Wellbeing Forum 2022 Report

FROM SURVIVING TO THRIVING

WELLBEING FOR THE INDIVIDUAL, SYSTEMS, AND SOCIETY

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FROM SURVIVING TO THRIVING

WELLBEING FOR THE INDIVIDUAL, SYSTEMS, AND SOCIETY

A WELLBEING FORUM PUBLICATION BY DIPLOMATIC COURIER | WORLD IN 2050 WASHINGTON, DC | FEBRUARY 2023

PUBLISHER

ANA C. ROLD

REPORT AUTHOR

WINONA ROYLANCE

REPORT EDITORS

KELLY RYAN BAILEY

ISABELLA MINUDRI

MANAGING EDITOR

SHANE SZARKOWSKI

ART DIRECTOR

MARC GARFIELD

MULTIMEDIA MANAGER

WHITNEY DEVRIES

PHOTOGRAPHY

DANIEL PEREZ

WELCOME NOTE

ANA C. ROLD, CEO, DIPLOMATIC COURIER

THE GLOBAL RISE OF UNHAPPINESS AND HOW LEADERS MISSED IT JON CLIFTON, CEO, GALLUP

GLOBAL HEALTH DIPLOMACY

• HE MATHILDE MUKANTABANA, AMBASSADOR OF RWANDA

• HE FERNANDO LLORCA CASTRO, AMBASSADOR OF COSTA RICA

• HE LISA GABLE, FORMER US AMBASSADOR TO WORLD EXPO JAPAN

• MODERATOR: ILANA RON LEVEY, MANAGING DIRECTOR, GALLUP

ACCESS TO HEALTH AND ADVANCING EQUITY

DR. LAUREN SMITH, CHIEF HEALTH EQUITY AND STRATEGY OFFICER, CDC FOUNDATION

MEASURING THE COST OF POOR WELLBEING

• DR. DAVID MOU, CEO, CEREBRAL

• DR. JIM HARTER, CHIEF SCIENTIST, GALLUP

• MODERATOR: SELENA WRIGHT, SENIOR DIRECTOR, CORPORATE REPUTATIONS & DEI, APCO WORLDWIDE

UNDERSTANDING THE OPIOID CRISIS

• DR. DOUG NEMECEK, CHIEF MEDICAL OFFICER, CIGNA

• DR. LIPI ROY, ADDICTION MEDICINE PHYSICIAN, NEWS MEDICAL CONTRIBUTOR

• MODERATOR: REBECCA BAGLEY, PRESIDENT & CEO, THE KENNEDY FORUM

MENTAL HEALTH AND SUICIDE PREVENTION

ANNE BROWN, PRESIDENT & CEO, THE COOK CENTER FOR HUMAN CONNECTION

THE ECONOMICS OF WELLBEING

DAN WITTERS, RESEARCH DIRECTOR, GALLUP NATIONAL HEALTH AND WELLNESS

INNOVATING FOR A FUTURE OF HEALTH THAT IS INTEGRATIVE AND EQUITABLE

• DANIELLA FOSTER, SVP & GLOBAL HEAD OF PUBLIC AFFAIRS, SCIENCE AND SUSTAINABILITY, BAYER’S CONSUMER HEALTH DIVISION

• DR. TIM LOMAS, SCIENTIST, THE HUMAN FLOURISHING PROGRAM, HARVARD UNIVERSITY

• SARA PIERCE, SENIOR VP OF STRATEGY, MAGELLAN HEALTH

• DAVE ALLMAN, CHIEF GROWTH OFFICER, WELLBEING AT WORK

• MODERATOR: KELLY RYAN BAILEY, CIO, WORLD IN 2050

FROM INFOBESITY TO INFO WELLNESS

MARIO VASILESCU, CEO & CO-FOUNDER, READOCRACY

WELCOME

Our 2022 Wellbeing Forum was held during two auspicious global occasions: World Mental Health Day, as well as the annual IMF/World Bank Meetings. As we reconvened in person again after two and a half years, we looked to this auspicious day as an opportunity to re-kindle our efforts to protect and improve mental health.

For those delegates that have attended our global summits before, you know we gather to talk not just about the world today but also about the world in 2050—which is the name of our futuristic do-tank and think tank. And the future is such an intriguing space to start our discussions. We are not fortune tellers. We look to the past and present in order to help the future arrive well, which is our motto.

