
radically and have caused many other bio-extinctions of other species.
If current trends continue the picture will get worse. The projected
extra six billion people in the next hundred years, predicted for 2020
would need more room to live and grow food. If there are more of us,
there is less room for plants and animals. There is less room for the
tropical rainforests and the planetary biodiversity of species.
Human beings are causing extinctions at 100-10,000 times the natural
rate. This is the greatest wave of extinction since the end of the
cretaceous period 65 million years ago when the dinosaurs were
annihilated.
Yet, politicians generally do not think in terms of large periods of
time or even the next generation. Perhaps the maximum term they can
think of is three years which may be the tenure of their political term
or contract.
The Economics of Happiness
This split between the more rational, the logical and the creative
approaches to economics is expressed also in the way quality of life
has been measured up until now. In his 1974 paper, the Economic
Historian, Richard Easterlin formulated what was later known as the
Easterlin Paradox. Basically above a very low level, economic growth
does not seem to improve human welfare. Later evidence confirms his
observation. Americans were no more likely to describe themselves as
happy in the 1990's than they had been in the 1940's.
Economist, Andrew Oswald at Waricks University, England in his paper,
'Happiness and Economic Performance', April 1997, stated that
industrialised well-being appears to rise as national income grows but
the rise is so small it is sometime undetectable and unemployment
however, seems to be a large source of unhappiness.
This suggests that governments ought to be trying to reduce the amount
of joblessness in the economy. In a country that is already rich,
policy aimed instead at raising economic growth may be of comparatively
little value.
In his most recent paper, Oswald was studying whether money makes
people happy. It showed that people who won lottery money or received
an inheritance had a higher mental well being in the following year. A
windfall of 50,000 pounds, was associated with a rise in well-being of
0.1 and 0.3 standard deviations. He ended by saying whether these
happiness gains wear off over time remains a good question.
It is interesting to see that the kind of parameters he was using was
dependent on the British Household Panel Survey which consists of
questions which could just as easily be asked by a GP on his patients
if the GP wanted to find out whether they were depressed or not.
They were also based on stress reactions and did not seem to be
measuring basic personality types, cultural acquisition, creativity,
levels of actualisation, educational attainment and other things.
Quality of Life and Culture
One thing we can say is that culture alters quality of life and that
that individual quality of life is enhanced by a person's ability to be
educated and be brought up in a warm, caring environment.
Within this context of mind and matter there are several papers which
are of interest. First it has been shown that the intellectual or
emotional development of children from the age of five to the
completion of high school is adversely affected by lack of social
capital. The social capital refers to unfavourable environments which
basically do not give care or support. The effect was specifically
noted in socio-economic deprived families, 'Pediatrics Volume 101 1998,
Children who Prosper in Unfavourable Environments, the Relationship to
Social Capital'.
Another study has found that dementia occurs at a much higher rate
amongst people with learning disabilities than it does amongst the
general population. This is independent of the association between
dementia and Downs Syndrome.
A further study examined the perception of parental caring obtained by
undergraduates relating to subsequent health over an ensuing
thirty-five years.
This was done on Harvard undergraduate men who participated in the
Harvard mastery stress study and the results show that subjects
identified in mid life as suffering from the common degenerative
diseases of Western society gave their parents significantly lower
ratings as perceived in terms of "parental care, loving and just and
share, hardworking, and clever," whilst in college.
It is obvious that intellectual stimulation and loving, caring support
from family, friends, and the community at large is extremely important
for the general well-being of the individual as well as for the
prevention of intellectual deficit later in life.
Globalisation
Globalisation on the free trade model of the neo-liberal Washington
consensus economics is colliding with local cultures natural economic
sovereignty, social customs and values, as well as traditional
agriculture, indigenous rights and the protection of biodiversity and
the environment. The fundamental issue is the very economic model
underlying today's Globalisation of technology, trades and markets. The
critics from many diverse perspectives agree that free trade doesn't
account for social and environmental costs and cultural disruption in
the price in traded goods and services will continue to cause more harm
than good.
The World Bank, the IMF, the US Government and the WTO still refuse to
recalculate prices and microeconomic indicators including the GDP to
include these social and environmental costs, which contribute towards
the deterioration of human life. Civil society movement groups
throughout the world are committed to the idea of preserving human
identity and enriching biological and cultural diversity.
Power of the Human Mind
Complex technologies have tremendous potential for harm. The most under
used resource on the planet is the human mind. Although we may have
finite resources, we have one infinite resource which is the human mind
and this faculty is the least understood aspect of humanity on the
planet, and should encompass the term bio-mind which means the complete
or self actualised human being.
Healing the Stressed Society
This has particular significance in terms of the pre-eminence healing
as an impact on creating a more successful, dynamic and sustainable
society, particularly in the Australian nation. If people can
understand the intimate connection between the mind and body they could
then realise how the power in each of us has the ability to affect not
only how we feel, but indeed how to affect the course and outcome of
illnesses.
Only recently in all medical schools in the Western world, the
connection between mind and body, that was the cornerstone of
Hippocratic medicine, was ignored. It was in the 1930's that Cannon
discovered the bodily fight and flight syndrome, a reaction to any
perceived threat by a living organism. Subsequently Canadian, Hans
Selye defined stress as the non-specific response of the body to any
demand. In the 1970's researchers began to understand the flight and
fight and stress responses were related to a variety of human disease
states and more recently with the work of George Solomon, Stanford
University, Robert Aider, University of Rochestor and Candice Pert at
John Hopkins, a new field has been mapped called psychoneuroimmunology
emphasizing the interconnection between the mind, brain and the immune
system.
