1、Defining Wellness PolicyNovember 2022Wellness Policy SeriesDefining Wellness PolicyNOVEMBER 2022Copyright 2022 by the Global Wellness InstituteQuotation of,citation from,and reference to any of the data,findings,and research methodology from this report must be credited to“Global Wellness Institute,

2、Defining Wellness Policy,November 2022.”For more information,please contact researchglobalwellnessinstitute.org or visit www.globalwellnessinstitute.org.Contents Preface1I.Why Do We Need Wellness Policy?3Introduction3The wellness movement has brought a lot of benefits to the world.5Expenditures on w

3、ellness are positively correlated with happiness and life expectancy.7Powerful macro forces are shifting wellness from a consumer movement to a policy imperative.9Wellness policy can be a unifying force for existing movements to improve human health and well-being.10Why should governments care about

4、 wellness policy?16Why should the private sector care about wellness policy?19The time to act on wellness policy is now.22II.What Is Wellness Policy?25Defining wellness.25Wellness policy 101.27Wellness policy:Three levels of action.29Wellness policy complements health and public health policy.30Well

5、ness policy supports well-being and happiness policy.31Wellness is a lens to reshape public policy and work toward well-being.33Wellness policy focuses on seven domains that affect both individual behaviors and supporting environments.36Who is responsible for wellness policy?39Acknowledgements41Indu

6、stry Research Sponsors43About the AuthorsAbout the Global Wellness InstituteThe Global Wellness Institute(GWI),a 501(c)(3)non-profit organization,is considered the leading global research and educational resource for the global wellness industry and is known for introducing major industry initiative

7、s and regional events that bring together leaders and visionaries to chart the future.GWI positively impacts global health and wellness by advocating for both public institutions and businesses that are working to help prevent disease,reduce stress,and enhance overall quality of life.Its mission is

8、to empower wellness worldwide.www.globalwellnessinstitute.orgAbout the AuthorsDefining Wellness Policy was prepared by Ophelia Yeung and Katherine Johnston,with assistance from Tonia Callender.As Senior Research Fellows at the Global Wellness Institute,Ms.Yeung and Ms.Johnston bring decades of resea

9、rch and strategy experience in the public and private sectors to pioneer groundbreaking methodologies in measuring the size of the global wellness economy.Their academic and professional background is in public policy and international development.Ms.Callender,Research Fellow,contributed research ex

10、pertise in multiple wellness sectors.Statistical analyses were conducted by Dr.Shun Wang,KDI School of Public Policy and Management,Republic of Korea.Defining Wellness Policy|1PrefaceWhy this report?Since its inception,the Global Wellness Institute(GWI)has embraced the vision of“empowering wellness

11、worldwide.”Even as we study and advocate for the$4.4 trillion wellness economy,we also recognize that the private wellness market and consumer action alone cannot bring about wellness for all.Widespread adoption of preventive approaches and healthy lifestyles is essential if we are to address our mo

12、unting global health crises and spiraling economic costs.And yet,not everyone has the resources,motivation,knowledge,or enabling environment to do so.Public policy is essential to fill these gaps.This realization is the genesis of this report and the forthcoming GWI Wellness Policy Series.What is in

13、 this report?Defining Wellness Policy is the first-ever study to define wellness policy and argue for why it is needed.Using GWIs wellness economy data,the report provides,for the first time,a quantitative analysis showing the relationships among wellness spending,happiness,and health outcomes acros

14、s countries.It makes a compelling case for why wellness policy is essential not only for governments,but also for businesses.The report situates wellness policy in the context of several major global movements that have been working toward improved human health and well-being.It articulates how well

15、ness policy can complement public health and health policy,as well as support the happiness/well-being policy efforts that are gathering steam in different parts of the world.Who is this report for?If you are a government leader,this report will make the case for why wellness policy is crucial for y

16、our citizens health and well-being(whether your country is ready to reorient national priorities toward well-being or not).If you are a policymaker or public servant,this report will provide ideas on how you can advance the cause of wellness,working within existing policy siloes,departments,and fund

17、ing structures.If you are a private business or nonprofit,this report shows why you should care about wellness policy,become an advocate,and partner with governments and communities.If you are a concerned citizen or community member seeking to advocate for wellness,this study provides the framework

18、and compelling evidence to make your case.What next?This report sets the stage for a series of Wellness Policy Toolkits,to be released by GWI in 2023.The toolkits will address seven domains of wellness:physical activity,healthy eating,mental wellness,traditional and complementary medicine,wellness i

19、n the built environment,wellness at work,and wellness in tourism.Each toolkit will address both the why and how of wellness policy:What is the rationale and need for wellness policy action in each domain?How can stakeholders(governments,businesses,communities,nonprofits)take action to address import

20、ant issues and gaps?This report and the toolkits are intended to be just the beginning of a cross-cutting,global conversation.We hope that they will spark a wellness policy movement that can be championed by any interested stakeholder groups.2|Global Wellness Institute:Wellness Policy SeriesDefining

21、 Wellness Policy|3I.Why Do We Need Wellness Policy?IntroductionWellness is a powerful consumer movement and a growing force in the global economy.Prior to the pandemic-induced downturn,the wellness economy and its component sectors consistently grew faster than global GDP over the last decade,peakin

22、g at$4.9 trillion(or 5.6%of global GDP)in 2019.1 The rapid rise of consumer spending on all things related to wellness has attracted widespread attention of media,businesses,investors,and,increasingly,the health sector all of whom are interested in opportunities to grow the wellness economy and thei

23、r share in it.In a world that has not yet emerged from the COVID-19 pandemic,and that continues to face economic volatility,it is time to step away from the hype of wellness as a consumer trend and a business investment opportunity.The impact of the pandemic on wellness has been complex.It temporari

24、ly put a pause on many wellness services,businesses,and activities,while simultaneously accelerating our interest in self-care,prevention,and immunity.We are grappling with the massive failures of public health systems,millions of deaths,and widespread suffering,while also recognizing the critical i

25、mportance of healthy lifestyles,personal resilience,community support,and social safety nets.In the midst of these complex forces,we now face many important questions related to the future of wellness and the wellness economy.Wellness efficacy:Is all of this spending actually making people well?When

26、 we are spending trillions of dollars on wellness,why do the rates of chronic disease and related health expenditures also continue to rise unsustainably?Are our wellness dollars spent on the right things?Who benefits from this spending?Wellness equity and justice:Is wellness a right or a privilege?

27、Why does wellness continue to feel so white and rich and exclusive?What about those who dont have the money or time to spend on wellness?Wellness of people and planet:Can we be well if the planet is not well?Can humankind stay healthy if our air,water,and soil are poisoned and our biodiversity is de

28、pleted?How can we feel physically and mentally safe when we are threatened by weather shocks and climate change?The Global Wellness Institute(GWI)has always advocated for“wellness for all.”Unfortunately,there is still a large gap to fill before there is universal access to wellness when everyone who

29、 desires a healthy lifestyle knows how to live it,is motivated and empowered to do it,and lives in an environment where they are enabled and supported to do so.Public policy has a critical role to play in moving us closer to the goal of wellness for all.1 Yeung,O.,and Johnston,K.(2021).The Global We

30、llness Economy:Looking Beyond COVID.Miami,FL:Global Wellness Institute.https:/globalwellnessinstitute.org/industry-research/the-global-wellness-economy-looking-beyond-covid/.4|Global Wellness Institute:Wellness Policy SeriesIn this Wellness Policy series,GWI aims to build a common language,framework

31、,and set of strategies for governments,industry,and communities to collaborate and work toward the goal of wellness for all.This report,Defining Wellness Policy,sets the stage by articulating what wellness policy is and establishing the case for why it is so important,not only from a public health p

32、erspective but also for the wellness economy and its related business and consumer interests.When we talk about policy,the implication is that we are speaking to governments,but this series is not just for government stakeholders.Policies to advance the cause of wellness for all require the attentio

33、n,participation,and cooperation of public,private,and nonprofit/community stakeholders.In fact,the separate development streams and“siloes”across consumer/business wellness,public health systems,and preventive health/medicine have impeded us from making greater strides toward this goal.This definiti

34、onal report will be complemented by seven policy toolkits(forthcoming in 2023),each covering a separate domain of wellness(see table below).Wellness Policy Domains Covered in GWIs Wellness Policy SeriesWellness Activities and LifestylesWellness-Supporting Environments Healthy Eating Physical Activit

35、y Mental Wellness Traditional&Complementary Medicine Wellness in the Built Environment Wellness at Work Wellness in TourismEach toolkit will address both the why and how of wellness policy:What is the rationale and need for wellness policy action in each domain?How can stakeholders(governments,busin

36、esses,communities,nonprofits)take action to address important issues and gaps?Within the seven domains,we also address the wellness needs of specific populations and lifespan groups,including underserved and vulnerable groups such as children and seniors,wherever relevant.This report and the toolkit

37、s are intended to be just the beginning of a cross-cutting,global conversation about wellness policy and how it can be pursued.Much more work needs to be done in wellness policy to ensure that it is embedded in all policymaking and government investment decisions.We hope that this Wellness Policy se

38、ries will spark a wellness policy movement that can be championed by any interested stakeholder groups.We invite all stakeholders in the public,private,nonprofit,and academic communities to join in this movement.Defining Wellness Policy|5The wellness movement has brought a lot of benefits to the wor

39、ld.The explosion of wellness in the economy has generated an ever-increasing array of criticisms of the“wellness-industrial complex.”Critics complain about wellness businesses preying on consumer fears to make a profit,and they attack celebrity influencers for peddling“snake oil”and false promises w

40、ithout any scientific evidence of safety or efficacy.In many cases,these criticisms are well-warranted.But amidst all of the fads and trends and hype around commercialized wellness,we need to remember that the wellness concept and global wellness movement are not rooted in selling things or making m

41、oney.The core of wellness is a holistic,multi-dimensional,and proactive approach to health and well-being.Beyond the significant economic activities it has generated,the modern wellness movement has brought its share of good to the world over the last decade.Embracing holistic health.The concept of

42、health as holistic dates back thousands of years,but this understanding was largely lost in developed and Westernized societies with the advent of modern,evidence-based medicine.The modern wellness movement has revived and popularized among mainstream consumers an understanding of their health as be

43、ing holistic,multidimensional,and interconnected.For example,when people are asked why they visit the gym or take exercise classes,they are now just as likely to mention the mental and social benefits as they are exercise.Mainstreaming traditional modalities for prevention and self-care.Many of the

44、practices and products that we associate with wellness today e.g.,meditation,yoga,herbal supplements,plant-based medicines,spirituality,looking to nature for healing,psychedelic mushrooms date from ancient times.Most were considered fringe or“woo woo”in Westernized societies until they were embraced