As you know, healthcare is massively broken and entrepreneurs are finding new ways every day to make us the CEO of our own health. We are on the cusp of witnessing some of the biggest breakthroughs humanity has ever seen.

But there is more to health than the absence of disease. Some call it happiness. Others call it wellbeing. And others call it quality of life.

And we fundamentally agree: everyone wants to be happy. But what we have not figured out yet is how we should do it with policy, edu-

Ana C. Rold, CEO & Founder, Diplomatic Courier & World in 2050.

Photo by Daniel Perez.

cation, and community investment. When the discussion goes there, the question becomes: who will pay for all this innovation?

But even beyond innovation, this discussion centers on our elevated sense of purpose in life. Psychologists have found that people who have this tend to live longer and experience less physical illness.

While our healthcare has focused thus far on intervening before a disease is developed or trying to prevent progression of a disease when people are already sick—early prevention looks at inhibiting the risk factors in the first place.

And the best place to start is figuring out what allows people to attain and maintain health in the long term. Is it nutrition? Is it tech and innovation? Is it policy?

On World Mental Health Day, the World Health Organization and its global partners launched a campaign around the theme of “Making Mental Health and Wellbeing for All a Global Priority.”

This is an incredibly important moment in time not just for individuals and organizations to be vocal and come together, but for leaders of nations to prioritize the wellbeing of their citizens—to put wellbeing and mental health at the very top of multilateral agendas, the way defense budgets and GDP and economics occupy leaders’ minds.

It goes without saying, the COVID-19 pandemic created a global crisis for mental health. The WHO estimates the rise in both anxiety and depressive disorders at more than 25% during the first year of the pandemic.

At the same time, mental health services have been severely disrupted and the treatment gap for mental health conditions has widened. Add to that lingering conflicts, growing social and economic inequalities, and displacement from natural disasters and we have a perfect storm.

Sounds daunting? We hope the discussions and presentations from our forum, as distilled expertly here by our team, will lead the way to more collaboration and partnership and lead us into a world in which mental health is valued, promoted and protected; where everyone has an equal opportunity to enjoy mental health and to exercise their human rights; and where everyone can access the health care they need. Thank you for being a part of this year’s Wellbeing Forum. We look forward to learning and creating together.

Ana C. Rold Washington, DC February 2023

THE GLOBAL RISE OF UNHAPPINESS AND HOW LEADERS MISSED IT

While we have nearly perfected the measurement of almost every economic aspect from GDP per capita to unemployment, we have yet to figure out how to quantify how people feel—and more importantly, how to make world leaders understand why it matters. In an effort to measure the overall wellbeing of people around the world, Gallup created the World Happiness Report, a comprehensive collection that measures emotions and wellbeing on a scale of 1 to 10, with 10 being the best possible life and 1 being the worst. In fact, while over the past 15 years traditional economic indicators have shown us that GDP per capita is rising for many countries, the World Happiness Report found that those same countries were experiencing more unhappiness than ever before—and even more alarming, that this rate of global unhappiness is increasing quickly. The question is, then: what is causing such a drastic increase in unhappiness, and how are leaders missing it?

We have widely-accepted indicators and measurements that tell us just about everything—except emotions.

Jon Clifton, CEO of Gallup. Photo by Daniel Perez.

Traditional economic indicators may be able to tell us what people are making and spending, but they don’t tell us what people feel—and without recognizing human emotions on both an individual and global scale, levels of unhappiness will only continue to rise. For example, the years leading up to Brexit showed the UK’s GDP on an upward trend, while Gallup’s Happiness Index showed a decrease in happiness for several years leading up to the UK leaving the EU—with the largest single drop in their database showing a decrease from 55 percent in 2013 to 40 percent in 2015. Indeed, while a 15 percent increase in unemployment would make headlines everywhere, a 15 percent increase in unhappiness still goes almost completely unnoticed by leaders. Perhaps most interesting of all, when surveyed about the leadup to Brexit, most people in the UK answered “it would be bad for the economy to leave the EU” and “but I think it will be better for my life.”

There is a methodology to measuring happiness and wellbeing —as well as unhappiness.

Gallup has created a methodology. In order to measure the wellbeing of people across the globe, Gallup conducts phone and face-to-face interviews with over a thousand people per country in 140 countries worldwide. By not only having people rate their lives on a scale of 1 to 10, but also asking questions ranging from “How safe do you feel walking alone at night in the area where you live?” to questions that ask participants to describe their entire previous day, Gallup is able to measure happiness and wellbeing along a number of dimensions.

