Systematically considering indicators of human well-being in terms of economics, health and education, alongside subjective notions of wellbeing, the book draws together research and data from around the world. It uses the United Nations Development Programme's Human Development Index as an underlying framework from which to examine the ways in which wellbeing has improved since WWII. Analysing leading scholarship and empirical work aloows the authors to determine policy recommendations for how we might continue to build a better world of human wellbeing.
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About the Author
M. Joseph Sirgy is Virginia Tech Real Estate Professor of Marketing at Virginia Polytechnic Institute and State University, USA.
Read an Excerpt
Advances in Human Well-Being
Humankind has arrived at a dramatically different level of well-being in 2017 than that which existed fifty years ago or that which characterized people worldwide at the outset of the twentieth century. The advances we have the privilege to witness today reflect changes in the quality of life of people everywhere, and the forward momentum we would like to focus on continues with the promise of even more significant advances in the years ahead. While distinct drivers for the progress we discern are difficult to isolate in terms of causality, the rich tapestry of multistakeholder and multisector collaboration that has made this dramatic story possible stems from what we believe to be a near-organic, DNA-level imperative in human beings to "make life better for oneself and others." In health and life expectancy alone, people in North America and Europe are living thirty-one years longer on average (as of 2015) than in 1900, a net increase in the average number of years of life expectancy from forty-seven to somewhat more than seventy-eight years in the span of a single century. An increase of this magnitude is extraordinary and reflects social progress across a broad range of social, political, and economic sectors.
Most importantly, our children appear to be surviving at higher numbers the often harsh and precarious experiences of birth and early childhood encountered by earlier generations of children. Rates of infant and child mortality, which have posed major threats to child survival worldwide, are now at historically low levels — down from an average of sixty deaths per 1,000 live born in economically advanced societies in 1990 to an average of well below five or six infant deaths per 1,000 live born infants in these same societies by 2015. Figure 1.1, which covers the 100-year period from 1950 to 2050, confirms that the same pattern of child survival is occurring in all regions of the world including those that comprise the nonindustrialized nations of Africa, Asia, the Caribbean, and Latin America (United Nations, 2009). As with the dramatic increases in average years of life expectancy, the high level of child survival that characterizes the world today is unparalleled in human history or in our contemporary sense of well-being. These gains have had a secondary effect that, increasingly, allows families to voluntarily reduce the number of children or to space pregnancies consistent with their level of economic resources, especially in situations where they have sufficient numbers of male children, who are expected to support their parents in old age (van Soest and Saha, 2012). Fertility rates also are expected to drop even more once income security for the aged and other vulnerable populations is put in place. In either case, parents need no longer "expect" that large numbers of their offspring will die before reaching the first year of life or during the years that follow. Rather, more and more families can add to their numbers as they judge appropriate without fearing that some of their children will die before reaching adulthood (figure 1.1).
Similarly, mothers are more likely to survive childbirth. Rates of maternal mortality have declined dramatically almost everywhere in the world as increasing numbers of pregnant women gain access to quality prenatal care, improved diets and nutritional supplements, and safer, more sterile deliveries in health centers staffed by skilled health care professionals. These include mostly midwives, but in economically advanced societies include physicians and physician assistants with access to at least midlevel diagnostic equipment.
The number of maternal deaths associated with hemorrhage, infection, sepsis, genital trauma, and unsafe abortions has declined dramatically everywhere in the world by an average of at least 13 percent (World Health Organization, 2017). Enabling safe pregnancies and deliveries for women living in remote rural communities remains one of the greatest challenges facing humanity, but the knowledge and the resources needed to solve this challenge are gradually becoming available.