45、 and mainstreamed by the wellness movement.Even in their countries of origin,many traditional healing practices had fallen out of favor among younger generations,until they were modernized and brought back by the wellness industry(e.g.,TCM in China,Ayurveda in India).The increasing popularity of anc

46、ient and traditional wellness practices has greatly expanded our understanding of self-care and strategies to improve resilience.It has also forced the scientific and medical communities to take a new look at traditional healing modalities and their scientific efficacy for both prevention and treatm

47、ent purposes.Increasing consumer choice and business innovations.The desire for healthier lifestyles and for alternatives/complements to allopathic care has spurred demand for new wellness services,products,practices,and businesses.The wellness market is driven by personal agency;the desire for choi

48、ces;experimentation with ancient and new modalities;and a delivery that meets the need for convenience,customization,privacy,and access.This dynamic environment has stimulated countless new business innovations,research,investments,and products/services,mostly to the benefit of consumers.Everyone wa

49、nts and needs something different when it comes to their personal wellness,and the wellness market provides an ever-expanding array of options to meet those needs,as well as the opportunity to scale and expand services and access for different populations.6|Global Wellness Institute:Wellness Policy

50、Series Destigmatizing mental health.Wellness is not only about preventing disease,but also about moving toward a higher state of health and well-being across many dimensions(physical,mental,social,etc.).The mental dimension of wellness,in particular,has received increased attention during the pandem

51、ic.Rather than just coping with or stigmatizing mental health conditions,mental wellness helps shift our focus toward a more positive and empowering approach.It highlights the pervasiveness of stress and social isolation,the importance of resilience,the value of finding purpose and meaning,and the n

52、eed to build social connections.This increased awareness helps to build understanding,compassion,and support toward shared human conditions,no matter what our mental health challenges might be.Moving from“sick care”to prevention.Research has shown that 80-90%of our individual health outcomes are det

53、ermined by environmental,socioeconomic,and lifestyle factors(also known as the social determinants of health).2 Healthcare systems have little influence on the social determinants that so heavily influence our health and longevity.Currently,our healthcare systems are primarily“sick care”systems,emph

54、asizing diagnosis and treatment of illness and injuries,while doing a very poor job at prevention.The wellness movement has raised awareness of the shortcomings of our“sick care”model and the importance of self-care and community care approaches,emphasizing prevention and health-enhancing practices.

55、This shift can potentially help more people live longer and healthier lives while lessening the costs on our overburdened healthcare systems.Building pathways for sustainability and health equity.The modern wellness movement may have started out as a self-centered approach for individuals to pursue

56、healthier and happier lives,but it is steadily evolving from a personal aspiration toward a recognition of our connection to the collective.Increasingly,we are recognizing that our individual health and well-being are inextricably linked to the well-being of other people,our communities,and the plan

57、et.We cannot be truly well if we confine our existence to a personal wellness bubble.For example,people are now asking important questions about their neighborhoods and living environments:Is our indoor and outdoor air safe to breathe?Why dont we have good public spaces to socialize or to exercise?A

58、 growing segment of consumers is shifting from a“me”to a“we”perspective about wellness:How can people be healthy if they cannot afford healthy foods?Why is there so little green space in poor neighborhoods?Is the person doing my massage or serving my food treated fairly at work?As these perspectives

59、 evolve,the wellness movement is bringing sustainability and health equity issues closer to home.2 Magnan,S.(2017).Social Determinants of Health 101 for Health Care:Five Plus Five.NAM Perspectives.Washington,DC:National Academy of Medicine.https:/nam.edu/social-determinants-of-health-101-for-health-

60、care-five-plus-five/.See also:Hood,C.M.,et al(2016).County health rankings:Relationships between determinant factors and health outcomes.American Journal of Preventive Medicine,50(2),129-135.https:/doi.org/10.1016/j.amepre.2015.08.024.Defining Wellness Policy|7Expenditures on wellness are positively

61、 correlated with happiness and life expectancy.As spending on wellness continues to grow,it raises many important questions.Is a growing wellness economy a good thing?Who is benefitting from the trillions of dollars spent on wellness every year?Is this spending even making people well?Does it improv

62、e our health or well-being?To shed light on these questions,GWI collaborated with a key author and statistician of the World Happiness Report3 to examine the relationships among wellness spending,happiness measurements,and health outcomes.Utilizing data from GWI,Gallup,and the World Bank,and adjusti

63、ng for population size and wealth level,the analyses led to some key findings.Regression analyses show that,across countries,for every$844 increase in wellness economy per capita,the average happiness level increases by nearly 7%.Furthermore,an increase of$769 in wellness economy per capita is assoc

64、iated with 1.26 years of extra life.The results are statistically significant at the 1%level.These results indicate that wellness spending across countries is strongly and positively correlated with both health and happiness(see box below for details).Correlation does not mean causation,so we cannot

65、 definitively say that wellness spending caused happiness levels to rise or life expectancies to increase.Nonetheless,these important results signal that there are health and well-being benefits from wellness spending.3 Helliwell,J.F.,Layard,R.,Sachs,J.D.,De Neve,J.-E.,Aknin,L.B.,and Wang,S.(Eds.).(

66、2022).World Happiness Report 2022.New York:Sustainable Development Solutions Network.https:/worldhappiness.report/ed/2022/.WELLNESS ECONOMY&HAPPINESSWELLNESS ECONOMY&LIFE EXPECTANCYThese two scatterplots visually depict the positive correlations between wellness economy per capita spending and measu

67、rements of happiness(Cantril Ladder)and health/longevity(life expectancy),using data from the Gallup World Poll,the World Bank,and GWI.Source:Shun Wang and Global Wellness Institute8|Global Wellness Institute:Wellness Policy SeriesWellness Economy,Happiness,and Health:Preliminary Analysis*Measures:I

68、n this analysis we employ the Cantril ladder as the measure of happiness,using survey data drawn from the Gallup World Poll.Respondents are asked to self-evaluate their current lives on a scale from 0(worst possible life)to 10(best possible life).Life expectancy is used as the measure of health,draw

69、n from the World Banks World Development Indicators(WDI)2022.Income level is measured by GDP per capita,purchasing power parity(PPP)adjusted for 2017 international dollars,also drawn from WDI 2022.Global wellness economy data(2017,2019,and 2020)are compiled by the Global Wellness Institute.The overa

70、ll wellness economy and its subsectors are all measured on a per capita basis,to adjust for population size across countries.The wellness economy data used for this analysis excludes the wellness tourism sector,because tourism includes a large amount of spending by non-residents and therefore may sk

71、ew the results in highly tourism-dependent countries.Empirical Framework:We conduct the following empirical analysis on the correlations between the wellness industry and happiness and health outcomes,using the following Pooled Ordinary Least Squares(OLS)model:where i,j,and t denote country,region,a

72、nd year,respectively.The dependent variable Y is a national-level outcome such as happiness measures or life expectancy.x denotes the per capita value of the overall wellness economy.lngdppc is the natural log of GDP per capita in 2017 international dollars,adjusted for PPP.GDP per capita is control

73、led for,since it is an important determinant of happiness and health,and it is also likely to be highly correlated with the wellness economy.j and t denote region and year dummies,respectively.ijt is the error term.1 denotes the coefficient of correlation between the wellness economy and the outcome

74、 variable.Regression Results:Regression results show that the coefficient of wellness per capita is 0.000447,which is statistically significant at 1%level.It implies that for an increase of one standard deviation($844)in wellness economy per capita,the average Cantril ladder will increase by 0.377(=

75、1,000*0.000447)units on the scale of 0 to 10.This is equivalent to 6.7 percent changes in Cantril ladder evaluated at the sample average(5.594).Regression results also show that wellness economy per capita is significantly correlated with life expectancy.An increase of one standard deviation($769)in

76、 wellness economy per capita is associated with 1.26 years of extra life(=769*0.00164).In summary,regression analyses show that the wellness economy has statistically significant effects on both happiness and health.*These are the results of a preliminary analysis conducted by Shun Wang,KDI School o

77、f Public Policy and Management(Republic of Korea),in collaboration with Ophelia Yeung and Katherine Johnston of GWI.The full results will be released in an upcoming GWI White Paper.!#=$+%!#+&!#+#+!#Defining Wellness Policy|9Powerful macro forces are shifting wellness from a consumer movement to a po

78、licy imperative.In the last 50 years,wellness has gone from fringe to ubiquitous in the consumer market,and this shift has only accelerated since the COVID-19 pandemic.Wellness is no longer just a leisure-time activity(like getting a massage or going to the gym)but is now a dominant lifestyle value.

79、It has permeated the global consumer consciousness,as people increasingly filter all of their daily routines and decision-making through the lens of wellness including housing,vacations,food purchases,exercise,personal care,social activities,and more.The rise of wellness has occurred in an era of va

80、st economic,technological,social,demographic,and environmental changes,which have transformed every aspect of our lives,and which have had both positive and negative impacts on our individual and societal health and well-being.The growth of the wellness movement is fundamentally a consumer response

81、to these megatrends(see figure below).4 To address the immense challenges posed by these macro forces,we must shift our understanding of wellness from just a consumer trend to a policy imperative for governments,businesses,and communities alike.MACRO FORCES MAKING WELLNESS A POLICY IMPERATIVE4 Yeung

82、,O.,and Johnston,K.(2019).Understanding Wellness:Four Global Forces Driving the Growth of the Wellness Economy.Miami,FL:Global Wellness Institute.https:/globalwellnessinstitute.org/industry-research/understanding-wellness-four-global-forces-driving-the-growth-of-the-wellness-economy/.Source:Global W

83、ellness Institute The environmental crisis is also a health crisis.Environmental degradation directly and indirectly affects us,through the air we breathe,how we procure and consume food,and how we live and travel.As people become aware of these risks,they are seeking out alternative lifestyles that

84、 are simultaneously healthier for themselves and more sustainable for the planet.Demographics,value systems,&lifestyles are evolving toward wellness.Consumer values are changing,moving toward a lifestyle of wellness that is fundamentally shifting consumer behaviors and consumption patterns.This shif

85、t is bolstered by the rise of the middle class,the accessibility of new options,and a burgeoning concern about the impacts of ubiquitous technology.Health systems are failing to keep up,while the economic burden rises.Health systems are failing in countries all around the world,and the economic burd

86、en is unsustainable.Therefore,it is not surprising that consumers,employers,and even governments are turning to wellness approaches to complement and address deficiencies in healthcare and to turn from“sick care”to prevention.The worlds population is growing sicker,lonelier,and older.Deteriorating h

