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.
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.
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 way 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
maybe 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 employment 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 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, Quote
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 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.
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 premature babies 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 Banks
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.
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 peoples 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
over use 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.
| 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 |