THE DEMOGRAPHIC CHALLENGE
More people in the early part of the twenty-first century are being born and living longer than ever before in human history. This simple demographic reality has changed the face of our communities for many decades into the future and, in doing so, has reshaped the set of responsibilities for promoting the well-being of their growing number of citizens by both the state and private sectors. Indeed, two remarkably similar trends across societies dominated, namely, a continuing high rate of child fertility in combination with high rates of population aging. At some point in the near term, child fertility patterns in developing countries are expected to decline as the percentage of their populations sixty years of age and older increases (Population Reference Bureau, 2016). This means that today and in the years ahead, fewer babies will be born, and people will continue to live longer. Most developing countries must thus inevitably struggle with a wide range of policy issues related to rapidly increasing numbers of age-dependent persons relative to numbers of working-age individuals (persons aged fifteen to sixty-four years) who generate most of the wealth needed to build the society and to support their families and the larger community. Chronic joblessness of young people, including university graduates, and uncertain income streams for the elderly are among the most frequent demographic challenges that developing countries face as they seek to increase their competitiveness in global markets while maintaining social stability at home (Estes & Tiliouine, 2016). The solutions needed to solve this challenge are not simple and will require active participation by all segments of society working together toward a shared set of solutions.
Figure 1.2 identifies the years of average life expectancy for males and females for the world's ten most populous countries. The data are for midyear 2016. Added together, the combined population of these countries equals about 58 percent of the world's total population. Of interest is that only one of these countries, the United States, is classified as an economically advanced society; the remaining nine are classified by the World Bank as either "lowincome" or "developing" countries (World Bank, 2017). All ten of these countries, though, engage in robust trade with one another, and this trade has added new resources to the economies of all of these nations for use in supporting a wide spectrum of advances in well-being.
Using bubbles to represent the comparative population size of each country, figure 1.2 also shows the years of average life expectancy for males and females residing in each of the countries. The intention in using bubbles in the figure is to graphically summarize three variables: (1) to represent the different population size of each country, (2) to report average years of life expectancy by gender, and (3) to reflect gender-based disparities in average years of life expectancy. The use of this type of data visualization makes it easier for the reader to readily discern complex patterns that are not so clearly visible when examining columns of numbers alone. (The authors are indebted to the late Swedish medical statistician Hans Rosling for promoting the use of such approaches for presenting complex data patterns more simply.)
The population and gender data reported in figure 1.2 are for mid-2016. The data confirm the relationships that exist in population size when disaggregated, using gender as a control factor. The figure also confirms that highly populated countries, though advancing at different rates, are moving in the same direction in extending the lives of their residents and are doing so quickly. This is an especially important finding since these very large nations must work not only toward advancing the longevity of hundreds of millions of people but also toward establishing the means required to provide for at least the basic needs and wants of their rapidly increasing numbers. The demands placed on the governments of these nations are especially intense for improved health care, better education, and more secure employment. These are not easy well-being outcomes, even for affluent nations to accomplish. At the same time, the challenge for highly populated developing countries is to achieve the same outcomes as more economically advanced countries but to do so with fewer material resources. And, yet, the majority of the world's most populous nations have achieved this outcome, including all four of the population "super giants" shown in the figure, that is, China, India, the United States, and Indonesia.
Figure 1.2 also confirms the existence of increased parity in average years of life expectancy among the ten most populous countries. Women, as is the case worldwide, in each of the ten countries live longer than men by an average of four to five years, often longer, but both men and women are living substantially longer on average than did earlier generations. This pattern is expected to continue over the near term as rich and poor countries achieve average years of life expectancy that are increasingly comparable to one another. These changes will occur most dramatically in countries with accelerated rates of economic growth, improved health conditions, and greater availability of at least basic education. The steady introduction of reasonably secure "social safety" nets also will add to this advancement in well-being among developing countries, as will decline in average family size and, viewed globally, the size of the total world population (International Social Security Association, 2017; United Nations Population Division, 2016).
The very significant positive gains just reported are confirmed by the strikingly upward direction in which population longevity is increasing in nine of the ten countries. This is the case even for Nigeria, the major outlier shown in the figure, which continues to struggle with a legacy of poverty, high levels of diversity-related social conflict, classism, and political instability — all despite the great oil wealth of the country. Even so, today, men and women are living longer in Nigeria than during earlier decades despite their lagging economic and political positions.