87、ealth,the spread of loneliness and mental illness,and the ramifications of aging all negatively impact peoples happiness and wellbeing.In response,consumers around the world are proactively turning to wellness modalities as alternatives to address these challenges.10|Global Wellness Institute:Wellne

88、ss Policy SeriesWellness policy can be a unifying force for existing movements to improve human health and well-being.Many movements are seeking to address our global crisis of human health and well-being.The quest for a happier and healthier human existence is as old as mankind itself.The wellness

89、movement is just one among several major movements over the last century that have sought to improve human health and well-being(see figure below).These movements cut across government,business,academia,science,and medicine,and they have made significant strides and achievements.Achievements:Health

90、and Longevity Movement.The development of modern medicine has been one of the greatest human achievements in the last 150 years.Advances in science and medicine,alongside the development of the public health system,have allowed us to prevent,treat,cure,and eradicate many health threats.The infectiou

91、s diseases and hazards that killed most people just a century ago have mostly been eliminated or controlled,while global life expectancy has more than doubled since 1900,from 32 years to more than 72 years.5 Achievements:Modern Consumer Wellness Movement.The modern wellness movement has emerged larg

92、ely in response to the failures of our“sick care”medical systems,and it has manifested in a consumer-driven and private sector-based wellness economy worth$4.4 trillion in 2020.In addition to generating trillions of dollars in economic activity and endless new business innovations,the wellness movem

93、ent has had a major impact on reshaping our individual and collective understanding of health and well-being(see Pages 5-6).Achievements:Happiness and Well-Being Movement.The modern happiness and well-being movement has emerged from parallel developments in psychology and academia(e.g.,shifting the

94、focus from mental illness toward evolving theories of subjective well-being,positive psychology,etc.)and in governments(e.g.,the advent of“Gross National Happiness”in Bhutan in 1972).Like“wellness,”the importance of“happiness”has proliferated in popular culture and consumer mindsets,fueled by media,

95、influencers and celebrities,self-help books,podcasts,and more.In the policy arena,the United Nations World Happiness Report6 which recently celebrated its 10th anniversary has brought increased attention to the importance of subjective well-being and happiness in policymaking.It has fueled the call

96、to reassess the goals of government policymaking and turn governments away from Gross Domestic Product(GDP)as the dominant measure of human progress and societal achievements.7 In recent years,a few countries have established 5 Roser,M.,Ortiz-Ospina,E.,and Ritchie,H.(2019).Life Expectancy.Our World

97、in Data.https:/ourworldindata.org/life-expectancy.Accessed 14 September 2022.6 Helliwell,J.F.,et al(2022).7 See,for example:1)Diener,E.,and Seligman,M.E.P.(2004).Beyond Money:Toward an Economy of Well-Being.Psychological Science in the Public Interest,5(1),1-31.https:/doi.org/10.1111/j.0963-7214.200

98、4.00501001.x.2)Global Wellbeing Initiative,https:/www.globalwellbeinginitiative.org/.3)Wellbeing Economy Alliance,https:/weall.org/.Defining Wellness Policy|11MOVEMENTS TO IMPROVE HEALTH AND WELL-BEING:ACHIEVEMENTS AND GAPS19001950Modern Consumer Wellness MovementLed By:Consumers,businesses,mediaAch

99、ievements:Empowering&educating individuals to focus on their own preventive health.Building understanding of health as holistic.Mainstreaming wellness modalities.Market innovations,making wellness more accessible.Growth of a massive,multi-dimensional$4.4t global industry.Gaps:Inequities in access to

100、 wellness modalities&services.Many consumers are left out of the private market for wellness.Has failed to slow the rise of chronic disease.Health&Longevity MovementLed By:Scientists,researchers,medical professionals,governmentsAchievements:Advanced medical care,vaccinations,&drugs.Public health sys

101、tem;modern sanitation;urban planning.Reduction/eradication of infectious diseases.Increased lifespans.Gaps:Inequities in lifespans&health risks.Unsustainable/rising health care costs.Rampant chronic disease.Healthcare model focused on sick care&pharmaceuticals rather than prevention.Over-emphasis on

102、 individual behaviors over community/environmental influences.2000Happiness&Well-being MovementLed By:Governments,academicsAchievements:Reshaping government priorities for policymaking.Emphasis on human happiness,well-being,&quality of life over economic aims&GDP.Better metrics for understanding wel

103、l-being.Increased focus on mental/emotional health.Gaps:Very few governments(in small countries)have adopted the approach.Still mainly a theoretical conversation about priorities&metrics.Requires systemic change that will be very slow and challenging.Stakeholder Welfare&Sustainability MovementLed By

104、:Consumer activists,NGOs,businesses,investorsAchievements:Reshaping business&investor priorities.Growing emphasis on planetary health&stakeholder welfare alongside profits&stock prices(stakeholder/conscious capitalism,B Corp,etc.).New frameworks/metrics(ESG,3BL)and better transparency.Gaps:Do busine

105、sses really embrace these values or is it a branding strategy?Not yet a mainstream or widespread movement(primarily large,multinational corps.in wealthy countries).Emphasis largely on planetary health rather than human health/well-being.Requires systemic change that will be very slow and challenging

106、.Source:Global Wellness Institute12|Global Wellness Institute:Wellness Policy Seriesministries of happiness(e.g.,United Arab Emirates,Ecuador,Nigeria,Venezuela),and a few others have adopted“well-being budgeting”as a way to allocate public resources toward improving well-being,as measured by specifi

107、c metrics(e.g.,New Zealand,Scotland,Iceland,Finland,Wales).8 Achievements:Stakeholder Welfare and Sustainability Movement.In recent years,many businesses have been responding to a rising call for corporate social responsibility,as consumer activism and escalating business risks(e.g.,climate change,w

108、orkforce,supply chain,reputation,etc.)converge in a growing stakeholder welfare and sustainability movement.The concept of corporate social responsibility(CSR)has been around for decades,and it broadly translates into practices that promote ethical business behavior,environmental sustainability,fair

109、 labor practices,and social impact in the community.Some businesses have begun to reframe their missions and visions in terms of broader societal and environmental impacts,moving toward a purpose-driven mission rather than a profit-driven one(e.g.,“benefit corporations”).The spread of Environmental,

110、Social,and Governance(ESG)reporting,the development of ESG guidelines,and the growth of socially responsible investing and impact investing are also helping to encourage companies to consider their business mission,practices,and impacts.Even the World Economic Forum has sponsored the development of

111、Stakeholder Capitalism Metrics aimed at measuring the ESG achievements of businesses.9 These developments in the private sector largely parallel the happiness and well-being movement in the government arena that is,encouraging businesses to reprioritize their missions and contribute positively to in

112、dividual,social,and planetary health and well-being,and establishing new mechanisms for tracking and measuring progress toward those aims.Each of these movements on their own cannot solve our global crises.In spite of the positive changes resulting from all of these movements,many gaps and challenge

113、s endure.Gaps:Health and Longevity Movement.Unfortunately,the benefits of modern medicine and healthcare have not been enjoyed by all.Marginalized and poorer populations,and those living in less developed regions,face significant health inequities,including lower life expectancies;higher rates of in

114、fectious and chronic disease;higher rates of infant/child/maternal mortality;and lack of access to preventive,primary,acute,and mental health care.Our healthcare systems are primarily“sick care”systems,focusing on acute care over chronic care and prevention.We are failing to address the mounting cha

115、llenges of our modern era:aging populations,rising rates of noncommunicable disease and mental health conditions,global pandemics,and unsustainable healthcare costs.As evidenced during the COVID-19 pandemic,our public health systems are under-resourced and lack the strength or mandate to deliver pre

116、vention on a large scale.10 GWI 8 See:Durand,M.,and Exton,C.(2019).Chapter 8:Adopting a well-being approach in central government:policy mechanisms and practical tools.In Global Council for Happiness and Wellbeing,Global Happiness and Wellbeing Policy Report 2019(pp.141-161).New York:Sustainable Dev

117、elopment Solutions Network.https:/www.happinesscouncil.org/report/2019/global-happiness-and-well-being-policy-report.9 WEF(2020,Sept.).Measuring Stakeholder Capitalism:Toward Common Metrics and Consistent Reporting of Sustainable Value Creation.Geneva:World Economic Forum.https:/www3.weforum.org/doc

118、s/WEF_IBC_Measuring_Stakeholder_Capitalism_Report_2020.pdf.10 Sachs,J.D.,et al(2022,Sept.14).The Lancet Commission on lessons for the future from the COVID-19 pandemic.The Lancet.https:/doi.org/10.1016/S0140-6736(22)01585-9.Defining Wellness Policy|13estimates that only about 4%of annual global heal

119、th expenditures are on prevention,risk reduction,and public health.11 The human and economic costs of these failings are enormous.Gaps:Modern Consumer Wellness Movement.The wellness economy may be massive and growing,but it is not bringing wellness to all.Among the$4.4 trillion of wellness economy s

120、pending in 2020,68%was concentrated in the countries designated as“high-income”by the World Bank.Just over 26%of wellness spending was in“upper-middle-income countries,”while only 6%was in“lower-middle”and“low-income”countries.12 Additionally,GWI analysis has found that there is a strong,positive co

121、rrelation between wellness spending(measured by wellness economy per capita)and consumer wealth(measured by GDP per capita).13Across the world,most segments of the wellness economy continue to cater to the wealthy,following the global trend of bifurcating wealth and incomes between the richest and p

122、oorest populations.While an interest in self-care may be rising across the population,the fact remains that only people with means(i.e.,at least some disposal income beyond basic needs)can buy wellness services and products.Meanwhile,over 29%of the worlds population faces food insecurity,and 42%cann

123、ot afford a healthy diet.14 22%of the population lacks basic sanitation services,15 and 26%uses a drinking water source contaminated with feces.16 Nearly the entire global population(99%)breathes unhealthy air outdoors.17 Billions have no time or place to exercise,or work in a toxic environment,or e

124、ndure all of the above.How can we laud the growth and achievements of the wellness economy when even the most basic health needs are not being met for such a large share of the worlds population?Gaps:Happiness and Well-Being Movement.While happiness and well-being are now in the mainstream lexicon o

125、f consumers,businesses,and governments,much of the impact has been just“conversation”or discourse about the topic.A very small number of countries(and mostly small,wealthy countries,at that)have embedded well-being into their national budgeting priorities and processes,while some of the nations that

126、 established new ministerial positions have either paused or refocused these efforts(e.g.,UAE,Venezuela).All of these experiments are still in their early stages,and it is too soon to see measurable change or progress.In addition,much of the discussion remains theoretical,or focuses largely on chang

