Time to extend ‘a visible helping hand’
| Pages | 16-18 |
| Published date | 01 December 2004 |
| Date | 01 December 2004 |
| DOI | https://doi.org/10.1108/17465729200400024 |
| Author | David McDaid |
| Subject Matter | Health & social care |
journal of mental health promotion •volume 3•issue 4 •december 2004 © Pavilion Publishing (Brighton) Ltd
Time to extend ‘a visible helping hand’
ABSTRACT
Adam Smith was wrong: the new economics foundation is right: economic prosperity does not of itself bring enhanced individual and social
well-being. Indeed, it carries a significant downside. But implementing the nef manifesto would be no easy matter. In this short commentary,
David McDaid outlines some of the hurdles and pitfalls that would have to be negotiated.
David McDaid
Research fellow
LSE Health and Social Care
London School of Economics and Political Science
Commentary
The central argument of the nef well-being manifesto is
that far too much emphasis is placed both on the
narrow pursuit of income by individuals and on
economic growth. It argues that well-being is
dependent on many other factors, including
upbringing and genetic make-up, neighbourhood and
environment, social networks, friendships and
meaningful work with job security.
This message is timely, and consistent with other
recent reports on more holistic approaches to the
promotion of well-being and the prevention of mental
disorders (WHO, 2004). It also recognises that the
conventional economic wisdom on the links between
health and economic growth may,in fact, serve to
divert attention from policies that are more beneficial
to the promotion of well-being.
These limitations of economic analysis in measuring
life satisfaction areincreasingly recognised (Easterlin,
2003). Mainstream economics (based on revealed
preference theory through observed individual
behaviour) has assumed that any increase in income is
consistent with an improvement in satisfaction or well-
being, as individuals will engage in those activities that
maximise their well-being.
Yet there is a growing body of evidence from
psychologists, sociologists and even some economists all
across the world that the pursuit of income is but one,
minor factor contributing to our overall levels of well-
being. Increased income does not lead to much, if any,
increased happiness, as individual aspirations also
increase. There is also growing evidence that individuals
do not adapt fully to adverse changing circumstances
that may be associated with increased income.
Thus there is a need consistent with the well-being
manifesto to moveaway from putting the emphasis
solely on growth in GDP in formulating macro-
economic policy. A more holistic approach to health,
and mental health in particular, is also required, given
that many of the determinants and consequences lie
outside the health sector. Too often in the past policy
approaches in most developed countries, not only for
mental health but also for health more generally, have
focused on a narrow illness model, with little attention
paid to addressing the broader determinants and
consequences of poor well-being. The manifesto,
however,argues for going even further – using ‘visible
helping hand’ policies to influence individual behaviour
on issues such as the work–life balance.
Atfirst glance this might be seen as interfering with
an individual’s freedom to choose how they live. If an
individual makes a fully informed choice then, from an
economic perspective, the case for some of the actions
outlined in the manifesto is somewhat weakened.
However it is difficult to argue that these choices are
fully informed. Economists’ faith in Adam Smith’s
‘invisible hand’ – the belief that the pursuit of individual
self-interest will lead to enhanced well-being for all – is
too simplistic. Individuals seem unable to take into
account that any gains in income may be offset bytheir
increasing aspirations. This may lead them to devote a
higher share of their time and resources to the pursuit of
the pound than may be efficient. Undoubtedly thereis
an economic case for action in each of the eight areas
outlined in the manifesto.
For instance, improving the knowledge and
measurement of well-being is of particular importance
as it may allowsociety to allocate resources to address
particular high-risk groups. This is especially pertinent
when thinking of mental health, where poor well-being
can havesevereconsequences. Evidence from Finland
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