Today, people living everywhere in the world are enjoying longer, healthier, and better-educated lives than at any time in human history. In combination with emerging and the already secure social safety nets that exist in most economically advanced countries, the quality of life of hundreds of millions of people already has been improved. In the decades just ahead, even more gains in population longevity and fertility control are expected. When that threshold is reached, the world is expected to experience a stabilization of population growth rates and an overall, in time, reduction in the overall size of the world's total population (United Nations Population Division, 2016).
Looking ahead, figure 1.3 shows the expected rate of population increase for the world by developmental stage. Included with each stage are the expected patterns associated with births, deaths, and rates of natural increase and decrease that result from patterns of births and deaths. The dynamics of child fertility and population aging are reported in the bottom boxes of the figure. The chart presents a picture of the general pattern of economic change that most countries undergo as they move from stage 1 to stage 5 of population growth.
These generally "expected" patterns are useful in comparing the population trends occurring within and between various groups of nations. In applying this framework, we can easily see variations that may prevent countries from moving from one development stage to another.
The differences that exist in population distribution patterns are apparent in charts such as that portrayed in figure 1.4, which summarizes the important age and gender distributions that take place in countries. Figure 1.4 illustrates what is referred to as a "population pyramid," which groups national populations by gender and age. The information summarized in the figure is for Mexico in 2015. The ideal pattern, of course, is to have many economically active persons (ages fifteen to sixty-four) who generate the resources needed to provide for age-dependent family members and to support the overall development of the community
Mexico's population pyramid reflects the imbalance that exists between the numbers of noneconomically productive children, youth, and older persons vis-à-vis the numbers of persons in the economically active age group. In Mexico, the percentage is much lower than that of most postindustrial societies because of the large number of children in most Mexican families. The growing number of older persons, though still small, also makes large demands on the financial resources of the family and of the country. Taken as a percentage of Mexico's total population, the volume of demand for support placed on Mexican families by their children and their elders is large. At the same time, the proportion of economically active age groups in Mexico is steadily shrinking, which imposes yet another set of policy demands on a midlevel developing country.
What does this all mean? The economic burden placed on Mexico's economically active workforce is high as it struggles to meet the needs of so many children and a steadily increasing population of elderly persons. The demographic challenges for Mexico represented by these trends are substantial and have major well-being implications not only for Mexico but also for the world. Moreover, increased gender inequality, a lingering problem in Mexico, in combination with moderate to high rates of economic growth, has caused families to voluntarily reduce their birth rate and invest more in their elders (Ghose, 2013). Despite the complexity of these trends and the range of drivers that support them, there is little determinism or fatalism that may be applied to these dynamics. These decisions are made by families themselves, and they, as with nearly all families, hold in their own hands the power to enhance their overall quality of life, standard of living, and well-being.
Private decision making and public policies formulated by policy makers in support of families play a vitally important role in enhancing the quality of life in society across the board. Evidence-based decisions of this kind provide the foundations upon which individuals, families, and societies achieve their collective progress. This is one of the many results of adopting a positivist approach to understanding and acting on the challenges that confront all sectors of personal and communal life.
DECLINING RATES OF INFECTIOUS AND COMMUNICABLE DISEASES
Perhaps most exciting and least appreciated in terms of making headlines has been the impact of modern medicine on the preponderance of infectious and communicable diseases such as diphtheria, pertussis, tetanus, polio, cholera, malaria, and tuberculosis. Each has declined to its historically lowest levels in response to aggressive health outreach services to large numbers of urban and rural dwellers. Vaccinations against crippling childhood diseases — diphtheria, pertussis, tetanus, and polio — now reach nearly 80 percent of the world's infants and children. If we think about this, this level of achievement in human progress is nothing short of a modern miracle. These diseases are entirely preventable, especially in their early stages, and the cost of vaccines has dropped to historically low levels. The recently launched United Nations Sustainable Development Goals initiative has been designed to reach the remaining 20 percent of unvaccinated, difficult-to-reach children. Every expectation exists for believing that this goal will be achieved by no later than 2025. Progress in treating drug-resistant tuberculosis likely will proceed more slowly, given the complexities of both the disease and the health delivery systems needed to treat the disease at its earliest stage.
Excerpted from "Advances in Well-Being"
Copyright © 2018 Richard J. Estes and M. Joseph Sirgy.
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