127、ing priorities,outcomes,and metrics.The kinds of changes sought by the happiness and well-being movement are systemic and require political will and compromises.It will take a long time and monumental effort to radically change the way governments operate and allocate resources,given entrenched orga

128、nizational structures and interests.11 Yeung,O.,and Johnston,K.(2021).12 GWI analysis of 2020 global wellness economy data,using 2020 World Bank income groups(see:https:/datahelpdesk.worldbank.org/knowledgebase/articles/378834-how-does-the-world-bank-classify-countries).13 Yeung,O.,and Johnston,K.(2

129、022).The Global Wellness Economy:Country Rankings.Miami,FL:Global Wellness Institute.https:/globalwellnessinstitute.org/industry-research/2022-global-wellness-economy-country-rankings/.14 FAO,IFAD,UNICEF,WFP,and WHO(2022).The State of Food Security and Nutrition in the World:Repurposing food and agr

130、icultural policies to make healthy diets more affordable.Rome:FAO.https:/doi.org/10.4060/cc0639en.15 WHO(2022,March 21).Fact Sheets:Sanitation.https:/www.who.int/news-room/fact-sheets/detail/sanitation.16 WHO(2022,March 21).Fact Sheets:Drinking-water.https:/www.who.int/news-room/fact-sheets/detail/d

131、rinking-water.17 WHO(2021,Sept.22).Fact Sheets:Ambient(outdoor)air pollution.https:/www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health.14|Global Wellness Institute:Wellness Policy SeriesGaps:Stakeholder Welfare and Sustainability Movement.Similar to the happiness and w

132、ell-being movement,the stakeholder welfare and sustainability movement has fueled growing discourse globally on the values,responsibilities,and impacts of business.But adoption and implementation of these new value systems,frameworks,and metrics has been far more limited,confined mostly to larger,mu

133、ltinational corporations based in wealthy countries.The reality is that only a very small portion of the worlds businesses will engage in voluntary ESG initiatives and stakeholder capitalism.18 Many companies may be pushed into ESG reporting by activist consumers or investors,or by regulatory effort

134、s,but that does not necessarily mean they are meaningfully integrating ESG aims into their corporate values,structures,or supply chains.Some recent analyses have found that companies in ESG fund portfolios actually perform poorly on labor and environmental metrics,and that companies may publicly emb

135、race ESG aims as a cover for poor business performance.19 In addition,ESG reporting frameworks have been skewed toward environmental metrics,while the“Social”component of ESG remains very limited and basic(e.g.,focusing on occupational safety).Perhaps we can hope that rising pressure for corporate r

136、esponsibility could lead to less harm on people and the planet,but given the entrenched structures and incentives of our globalized,capitalist economy,it would be unrealistic to expect that the private sector will deliver wellness to their employees or their communities at any meaningful scale at an

137、y time in the near future.Indeed,can we even expect the private sector to take responsibility for the dire health and well-being needs of the worlds poor,marginalized,and disadvantaged populations who are not their direct customers or stakeholders?18 See:Bebchuk,L.A.,Kastiel,K.,and Tallarita,R.(2022

138、,August).Stakeholder Capitalism in the Time of COVID.Harvard Law School Program on Corporate Governance Working Paper 2022-2.Forthcoming,Yale Journal on Regulation,40(1),2023.http:/dx.doi.org/10.2139/ssrn.4026803.19 See:Bhagat,S.(2022,March 31).An Inconvenient Truth About ESG Investing.Harvard Busin

139、ess Review.https:/hbr.org/2022/03/an-inconvenient-truth-about-esg-investing.Defining Wellness Policy|15Wellness policy can be a unifying force that will build on the strengths of these movements to promote greater health and well-being for all.The need for new solutions grows even more pressing,as w

140、e grapple with the escalating macro crises that threaten our health and well-being(see Page 9):aging populations,rising chronic disease,mental health challenges,the health impacts of environmental degradation,failing health systems,socioeconomic turmoil,and the pressures of technology.As a consumer-

141、friendly concept that is holistic and multidimensional,wellness can be a unifying force in public policy that can help to cut across the existing siloes,while building on the strengths of each of these movements.Complementary to the health and longevity movement,wellness policy can help shift public

142、 resources toward prevention,self-care,and community care,with the potential to address the unsustainable,rising burdens and costs borne by our healthcare and public health systems.Leveraging the modern consumer wellness movement,wellness policy can help expand access to self-care,prevention,and hea

143、lth-enhancing environments,practices,products,and modalities for the underserved and marginalized populations who need them the most.Alongside the happiness and subjective well-being movement,wellness policy provides tools for making incremental,bottom-up changes within existing policy/governmental

144、structures toward better human health and well-being,while we continue work at the macro,top-down level to reprioritize governmental and economic structures toward non-financial measure of progress(i.e.,happiness and well-being).Expanding on the stakeholder welfare and sustainability movement,wellne

145、ss policy can bring support to populations and regions that cannot wait for corporate largess,while bringing greater focus on the“Social”aspect of ESG beyond the basics.16|Global Wellness Institute:Wellness Policy SeriesWhy should governments care about wellness policy?Wellness is not well understoo

146、d by governments and,therefore,has not been broadly incorporated into policymaking as an overarching framework or priority.To date,there has been virtually no research on“wellness policy”or evidence that governments have adopted wellness as an overall policy goal,strategy,or priority at the national

147、,regional,or local levels.The first and only broad-based study on wellness policy was produced by the authors of this report as a background paper for the Asian Development Banks Asian Development Outlook in 2020(and later published in book form in 2021).20 A Google search on the keywords“wellness p

148、olicy”turns up thousands of documents on developing wellness policies within local school districts(e.g.,health-promoting policies to encourage good nutrition and physical activity among schoolchildren),but nothing on wellness as a cross-cutting framework for policymaking in other governmental depar

149、tments or functions.Insofar as governments are paying attention to wellness at all,they tend to view it through the lens of industry sectors that can bring economic development impacts(e.g.,foreign investments,tourism receipts,employment,tax revenues,etc.).For this reason,the wellness sector that se

150、ems to have garnered the most government attention is wellness tourism,and to a smaller extent,the associated spa and thermal springs sectors that are also associated with recreation and hospitality.This is an unfortunate and extremely narrow view of the potential impact of wellness on society and t

151、he economy,or the potential space for policy interventions.As a primarily consumer-driven and private sector activity,wellness is not well understood by governments,even though the wellness movement and industry have arisen to address the gaps left by healthcare systems in addressing the increasingl

152、y dire physical and mental health challenges faced by people around the world.Chronic diseases and mental health conditions stem from a confluence of factors and are closely linked with lifestyle and environment.These factors do not fit neatly within traditional policy siloes.For example,our ability

153、 to engage in physical activity depends upon urban planning,infrastructure,transportation,parks and recreation,and youth/education policies and programs,while our eating habits are heavily shaped by agriculture,economic,trade,and food-related government agencies and policies.All of these policies ar

154、e far outside the realm of our public health and healthcare systems,and they also span multiple levels of government(from local to national).Simply put,the policies that shape our wellness cut across numerous government domains,and they have not been effectively put under a unifying framework for po

155、licymaking or prioritization.20 See:Johnston,K.,Yeung,O.,and Bodeker,G.(2020).Policy Options to Promote Wellness in Asia.ADB Background Paper.https:/www.adb.org/sites/default/files/institutional-document/633886/adou2020bp-policy-options-wellness-asia.pdf.Defining Wellness Policy|17Wellness policy is

156、 an opportunity to unify converging global values and implement a new vision centered on human and environmental health and well-being.Wellness offers a unifying vision and a framework through which governments can prioritize policies centered on the well-being of both people and planet.One of the l

157、ongstanding challenges facing the environmental and sustainability movement has been consumers reluctance to be inconvenienced or to pay more for things that do not bring immediate,personal benefits.Wellness,on the other hand,rallies us around a shared desire to be healthier and happier.For example,

158、consumers may be reluctant to pay more for a“green home”that may help to reduce future pollution,but they are more willing to pay a premium for a“healthy home”that may reduce their risk of cancer.Wellness is a powerful concept for policy action because it uses the language of consumers,and it appeal

159、s to personal agency and empowerment.This vision is focused on prevention,lifestyle changes,and the environmental factors that affect our well-being and our ability to live healthy lives.It ensures that wellness is equitable,inclusive,and culturally appropriate.It aims to reframe the perception of w

160、ellness as not just a leisure or luxury activity for the wealthy,but as an everyday behavior and lifestyle that we can all adopt.A wellness policy approach can help to reset the relationship between human health and planetary health,by recognizing that these aims go hand-in-hand and can have both sh

161、ort-term benefits for individuals and long-term benefits for society.Wellness policy provides a range of solutions that can be led by multiple actors,at different levels of government,and for the benefit of different groups.Wellness policy does not require wholesale,transformative change in governme

162、nt structures and systems.It can be implemented immediately and incrementally,within the existing system,and by actors at any level/unit of government.For example,government stakeholders working in the departments of transportation,tourism,parks and recreation,city planning/management,and others can

163、 easily incorporate wellness policy approaches within their existing policy frameworks and portfolios,no matter what level of government they are in(local/municipal,regional/provincial,or national).Businesses,nonprofits,and local communities can partner and collaborate with governments on specific p

164、rojects and initiatives.Governments have many important roles to play in facilitating wellness and many policy tools to deploy,such as:encouraging new innovations;funding new research;scaling effective services and activities;educating and building awareness of healthy lifestyles;increasing access t

165、hrough public investments in infrastructure,services,and programs;collaborating with the private and nonprofit sectors for delivering services;and using tax and regulatory tools to create incentives/disincentives where appropriate.There are already ample examples of successful wellness-enhancing ini

166、tiatives in many areas,and governments can leverage this experience and knowledge to benefit target populations.This report and the related policy toolkits aim to serve as a starting point,providing operational help and the tools for governments and communities to consider,plan,and implement wellnes

167、s policy in their jurisdictions.18|Global Wellness Institute:Wellness Policy SeriesWellness policy and the wellness industry can support and cross-fertilize a wide range of government priorities,from health,to economic growth,workforce development,and quality of life.Population health and well-being

168、 is just one among many priorities that governments must balance.As both an economic activity and a policy tool,wellness has many cross-cutting implications and impacts on growth and development,extending far beyond public health,prevention,and well-being.Using a wellness-driven approach for policy

169、can also support and reshape important priorities in the areas of economic development,competitiveness,and growth;small business development;workforce development;urban development;civic engagement;environmental and cultural sustainability;social and cultural affairs;equity and diversity;female empo