George Engel a Professor of Medicine at the University of Rochestor,
has studied hundreds of patients with chronic disease over a period of
twenty years. He found that 70-80% of these people who had suffered
from heart attacks, cancer, stomach ulcers, ulcerative colitis,
multiple sclerosis, and other conditions had all experienced extended
periods of helplessness and times when they felt like giving up.
The vulnerability of the human being is found even at the earliest age.
Tiffany Field, and her colleagues at the University of Milan Research
Institute showed that premature infants who were massaged several times
a day for ten minutes demonstrated a 47% weight gain and were able to
leave the hospital six days earlier than other prems who received only
the customary hospital care. This saved the hospital costs of $10,000
per baby per day.
The Control and Moderation of Stress
In quality of life assessment therefore we have to understand that
control and moderation of stress is a prerequisite for people who wish
to live long fulfilling lives.
On top of this, what quality of life surveys have not addressed is
happiness and health. Happiness is not even touched in quality of life
assessments. A reference can be made to the poverty outline discussed
in the World Bank's dissertation and research on poverty. It is
interesting to see that in the context of physiological change,
humanity has barely moved out of bodily integrity.
Self Actualisation
The primitive physiological drives for survival for flight and fight
and hunger are the basic modus vivendi for most of humanity. What we
need to emphasise and encourage in the creation of culture are the
dynamic needs that Maslow so aptly describes in his dynamic hierarchy,
which are safety needs, belongingness and love, esteem and self
actualisation. Our current culture is a rapacious assault on people's
senses of a belief system of success at all costs, competition,
exploitation of people and environment.
Healing above all else in terms of mind/body medicine is the key to
creating a culture that is more sustainable and vital. A nation that is
actively involved in its own healing and thereby creating a unique
culture is more able to satisfy and enhance its creative needs.
Such a nation would be able to set an example to the rest of the world
in terms of its creative performance and economic success. The
ingredient is the development of a culture, which is based on
physiological happiness which then becomes the determinant for actual
self-actualisation both in terms of the individual and also in terms of
society. This reduction of stress will also save billions of dollars in
terms of the prevention of cardiovascular disease, cancer and other
degenerative diseases of western society.
The Healed and Creative Nation
From this point of view, the healer comes into focus as being a
significant player in the building of a knowledge and creative nation.
In this aspect everyone who comes to see a physician could be helped to
understand the emotional, environmental, work and social stresses that
contribute to their illness. They could be advised about proper
nutrition, exercise and taught relaxation techniques, self-hypnosis and
other appropriate strategies for self awareness, self regulation and
self actualisation.
Kofi Annan has recently talked about the ecological print of
unsustainability that humankind currently has on this planet. The
population is currently at 6,169,232,000, and increases at about 438
every ten minutes. "Humanity must solve a complex equation". Annan
said. "We must stabilise our numbers, but equally importantly we must
stabilise overuse of resources and ensure sustainable development for
all."
There are certain fundamental factors that need to be understood in
healing. These are:
1. The control of stress
2. Nutrition
3. Mastery of life, and control of destiny
4. Support of the community
These four factors are essential for the health and well being of the
individual in society.
Mastery of life also includes: challenge, participation, commitment and
control. It has been found particularly that when people are
challenged, whether they are small children or adults, they rise to the
occasion much more effectively if they are not spoon-fed.
A sense of involvement and participation in the community is another
form of healing as it empowers the individual. This is one of the
ideologies underlying the creation of development and parental centres
for children, in which children and parents work together in a process
which enables them to create unified families and a productive and
positive future.
The dominance of the market system has meant that the GNP does not
include environmental costs and benefits, or social indicators. A new
economics of sustainability should include such social indicators as
literacy, education, women's rights, crime, suicide health and illness.
The GNP does not reflect the way people feel about themselves, or
society. In this respect, we need a new index, which encompasses
quality of life and wellbeing for a nation in rapid transition and
renaissance.
References
| 1. |
Protection
and Damaging Effects of Stress
Mediators, McEwen B.S., New England
Journal of Medicine, 1998 |
| 2. |
Mechanisms
of Brain Development - Developmental
Health and the Wealth of Nations
- Cynader and Frost, Book 1999 |
| 3. |
Early
Years Task Force Study Report
for the Government of Ontario,
Canada -April 1998 |
| 4. |
Independent
Inquiries into Inequalities in
Health Report, London, The Stationery
Office, Nov. 1998. |
| 5. |
"A
Precarious Balance: Economic Opportunities,
Civil Society, and Political Liberty".
The Responsive Community Vol.
5., Issue 3, Summer 1995, pages
unnumbered |
| 6. |
"Investing
in the Future", World Bank
Conference on Early Childhood
Development, Atlanta, Georgia,
1996 |
| 7. |
The
Selected Works of Melanie Klein
and The Undiscovered Self, Carl
Jung |
| 8. |
Civilisation
and Its Discontents, Sigmund Freud |
| 9. |
Conclusions
About the Assessment and Management
of Common Mental Disorders in
Australian General Practice, School
of Psychiatry, University of New
South Wales, MJA, July 2001 |
| 10. |
Men's
Health Paper, Prof. Avni Sali,
Head of Graduate School of
Medicine, Swinburne University,
Victor
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