Mental health and blood pressure are a better indicator of happiness in European countries than economic performance, according to research co-authored by a member of the Bank of England's interest rate-setting Monetary Policy Committee.
The authors say that a modern statistical literature argues that countries such as Denmark and Ireland are particularly happy while nations like East Germany are not. Are such claims credible, they ask? In a paper published this month, they explore the issue by building on two ideas. The first is that psychological well-being and high blood-pressure are thought by clinicians to be inversely correlated. The second is that blood-pressure problems can be reported more objectively than mental well-being.
Using data on 16 countries, the paper finds that happier nations report lower levels of hypertension. The authors say that the paper’s results are consistent with, and seem to offer a step towards the validation of, cross-national estimates of well-being.
A review of 16 European countries found that nations that regarded themselves as happy reported lower levels of hypertension. People in Sweden, the Netherlands, Denmark, the UK and Ireland had the fewest blood pressure problems, while those in Portugal, Germany, Italy and Finland were among those with the most.
The paper also looked at the quality of mental health in European countries and found similar results - those countries reporting the worst psychological health included Italy, former east Germany, Greece and France, while those with the best mental health were led by Denmark, the Netherlands, Sweden and Luxembourg.
"Happy countries seem to have less hypertension. This has a number of implications. First, it suggests that there may be a case to take seriously the subjective ‘happiness’ measurements made across the world: they follow a pattern like the (inverse of) high-blood-pressure estimates. Second, in constructing new kinds of economic and social policies in the future, where well-being rather than real income is likely to be a prime concern, there are grounds for economists to study people’s blood pressure. Third, the paper’s findings are relevant to our understanding of what (researchers) describe as a global epidemic of high blood pressure," according to the paper, by David Blanchflower, Professor of Economics at Dartmouth College, New Hampshire, USA and MPC member, and Andrew Oswald, Professor of Economics at UK's Warwick University.
The World Health Report 2002 identified hypertension -- one definition is blood pressure above 140/90 mmHg -- as a major determinant of disability-adjusted life years; WHO estimates that 1 billion people live with hypertension.
"Psychological health cannot be measured easily but it is high in Denmark and low in [former] East Germany and this, at some still poorly understood level, is what connects the observed data on happiness and hypertension," the authors say.
The paper, based on a 2001 Eurobarometer survey of 15,000 people, is part of the quest by academics involved in happiness economics to try to understand what social and economic policies should be designed to give people a greater sense of well-being, particularly in developed economies where the link between economic growth and happiness has broken down.
While, people in richer countries tend to be happier than those in poorer ones and economies sufficiently developed to provide most people with a reasonable standard of living, higher economic growth is not generally reflected in an increased sense of well-being or happiness.
The authors say that while countries like Denmark, Ireland and the Netherlands are particularly happy and nations such as Germany, Italy and Portugal are less happy, yet it is arguably implausible that words such as ‘happiness’ or ‘satisfaction’ can be communicated unambiguously and in exactly the same way across countries, so it is not easy to know whether such cross-national well-being patterns are believable.
It is argued that the persuasiveness of the paper rests on three assumptions:
(i) it is reasonable to treat survey evidence on high-blood-pressure problems as a proxy for objective hypertension;
(ii) people report high blood-pressure in a more objective way than they report levels of happiness;
(iii) the patterns in Figures 1 and 2 are not merely the product of something special to this sample of nations.
It might be conjectured that the paper’s conclusion is potentially illusory and a product of the fact that an inherently cheery nation will be optimistic about everything. However, it is not easy to believe that someone told by their doctor that they have a condition of high blood-pressure will have an incentive to conceal or misreport that. For researchers, the attraction of a blood-pressure question in surveys is that, because it relies on medical opinion given to the individual, it seems valuably different in character from conventional subjective well-being questions.
The mental health questions, known as a general health questionnaire, included such questions as:
1. Lost much sleep over worry?
2. Felt constantly under strain?
3. Felt you could not overcome your difficulties?
4. Been feeling unhappy and depressed?
5. Been losing confidence in yourself?
6. Been thinking of yourself as a worthless person?
The authors say that the cross-country pattern in mental distress was consistent with those found in happiness, life satisfaction and hypertension.
While the paper did not provide answers for the difference in happiness levels between European countries, Professor Oswald said there appeared to be a link between insecurity and unhappiness. The generous social security systems operated by countries such as Denmark, which routinely tops happiness surveys, and some of the Nordic nations, appear to help diminish insecurity and fear, he said.
"A poor social security net is correlated with lower country happiness.
"Italy, for example, has relatively ungenerous unemployment insurance for workers," said Oswald. "Denmark and the Netherlands are famously kind to disadvantaged citizens, so it is very reasonable to explore the social security framework."