170、werment;and much more(see figure below).21 Broadly,wellness provides a new lens through which all types of development policies can bring wide-ranging benefits for people,society,and planet,alongside traditional economic growth objectives.WELLNESS SUPPORTS MANY PUBLIC POLICY PRIORITIES21 Yeung,O.,an

171、d Johnston,K.(2019).Understanding Wellness:Opportunities&Impacts of the Wellness Economy for Regional Development.Miami,FL:Global Wellness Institute.https:/globalwellnessinstitute.org/industry-research/understanding-wellness-opportunities-impact-wellness-economy-for-regional-development/.Wellness is

172、 an economic growth driver.Employment creation&small business development Promotion of locally-sourced,produced,&branded products Womens empowerment&benefits to familiesWellness supports protection of natural&cultural assets.Environmental protection Preserve&celebrate local culture&heritage Mitigate

173、 tourism-related challengesWellness improves public health.Mitigating rising healthcare costs Improving health equity by engaging wellness workers in the community Addressing the growing mental health epidemic Harnessing indigenous wellness knowledge,traditions,&modalities Wellness supports workforc

174、e development and worker welfare.Worker development,retention,&recruitment Worker welfareWellness enhances quality of life&social capital.Urban/community planning,zoning&infrastructure Social capital&trustSource:Global Wellness Institute Defining Wellness Policy|19Why should the private sector care

175、about wellness policy?The private sector often takes a negative view of public policy because they view government actions as unfriendly to business(e.g.,taxes,regulations,bureaucracy,COVID-era shut-downs,vaccine and mask mandates,etc.).In fact,policy can be beneficial to the private sector in many

176、ways,and businesses in the wellness economy should approach it with a positive outlook.When wellness businesses become advocates for wellness policies,and partners in their implementation,it can be a win-win situation for both the private and public sectors,customers,and their communities in deliver

177、ing the benefits of wellness to all.Public investments in infrastructure,workforce,and research support wellness businesses.Governments at all levels(national,state/provincial,and local/municipal)are major investors in the critical assets that underpin wellness activities and the wellness economy.Al

178、l around the world,governments build the essential infrastructure in communities including public squares,parks and playgrounds,trails and bicycle lanes,and public sports facilities where people conduct their exercise and leisure activities.Public educational institutions train a large,growing,and d

179、esperately needed wellness workforce,including hospitality workers,massage therapists,traditional and complementary medicine providers,nutritionists,exercise professionals,psychologists,architects and urban planners,and public health professionals.Governments are also one of the largest investors in

180、 the basic scientific research that powers todays innovations and technologies and generates new products,services,and business models.Importantly,government-supported research on public health provides the data that underlies much of the current wisdom on which the wellness economy is built(e.g.,ph

181、ysical activity,healthy diets,sleep hygiene,mental health,healthy built environments,etc.).The private sector should advocate and partner with government for these investments,because better infrastructure,workforce,and research not only underpin their businesses,but also strengthen and expand the c

182、onsumer landscape for wellness.Public policies can increase consumer confidence and protect the integrity of the wellness industry.The growth of the global wellness industry has been propelled by increasing consumer adoption of novel wellness modalities and the proliferation of wellness services and

183、 products.The past decade has brought a plethora of new wellness products,services,and therapies that were previously unheard of or considered fringe,with businesses sometimes stretching science to satisfy rising consumer demand and curiosity(e.g.,different types of supplements,fortified foods,and f

184、ad diets;extreme workouts;and therapies involving oxygen,light,manual techniques,extreme temperatures,shamanism,psychedelics,and even insect stings).Many products and therapies are innocuous,even if they are ineffective,while others can be risky or harmful when used the wrong way,by the wrong people

185、,or in combination with the wrong things.Suffice it to say,market demand and business innovations have outpaced science and evidence in many areas.While businesses often dislike any type of government controls on their products/services,public policies and regulations can increase consumer confidenc

186、e in the wellness market and strengthen it.For example,public education and awareness campaigns can help people become informed 20|Global Wellness Institute:Wellness Policy Seriesconsumers,by giving them the knowledge and data to choose effective products and modalities,and to identify qualified pro

187、viders.Good policies help ensure that companies make appropriate product and efficacy claims that do not mislead consumers.Registration,credentialing,inspection,labelling,and quality assurance systems can protect consumers,while still enabling market innovation.Regulation is a critical component of

188、maintaining the integrity,honesty,and reputation of the wellness industry.If wellness businesses do not partner with governments to ensure proper levels of evidence,regulation,labelling,credentialling,etc.,they risk losing the trust of their customers and will increasingly be seen as selling false p

189、romises and“snake oil”rather than valuable solutions for prevention and health promotion.Public policies can promote business growth and development.Whether businesses like it or not,governments set rules for the private market.These rules not only govern how businesses are run,but they can also sup

190、port/favor sectors that are deemed to be important to society.This was clearly demonstrated during the pandemic,in terms of which businesses faced shutdowns and which were allowed to remain open.Unfortunately,the physical activity sector(including for-profit gyms,community sports centers,sports leag

191、ues,etc.)was among the first to shut down and the last to reopen in many countries.Exercise facilities were treated as places of leisure,like bars and restaurants,and not as an essential service that supports the physical activity and social connections that have been so vital to maintaining good he

192、alth during the pandemic.A wellness policy approach would help to change the perception of physical activity from an optional leisure pursuit to an integral part of protecting public health,and it would allow the physical activity sector to receive greater recognition,priority,and support from gover

193、nment.Public policies can protect key assets and resources that enable the wellness industry.Wellness consumers increasingly demand and expect offerings that are unique,authentic,local,and sustainable.Virtually every sector in the wellness economy depends upon natural,cultural,and historical resourc

194、es for its offerings:thermal/mineral springs,wellness tourism,wellness real estate,outdoor exercise and recreation,natural personal care and beauty products,traditional and plant-based supplements and medicines,and so on.Government policies on conservation,biodiversity,and environmental and cultural

195、 sustainability protect the treasures that are essential to our wellness and ensure that they are utilized by businesses in a responsible manner.The design and quality of urban environments is also critical to our health and well-being and can either support or inhibit the development of new wellnes

196、s innovations and businesses.Public policies and partnerships with the private sector on urban planning and transit development can create walkable communities,protect diversity,and support safe and accessible public spaces where residents and businesses can thrive together.Defining Wellness Policy|

197、21Governments are stakeholders and clients in the wellness market.Governments not only tax but also spend.Public spending on healthcare can spill over to wellness sectors,such as public health systems offering or paying for traditional and complementary medicine,or subsidizing visits to health resor

198、ts and thermal spas for chronic illness and rehabilitation(e.g.,“Kur”and health tourism in Central,Southern,and Eastern Europe).In many countries,the operations of public/subsidized gyms,community centers,and sports/recreation services are contracted out to private operators.Governments invest in su

199、bsidized housing,and a prioritization of wellness in the built environment will spur opportunities for wellness real estate development in the affordable segment.Governments are major employers,and they operate and procure goods and services for a wide range of public institutions(e.g.,public school

200、s,universities,and childcare facilities;hospitals;military facilities;government departments;etc.);they therefore represent a potentially large market for healthy eating,wellness architecture/design,workplace wellness innovations,and more.In short,governments need the private sector in order to deli

201、ver and implement services that are deemed to be in the public interest.While many wellness sector innovations originate from the private sector,governments have the resources to scale the adoption of wellness products/services and to reach a broader customer base,especially those who cannot afford

202、these things on their own.22|Global Wellness Institute:Wellness Policy SeriesThe time to act on wellness policy is now.Globally,the metrics for health and well-being,which were precarious even before 2020,have been deteriorating on multiple fronts.The United Nations Sustainable Development Goals Rep

203、ort 202222 paints an alarming picture of humanity,with COVID-19,climate change,and global conflicts triggering cascading crises in physical and mental health,food and nutrition,poverty,environment,and so on prompting the UN Secretary-General to call for an“urgent rescue effort for the SDGs”among all

204、 stakeholders.Clearly,while consumer actions and private sector innovations in the wellness arena are important,they are woefully insufficient in the face of this grim reality.These cascading crises have caused widespread loss of life and human suffering that are unconscionable to ignore,and they wi

205、ll only worsen if we do not change course.Unwellness on many fronts(e.g.,malnutrition,sedentary behavior,mental unwellness,chronic disease,rising health expenditures,and environmental degradation),also imposes staggering and unsustainable economic costs,for which all of us are paying the price direc

206、tly or indirectly(see figure below).It is urgent that we act immediately to reorient public policy and our public and private resources toward health,wellness,and well-being.22 UN(2022).The Sustainable Development Goals Report 2022.New York:United Nations.https:/unstats.un.org/sdgs/report/2022/.Defi

207、ning Wellness Policy|23THE GLOBAL COSTS OF POOR HUMAN HEALTH&WELL-BEING ARE ENORMOUSSource:Global Wellness Institute Major Chronic Diseases&Mental Conditions Projected to reduce global economic output by an average of$2.3 trillion annually from 2011-2030.$2.3TRILLIONAll Forms of Malnutrition(Include

208、s Premature Deaths from Diet-related NCDs)Cause economic losses of$3.5 trillion annually($500 per person).$3.5TRILLIONIndoor&Outdoor Air PollutionResponsible for an estimated$8.1 trillion per year in health costs.$8.1TRILLIONPhysical InactivityCreates a$67.5 billion annual burden,including direct he

209、althcare costs and productivity losses.$67.5BILLIONGlobal Health ExpendituresMore than doubled in real terms from 1999-2019,reaching$8.5 trillion annually(nearly 10%of global GDP).$8.5TRILLIONEmployee Disengagement at WorkCosts an estimated$7.8 trillion each year.$7.8TRILLIONData sources for the gra

210、phic:1)Bloom,D.E.,et al(2011).The Global Economic Burden of Non-communicable Diseases.Geneva:World Economic Forum.https:/www.weforum.org/reports/global-economic-burden-non-communicable-diseases/.2)World Bank(2022).The Global Health Cost of PM2.5 Air Pollution:A Case for Action Beyond 2021.Internatio

211、nal Development in Focus.Washington,DC:World Bank.https:/doi.org/10.1596/978-1-4648-1816-5.3)WHO(2021).Global expenditure on health:Public spending on the rise?Geneva:World Health Organization.https:/www.who.int/publications/i/item/9789240041219.4)FAO(2013).State of Food and Agriculture 2013:Food sy

212、stems for better nutrition.Rome:Food and Agriculture Organization of the United Nations.https:/www.fao.org/3/i3300e/i3300e00.htm.5)Ding.,D.,et al(2016,July 27).The economic burden of physical inactivity:a global analysis of major non-communicable diseases.The Lancet,388,1311-1324.https:/doi.org/10.1

213、016/S0140-6736(16)30383-X.(Note that this study expresses the$67.5 billion of economic losses in“international dollars,”which means that the values in each country are converted to dollars at a purchasing power parity rate that accounts for differentials in the prices of goods and services across co

214、untries.)6)Gallup(2022).State of the Global Workforce:2022 Report.Washington,DC:Gallup.https:/ Wellness Institute:Wellness Policy SeriesInvesting in health and well-being has massive potential benefits.It is notoriously difficult to estimate the return on investment(ROI)for wellness.The impacts typi

215、cally manifest over a long time horizon,and they are shaped by the specific approaches,local conditions,population characteristics,and many other factors.There is no question that the benefits are enormous,especially for disadvantaged and lower-income populations.Various studies by the WHO and other

216、 organizations have estimated an ROI of$4-$14 for every$1 invested in public health,prevention,managing NCDs,and other health promotion efforts.More important than the measurable economic impacts are the intangible benefits for humankind,by reducing the suffering caused by disease,disability,and pre

217、mature deaths,and by improving well-being and quality of life for all.Interventions to prevent and manage NCDs in low-/lower-middle income countries could achieve a 15%reduction in premature mortality and$350 billion in economic growth over twelve years(an ROI of$7 for every$1 invested).23 Public he

218、alth interventions at the local and national levels are highly cost-saving,with an estimated ROI of$14 for every$1 invested.24 Investing in health in general brings economic returns to the health sector,other sectors,and the wider economy,with an estimated ROI of$4 for every$1 invested.25 Investment

219、s to meet UNSDG 3 targets(“healthy lives&well-being”)in low-/middle-income countries could prevent 97 million premature deaths globally and add up to 8.4 years of life expectancy in some countries over fourteen years.26 23 WHO(2018).Saving lives,spending less:a strategic response to noncommunicable

220、diseases.Geneva:World Health Organization.WHO/NMH/NVI/18.8.https:/www.who.int/publications/i/item/WHO-NMH-NVI-18.8.24 Masters,R.,et al(2017).Return on investment of public health interventions:a systematic review.Journal of Epidemiology&Community Health,71(8),827-834.https:/doi.org/10.1136%2Fjech-20

221、16-208141.25 Reeves,A.,et al(2013).Does investment in the health sector promote or inhibit economic growth?Globalization and Health,9(43).https:/doi.org/10.1186/1744-8603-9-43.26 Stenberg,K.,et al(2017).Financing transformative health systems towards achievement of the health Sustainable Development

222、 Goals:a model for projected resource needs in 67 low-income and middle-income countries.The Lancet Global Health,5(9),E875-E887.https:/doi.org/10.1016/S2214-109X(17)30263-2.Defining Wellness Policy|25II.What Is Wellness Policy?Defining wellness.To understand wellness policy,we must first understand

223、 wellness.The Global Wellness Institute(GWI)defines wellness as:the active pursuit of activities,choices,and lifestyles that lead to a state of holistic health.There are two important aspects to this definition.First,wellness is not a passive or static state,but rather an“active pursuit”that is asso

224、ciated with intentions,choices,and actions as we work toward an optimal state of health and well-being.Second,wellness is linked to holistic health that is,it extends beyond physical health and incorporates many different dimensions that should work in harmony(see figure below).Wellness is multidime

225、nsional.Physical:Nourishing a healthy body through exercise,nutrition,sleep,etc.Mental:Engaging the world with the intellectual mind.Emotional:Being aware of,accepting,and expressing our feelings,and understanding the feelings of others.Spiritual:Searching for meaning and higher purpose in human exi

226、stence.Social:Connecting and engaging with others and our communities in meaningful ways.Environmental:Fostering positive interrelationships between planetary health and human actions,choices,and well-being.Wellness functions on a continuum.Wellness is often confused with terms like health,well-bein

227、g,and happiness.While there are common elements among them,wellness is different in that it is not associated with a static state(i.e.,being happy,in good health,or a state of well-being),but rather an active process of being aware and working toward optimal holistic health and well-being.Wellness i

228、s best viewed as a continuum that extends from poor health to an optimal state of well-being(see figure).27 The“sick”end of the continuum is addressed by the medical paradigm,with a focus on treating disease(the pathogenic approach).The right-hand side of the continuum 27 The continuum concept is ad

229、apted from Dr.Jack Travis Illness-Wellness Continuum.Travis was one of the pioneers of the modern wellness movement in the 1970s.SOCIALPHYSICALMENTALSPIRITUALEMOTIONALWELLNESSENVIRON-MENTALMedical ParadigmWellness ParadigmPoor HealthNeutralOptimal State of Well-beingSource:Global Wellness Institute,

230、adapted from Dr.Jack Travis THE WELLNESS CONTINUUM26|Global Wellness Institute:Wellness Policy Seriesrequires wellness i.e.,individuals proactively adopting activities and lifestyles that benefit their body,mind,and spirit(the salutogenic approach).28Wellness is both behavioral and environmental.Wel

231、lness is an individual pursuit based on self-responsibility,but it is also significantly influenced by the physical,social,and cultural environments in which we live.While we may carry genetic tendencies for many types of disease,our health outcomes are not pre-determined.Emerging research on epigen

232、etics and neuroplasticity tells us that our environment,lifestyle,and lived experiences not only can alter gene expression in our body but also can rewire our brain for better or for worse and these effects can be passed down to our children and future generations along with our genes.29 Indeed,rese

233、arch on the determinants of health indicates that environmental,socioeconomic,and lifestyle factors can account for 80-90%of our disease risks and health outcomes.30 Those who are very young,elderly,disabled,or poor are particularly vulnerable to these external factors.31A complex web of factors(acc

234、ess to healthcare,socioeconomic factors,and our natural and built environments)form a“wellness ecosystem”that can augment or mitigate our genetic disposition for disease.Our wellness ecosystem has a direct effect on our health by transmitting communicable and environmental diseases.It also indirectl

235、y affects our health by influencing our behaviors and lifestyles,which can lead to noncommunicable diseases.It can make healthy habits easy,convenient,and the“default”option or not.Governments and public policy exert enormous influence on our wellness ecosystem and all of these external and behavior

236、al factors from economic and social policies,to urban planning and transportation infrastructure,to health systems,to environmental regulations,and much more.28 For more information on pathogenesis vs salutogenesis,see:1)Bhattacharya,S.,et al(2020,Jan.).Salutogenesis:A bona fide guide towards health

237、 preservation.Journal of Family Medicine and Primary Care,9(1),16-19.https:/doi.org/10.4103/jfmpc.jfmpc_260_19.2)Mittelmark,M.B.,et al(Eds.)(2017).The Handbook of Salutogenesis.Cham,Switzerland:Springer.https:/doi.org/10.1007/978-3-319-04600-6.3)Fries,C.J.(2020).Healing Health Care:From Sick Care To

238、wards Salutogenic Healing Systems.Social Theory&Health,18(1),16-32.https:/doi.org/10.1057/s41285-019-00103-2.29 See:1)Pelletier,K.(2018).Change Your Genes,Change Your Life:Creating Optimal Health with the New Science of Epigenetics.San Rafael,CA:Origin Press.2)Choy,L.,and Bodeker,G.(2020,May).Resett

239、ing the World with Wellness:Mental resilience in a time of stress and trauma.Global Wellness Institute White Paper Series.Miami,FL:Global Wellness Institute.https:/globalwellnessinstitute.org/industry-research/resetting-the-world-with-wellness/.30 Magnan,S.(2017)and Hood,C.M.,et al(2016).31 See:1)Br

240、aveman,P.,et al(2011).Issue Brief#8:Neighborhoods and Health.Robert Wood Johnson Foundation.http:/www.rwjf.org/en/library/research/2011/05/neighborhoods-and-health-.html.2)Institute of Medicine and National Research Council(2013).U.S.Health in International Perspective:Shorter Lives,Poorer Health.Wa

241、shington,DC:The National Academies Press.https:/doi.org/10.17226/13497.Source:Global Wellness InstituteWELLNESSECOSYSTEMBuilt&Natural EnvironmentHealth CareEnvironmentGenetic/BiologicalFactorsUp to 80-90%of our health outcomes depend upon the external and environmental factors in our wellness ecosys

242、temSocioeconomicEnvironmentDirectBehaviors&LifestyleHEALTH OUTCOMESDefining Wellness Policy|27Wellness policy 101.Levels of action for wellness policy.Public policies can be formulated to shape our wellness at three different levels(as explained in greater detail later in this chapter):1.Micro-level

243、 wellness policy:Encouraging individuals to proactively make healthy choices,establish healthy habits,and live healthy lifestyles.2.Meso-level wellness policy:Creating living environments that support and encourage healthy behaviors and lifestyles.3.Macro-level policy:Reshaping all policies related

244、to our wider society and economy,with the aim of improving human health and well-being.In many cases,macro-level policies(such as reducing poverty,stopping armed conflicts,or addressing climate change)will have a greater impact on our health and well-being than the meso-and micro-level policies targ

245、eting individual behaviors and community environments.As noted in Chapter I,the happiness and well-being movement has drawn attention to the importance of changing overarching public priorities and approaches to address macro-level issues that affect well-being.This kind of top-down policy approach

246、is critical,but it requires long-term,systemic changes,as well as political will and compromises,which can be difficult to achieve.To date,only a few small countries have attempted this type of high-level change(e.g.,New Zealand,Scotland,etc.).Macro-level policies covering the entire range of public

247、 policy action are vitally important to human health and well-being.But in this study,we focus primarily on two levels of action(micro and meso),which can complement national-level well-being policy efforts,and can also be implemented independent of those longer-term endeavors.Who benefits from well

248、ness policy.Wellness policies can target the needs of specific populations and lifespan groups,including underserved and vulnerable groups such as children and seniors.Wellness policy is especially critical for lower-income and disadvantaged populations,who are at higher risk for poor health and are

249、 not well-served by the private wellness market.Wellness is not a luxury.It is not a“hierarchy of needs,”where basic needs(e.g.,safety,employment,food)must be met before we can pursue“loftier”wellness practices like exercise,healthy diets,Definition of wellness policy.The Global Wellness Institute d

250、efines wellness policy as follows:Wellness policy is a set of cross-cutting actions that encourage healthy lifestyles and create supportive environments for human health and well-being.28|Global Wellness Institute:Wellness Policy Seriesor meditation.To the contrary,wellness is a basic and critical r

251、esource that we all need,no matter our life circumstances.Even those living in the worst macro-level circumstances(e.g.,war zones,refugee camps)can benefit from individual wellness practices and pathways to help them cope,build resilience,and deal with adversity.Wellness policies at the micro-and me

252、so-levels can be implemented and have benefits for people immediately,even while we wait for the glacial progress in solving our long-term macro crises and shifting our overarching policy priorities toward well-being.Wellness policy versus health,public health,and happiness/well-being policies.Welln

253、ess is a lens through which we can reshape public policy and work toward improving human health,happiness,and well-being outcomes.Wellness policy complements and supports health,public health,and happiness/well-being policies(as explained in greater detail later in this chapter):Wellness policy prov

254、ides a framework and policy options that can be adopted across existing government agencies and economic sectors,at every level of government,and in partnership with the private and nonprofit sectors.Wellness policy complements health and public health policy by drawing attention to the many lifesty

255、le factors and the environmental determinants of health that are beyond the mandate of both healthcare and public health,and that cut across many government silos.Wellness policy supports the well-being and happiness movement by offering tools for incremental and immediate changes within existing po

256、licy structures,without waiting for the challenging political process of reorienting national government priorities toward human health and well-being.Key focus areas for wellness policy.Wellness policy focuses on seven domains that affect both individual behaviors and supporting environments(as exp

257、lained later in this chapter).These domains are closely interrelated,and policy actions within one domain can have impacts across other areas.GWIs Wellness Policy Toolkits(forthcoming in 2023)will address these seven domains in detail.Stakeholders working in many government functions,industry sector

258、s,and communities can take action across these domains,in both large and small ways,to spearhead bringing wellness to all.Wellness Policy Domains Covered in GWIs Wellness Policy SeriesWellness Activities and LifestylesWellness-Supporting Environments Healthy Eating Physical Activity Mental Wellness

259、Traditional&Complementary Medicine Wellness in the Built Environment Wellness at Work Wellness in TourismDefining Wellness Policy|29Wellness policy:Three levels of action.Public policies can be formulated to shape our wellness at three different levels,envisioned as a set of three concentric circles

260、(see figure below).Micro-level policies affect individual practices and behaviors.As individuals,we make a daily choice to behave in ways that either enhance or reduce our personal health and well-being.There are many factors that can affect our behaviors,including time,money,knowledge,motivation,in

261、terest,energy,access to facilities,and physical or health conditions.Policies can encourage healthy behaviors by making these choices more convenient and accessible for different populations.However,the importance of individual practices does not absolve society,governments,and businesses of respons

262、ibility for dealing with problems at the meso and macro levels.Meso-level policies shape our immediate living environments,including our communities,neighborhoods,workplaces,schools,and families.As mentioned previously,environmental factors(including built environment,natural environment,and social

263、environment)are a major determinant of our physical and mental health.We depend upon our local governments,employers,community organizations,and families to help build environments that are supportive of our health and well-being.Public policies and investments can play a huge role by investing in i

264、nfrastructure and environments that create a healthy“wellness ecosystem”(see Page 26),enable access to healthy choices,and nudge us toward healthy lifestyles.Healthy environments are especially critical for those living in marginalized/underserved areas and those who do not have the financial means

265、to participate in the private wellness market.Macro-level policies define our wider society and economy.Numerous broad,macro-level factors influence our health and well-being:poverty,unemployment,inequality,hunger,war and conflict,crime and safety,education,gender,economy,weather and climate,environ

266、ment,etc.Our individual wellness practices and lifestyles cannot solve these problems because they are largely outside of our own control.Addressing macro-level issues requires top-down,systemic efforts to reorient national priorities away from conventional economic objectives and toward comprehensi

267、ve human well-being.MESOImmediate Living Environments&CommunitiesMICROIndividual Practices&BehaviorsMACROSociety-&Economy-Wide FactorsSource:Global Wellness Institute 30|Global Wellness Institute:Wellness Policy SeriesWellness policy complements health and public health policy.Both public health and

268、 healthcare are well-defined policy fields,with dedicated government agencies,professionals,and funding streams to formulate and implement them.Medical advances have allowed us to treat,cure,and even eradicate many illnesses and health conditions,while dramatically increasing human life expectancy(s

269、ee Chapter I).Across the world,public health has accomplished a lot in the prevention and control of infectious diseases(e.g.,via immunization,sanitation,etc.),and in addressing major health threats such as workplace safety,food safety,sanitation and water safety,and motor vehicle safety.In many cou

270、ntries,the public health sector is at the center of educating consumers on entrenched lifestyle risks such as smoking,alcohol abuse,and recreational drug use.Unfortunately,healthcare and public health are less able to combat the rise of non-communicable diseases(NCDs),which have become the greatest

271、future challenge to global health.32 NCDs are largely preventable,and they mostly stem from key risk factors related to our modern,unhealthy lifestyles(e.g.,sedentary behavior,poor eating habits,stress,lack of sleep,loneliness,addiction,environmental toxins,etc.).33 In an ideal world,our healthcare

272、and public health systems would succeed at prevention and health promotion and would address the entire wellness continuum.The reality is that they do not,and in fairness,they cannot.The public health community is no match for the entrenched systems and massive commercial interests that profit from

273、things that are bad for our health(e.g.,unhealthy/processed foods,sugary drinks,tobacco,etc.),especially in developing countries.34 Moreover,our public health and medical care systems are not designed,equipped,funded,or mandated to address the underlying factors and policy issues that lead to these

274、challenges,or to change the environments that shape peoples health-related behaviors.Wellness policy can help fill these gaps,by providing a framework and policy options that can be adopted across existing government agencies and economic sectors(e.g.,transportation,urban planning,education,parks an

275、d recreation,etc.),and at every level(national,regional/provincial,and municipal/local),with the aim of improving human health and well-being.By leveraging the power and momentum of the consumer-and business-driven wellness movement,wellness policy also provides a platform for building essential par

276、tnerships between government and non-government stakeholders.32 See:1)WHO(2005).Preventing Chronic Diseases:A Vital Investment.https:/apps.who.int/iris/handle/10665/43314.2)Adler-Waxman,A.(2017,Dec.7).This is the biggest challenge to our health.World Economic Forum:Shaping the Future of Health and H

277、ealthcare Initiative.https:/www.weforum.org/agenda/2017/12/healthcare-future-multiple-chronic-disease-ncd/.3)United Nations(2018,Feb.16).New UN high-profile panel set to take on noncommunicable diseases,cause of seven in 10 deaths globally.https:/news.un.org/en/story/2018/02/1002921.4)Council on For

278、eign Relations(2014,Nov.33 WHO(2005).34 See:1)Tangcharoensathien,V.,et al.(2019).Addressing NCDs:challenges from industry market promotion and interferences.International Journal of Health Policy and Management,8(5),256-260-731.https:/doi.org/10.15171/ijhpm.2019.02.2)Delobelle,P.(2019).Big tobacco,a

279、lcohol,and food and NCDs in LMICs:an inconvenient truth and call to action.International Journal of Health Policy and Management,8(12),727-731.https:/doi.org/10.15171/ijhpm.2019.74.Defining Wellness Policy|31Wellness policy supports well-being and happiness policy.“Wellness”is often conflated with“w

280、ell-being”and“happiness”because all three concepts reflect human experience in a complex,subjective,and holistic way,including physical,mental,emotional,social,financial,environmental,spiritual,and other aspects.In recent years,the burgeoning fields of subjective well-being and happiness have garner

281、ed significant attention from governments,policy communities,researchers,and consumers(as discussed in Chapter I).The main focus has been on measuring happiness and exploring the role of government and policy in increasing peoples happiness.Happiness was first embraced as a policy goal by Bhutan(197

282、2),which later introduced its Gross National Happiness Index as an alternative to Gross National Product for assessing the countrys level of progress.Country-level happiness is now measured globally by the Gallup World Poll and published annually in the United Nations World Happiness Report.In 2017,

283、the Global Happiness Council was founded by the ruler of the Emirate of Dubai.Led by economists,psychologists,and happiness experts,the Council sponsors research on the policy approaches and best practices that could enhance happiness and individual well-being.To date,the Council has published a few

284、 editions of its policy report and convened discussions at the World Government Summit.35 The Councils policy research efforts are grouped under six themes:education,workplace,personal happiness,public health,city design,and management.36 As discussed in Chapter I,several countries have institutiona

285、lized well-being and happiness as a policy priority by:establishing new government departments,ministerial positions,or external agencies(e.g.,the What Works Centre for Wellbeing in the UK);embedding well-being in national budgeting priorities and processes(e.g.,well-being budgeting in New Zealand);

286、and instituting new accountability mechanisms(e.g.,appointing new Future Generations Commissioners in Wales and Scotland).Wellness policy does not aim to duplicate or replace these important efforts in happiness and well-being policy.Rather,wellness policy is a complement to the current discourse on

287、 happiness and well-being and helps to fill gaps and work toward this common goal:Happiness and well-being are outcomes that we seek to improve.That is why the happiness and well-being policy conversation primarily focuses on outcomes and metrics(What should be the main goal of government policy?How

288、 can we improve measurements of happiness or well-being among our citizens?).In contrast,wellness is a process and an activity.Wellness policy provides direction for what we can do to work toward the goal of improved happiness and well-being outcomes.The current discourse about happiness and well-be

289、ing focuses on priority-setting at the highest levels of government.Happiness and well-being policy takes a top-down approach that requires long-term,systemic change in how governments set priorities,allocate resources,and measure progress.This process is challenging and even uncertain,requiring pol

290、itical will,new mandates,and political compromises.In contrast,wellness policy offers tools for 35 See:Global Council for Happiness&Well-being,Global Happiness&Well-being Policy Reports(2022,2019,2018),https:/www.happinesscouncil.org.36 See:https:/www.happinesscouncil.org/council.32|Global Wellness

291、Institute:Wellness Policy Seriesmaking incremental,immediate,bottom-up changes within existing policy structures toward improving human health and well-being.The wellness policy toolkits developed by GWI in this Wellness Policy series(forthcoming in 2023)offer options for stakeholders in any governm

292、ent department(or in the nonprofit and private sectors),and at any level(national to local),to take action immediately and seek out partnerships to work incrementally toward improved health,happiness,and well-being.WELLNESS POLICY LEVERAGES&FILLS GAPS IN EXISTING EFFORTS IN HEALTH,PUBLIC HEALTH,&HAP

293、PINESS/WELL-BEING POLICIES ACROSS THE WELLNESS CONTINUUMMedical ParadigmWellness ParadigmPoor HealthNeutralOptimal State of Well-beingHEALTH&PUBLIC HEALTH POLICYWELLNESS POLICYHAPPINESS&WELL-BEING POLICY Focuses on treatment&prevention.Driven by pathology&scientific/clinical evidence.Dedicated gover

294、nment agencies,funding,and policy siloes.Overwhelmed by chronic disease&COVID-19.Lacks mandate or resources to address lifestyle&environmental factors.Focuses on prevention&health optimization,with the aim of improving well-being&happiness.Driven by individual lifestyles,access,&environments for wel

295、lness.Incremental,cross-cutting,&multi-disciplinary approach.Encourages reshaping existing policies across every government agency&level.Focuses on happiness&well-being outcomes.Top-down approach to changing government priorities&funding.Requires systemic change that is political&uncertain.New field

296、,still being formulated.Leverages connections&partnerships with private sector.Source:Global Wellness Institute Defining Wellness Policy|33Wellness is a lens to reshape public policy and work toward well-being.The fields of wellness and happiness/well-being can work together to reshape both the proc

297、ess and the outcomes of policymaking.Well-being as a main outcome of policymaking.As the saying goes,“if you cant measure it,you cant improve it.”Outcomes are the main changes,improvements,and impacts we are seeking to achieve through public policy.Champions of the happiness and well-being movement

298、have argued that better well-being should be a top priority of governments and policymaking equal to,or supplanting,GDP growth.37 Why are we using economic growth and GDP as our key metrics for“progress”when they are increasingly detached from peoples quality of life,happiness,and well-being?If we a

299、re to make well-being our top policy goal,we will need to measure progress.There are many different approaches for measuring and tracking well-being at the country level(see figure below).MEASURING WELL-BEING AT THE COUNTRY LEVEL37 For some of the foundational thinking on this topic,see:1)Diener,E.,

300、and Seligman,M.E.P.(2004).Beyond Money:Toward an Economy of Well-being.Psychological Science in the Public Interest,5(1),1-31.https:/doi.org/10.1111/j.0963-7214.2004.00501001.x.2)Adler,A.,and Seligman,M.E.P.(2016).Using wellbeing for public policy:Theory,measurement,and recommendations.International

301、 Journal of Wellbeing,6(1),1-35.https:/doi.org/10.5502/ijw.v6i1.429.3)Stiglitz,J.E.,Sen,A.,and Fitousi,J.(2010).Mismeasuring our lives:Why GDP doesnt add up.New York:The New Press.Subjective Well-Being/Happiness Life satisfaction(e.g.,Cantril ladder)Negative/positive affect(or emotions)Health Life e

302、xpectancy Self-reported health Premature deaths from non-communicable diseases Child/maternal mortality ratesCommunity&Connection Social support network/connections Loneliness Prosocial behaviors/kindness Participation in community orgs.,volunteering,etc.Environment Pollution,greenhouse gas emission

303、s,etc.Water quality Protection of natural resources,biodiversityOpportunities/Equity Discrimination,inequality,human rights Political rights,freedom of expression,etc.Civic engagement,voter turnout,trust in governmentBasic Needs Shelter/housing Nutrition Sanitation/water Basic safety(crime,violence,

304、etc.)Education&Employment&Income Educational attainment/access,knowledge/skills Employment/unemployment Job satisfaction,work-life balance Income/wealthWell-being OutcomesWell-being KPIsSource:Global Wellness Institute 34|Global Wellness Institute:Wellness Policy SeriesThe narrowest measurement of w

305、ell-being focuses on the psychological concept of“subjective well-being”(top row of boxes in the figure above).38 When researchers and reports measure“happiness,”this is the metric they typically use,gathered via self-reported survey data(e.g.,the Gallup World Poll and the UN World Happiness Report)

306、.Other studies use a very broad concept of well-being that includes many categories and metrics,drawn from a wide range of surveys and government datasets(e.g.,the OECDs Better Life Index and Hows Life?Indices).This approach roughly equates with our understanding of“quality of life,”and in many ways

307、 it aligns with the United Nations Sustainable Development Goals(UNSDGs).Research has shown that improvements in one sub-category of well-being often have corresponding improvements in the metrics for other categories(e.g.,higher levels of social support correspond with higher levels of subjective w

308、ell-being).Wellness as a lens for policymaking.As discussed above,wellness policy is not a new government function that requires creating new government departments,ministries,or funding streams.Wellness policy is also not the function of the ministry/department of health.Rather,wellness policy is a

309、 cross-cutting lens through which any and all existing government departments and agencies can assess their current activities,institute new priorities,reshape policies/activities,and develop partnerships to work toward the aim of improving human health and well-being(see figure below).The wellness

310、policy lens can be applied across nearly every government agency and at every level of government.RESHAPING POLICYMAKING WITH A WELLNESS LENS38 See:Diener,E.,et al(2009).Subjective Well-Being:The Science of Happiness and Life Satisfaction.In S.J.Lopez and C.R.Snyder(Eds.),Oxford Handbook of Positive

311、 Psychology,2nd edition(pp.187-194).New York:Oxford University Press.https:/doi.org/10.1093/oxfordhb/9780195187243.013.0017.Health/Public HealthAgriculture/FoodHousing/City PlanningTransport./Infrastructure/Public WorksEducationRecreation/Sports/YouthTourismTrade/Commerce/IndustryLabor/EmploymentEne

312、rgy/Natural ResourcesCriminal Justice/SafetyFinance/TreasuryPolicy FieldsRepresentative list,not exhaustiveWellness policy directly influences:Subjective Well-Being/HappinessHealthCommunity&ConnectionWellness policy indirectly influences:EnvironmentOpportunities/EquityBasic NeedsEducation&Employment

313、&IncomeWell-being OutcomesOther policy lenses can also be used to improve well-being outcomes,such as Sustainability or Human Rights.Source:Global Wellness InstituteWellness Lens for PolicymakingDefining Wellness Policy|35Using wellness as a lens for policymaking will lead to improvements in well-be

314、ing outcomes.The categories of well-being where we would expect to see the greatest impacts from wellness policy include subjective well-being/happiness,health,and community/connection.Wellness policy may also bring positive outcomes in other categories,such as environment,opportunities/equity,or ba

315、sic needs,even though these are not the direct focus of wellness policy activities.Numerous academic and research studies have established the connections between wellness activities/investments and these types of well-being outcomes.For example,GWIs own statistical analysis(presented in Chapter I)s

316、howed a strong positive correlation between spending on wellness,subjective well-being(measured by the Cantril ladder),and health(measured by life expectancy).Multitudes of other studies have found positive correlations and impacts from specific types of wellness investments,especially in the area o

317、f built environment.For example,walkable communities contribute to better physical,mental,and social health,along with environmental benefits such as reduced carbon emissions per capita.39 Investments in attractive and well-maintained public spaces,parks,and public art can increase civic engagement

318、and trust.40 There is incontrovertible evidence that healthy behaviors and lifestyles(including sufficient physical activity,a nutritious diet,and good sleep)are essential for improving health outcomes and longevity.But the science of behavior change i.e.,how to encourage healthy behaviors among ind

319、ividuals and communities is far less clear.Countries and regions around the world have experimented with various types of public policies,investments,and initiatives to support,enable,and motivate lasting behavior change and wellness.Far more study is needed to understand what approaches work in dif

320、ferent socio-cultural contexts,for different population groups,for different behavioral goals,etc.Where does sustainability fit into this picture?Like wellness,sustainability is a cross-cutting and multi-dimensional issue that does not fit neatly into government departments and siloes.In our propose

321、d framework(illustrated in the figure above),sustainability is an additional policy lens,which sits alongside wellness,and can be used to filter,shape,and formulate policies across all functions of government.Wellness policy aims to improve human health and well-being,while sustainability policy aim

322、s to improve planetary health but those two aims go hand-in-hand,because a healthy environment is essential for the health and well-being of humankind,and initiatives that promote human health can also be beneficial for the environment.There are other cross-cutting issues,such as human rights and eq

323、uity,which can also be deployed as a policy lens to work toward other aspects of well-being.Other policy lenses(like sustainability and human rights)are important because they influence different types of well-being outcomes that are not the primary focus of the wellness policy lens.39 See,for examp

324、le:1)Claris,S.,and Scopelliti,D.(2016).Cities Alive:Toward a Walking World.London:ARUP.https:/ al(2021).Walkability and Its Relationships With Health,Sustainability,and Livability:Elements of Physical Environment and Evaluation Frameworks.Frontiers in Built Environment.7(721218).https:/doi.org/10.33

325、89/fbuil.2021.721218.3)Howell,N.A.,and Booth,G.L.(2022).The Weight of Place:Built Environment Correlates of Obesity and Diabetes.Endocrine Reviews,bnac005.https:/doi.org/10.1210/endrev/bnac005.40 See:Center for Active Design(2016).Assembly:Research Brief I.New York:Center for Active Design.36|Global

326、 Wellness Institute:Wellness Policy SeriesWellness policy focuses on seven domains that affect both individual behaviors and supporting environments.GWIs definition of wellness policy encompasses actions that encourage healthy behaviors and lifestyles and that create wellness-supporting environments

327、.As such,our wellness policy framework lays out seven detailed domains for wellness policy that support these two aims(see table below).Within these seven domains,we also address the wellness needs of specific populations and lifespan groups,including underserved and vulnerable groups such as childr

328、en and seniors,wherever relevant.These seven domains do not function independently from one another.They are closely interrelated,and policy actions within one domain can have impacts across other areas.For example,policies focusing on the built environment can affect our individual behaviors relate

329、d to physical activity,mental wellness,and healthy eating.Policies that encourage physical activity can have an impact on mental wellness.Our Wellness Policy Toolkits(forthcoming in 2023)address these intersectionalities wherever they appear.The seven wellness policy domains cut across many differen

330、t government agencies and departments.They also depend upon many different businesses and sectors within the wellness economy.The table below outlines the seven domains and the key government departments and wellness economy sectors that play a leading role in each area(this list is illustrative,not

331、 exhaustive).Stakeholders working in these government functions and industry sectors are encouraged to utilize the Wellness Policy Toolkits as a jumping off point to spark new ideas and conversations about how they can take action in both large and small ways to spearhead bringing wellness to all.De

332、fining Wellness Policy|37WELLNESS POLICY DOMAINS COVERED IN GWIS WELLNESS POLICY SERIESWellness Policy DomainKey StakeholdersGovernment DepartmentsWellness Economy SectorsWellness Activities and LifestylesHealthy EatingExpanding access to nutritious diets and encouraging everyone to make healthy eat

333、ing choices.Agriculture/food Trade/commerce/industry Health/public health Education Social services/social affairs Environment Healthy eating,nutrition,&weight loss Wellness real estate Public health,prevention,&personalized medicine Wellness tourismPhysical ActivitySupporting people of all ages to engage in the recommended levels of physical activity to stay healthy.Parks/recreation Sports/youth