Jon Clifton, CEO of Gallup. Photo by Daniel Perez.

There is a global rise in unhappiness. Gallup’s Negative Emotions Index, which measures people’s experience of anger, sadness, physical pain, worry and stress, has shown an increase in negative emotions since 2012—and indicates that levels will continue to rise. Similarly, the index shows that while 15 years ago 2.5 percent of people gave their lives a 10 out of 10 rating—meaning they believed their lives to be near perfect—and 1.7 percent rated their lives 0 out of 10, today’s index shows that almost 8 percent rate their lives 10 and 8 percent rate their lives 0. This demonstrates not only a growing poverty gap, but a growing divide in terms of wellbeing as well.

There are five key elements of wellbeing.

In order to increase wellbeing for everyone everywhere, it is crucial that wellbeing among the following five aspects be promoted:

1. Social wellbeing. Having meaningful friendships in your life is the key to happiness. Unfortunately, loneliness is one of the most common problems people in the world face today, with 20 percent of people indicating they have no one to rely on in a time of need, and 6 percent revealing that they don’t have a single friend in their life at all. With a study from BYU showing that there is a 50 percent higher likelihood of dying from almost anything if you are truly lonely, it is critical that social wellbeing be increased globally.

2. Financial wellbeing. While money doesn’t buy happiness, it is extremely difficult to be happy without it. Today, however,

Jon Clifton, CEO of Gallup. Photo by Daniel Perez.

there are 200 million people globally who don’t have money to meet even their basic needs.

3. Physical wellbeing. Working out, eating well and having the energy to get things done is essential to wellbeing. Unfortunately, one of the biggest global challenges we face today is food insecurity, with over 30 percent of people globally indicating that they were moderately to severely food insecure.

4. Community wellbeing. Liking where you live and having people in the community that care about each other is important to wellbeing, yet Gallup found that a staggering two billion people worldwide wouldn’t recommend their community to others.

5. Work wellbeing. Studies have shown that the average person will spend 110 thousand hours of their lives working—second only to sleeping. However, with over two-thirds of people saying that stress from work affects their loved ones, there is no way to have a happy life if you are unhappy with work. But with only 20 percent of people indicating that they are thriving at work and another 20 percent answering that they are totally miserable at work, the need for an increase in work wellbeing is essential.

GLOBAL HEALTH DIPLOMACY

Negative emotions are on the rise globally, as is a growing discrepancy between those who are thriving and those who are suffering. However, while the conversation surrounding wellbeing is slowly making its way into government and policy, there is still much to be done in the way of finding what practices actually work to improve wellbeing at the local, country and global level. From Costa Rica, one of the happiest countries in the world, to Rwanda, a country recovering from a stretch of conflict, different countries around the world are beginning to demonstrate different policies and practices surrounding increasing wellbeing amongst their people. The question is, then: are nations taking the concept of wellbeing seriously? What practices, interventions and policies are being put into place to combat rising levels of unhappiness? And how can we leverage the power of global statistics to increase wellbeing?

Costa Rica has one of the highest levels of happiness in the world.

While global levels of unhappiness may be on the rise, Costa Rica has been appointed as one of the happiest countries in the world by several rankings, including the Happy Planet Index. This begs the question: how is it that Costa Rica is able to achieve such a high level of wellbeing?

Global Health Diplomacy Panel. Photo by Daniel Perez.

Costa Rica pays attention to life expectancy. Fernando Llorca Castro, Ambassador of Costa Rica to the United States, explains that Costa Rica has put a lot of focus on life expectancy by building a strong healthcare system with universal coverage and access. In fact, Costa Rica has been named one of the world’s five Blue Zones—areas where people live the longest lives, often reaching over the age of 100—due to not only their healthcare system, but also their culture of having an activity, sharing experiences with family and society, emphasizing the importance of community, eating healthy and working well.

Costa Rica is working to identify barriers to happiness and wellbeing. For example, issues such as transportation, mobility and long commutes are often cited as a large problem for denser populations, as are a variety of mental health issues. Castro also explained how it is issues like these where innovations need to be made in order to remove barriers to wellbeing.

Rwanda is using a grassroots approach to increase wellbeing in the country.

For several decades, Rwanda has been working to build happiness indicators into the nation’s agenda. However, with a lack of a robust private sector and a population reeling from internal conflict, mental health issues such as depression and social isolation still wreak havoc. Mathilde Mukantabana, Ambassador of Rwanda to the United States, explains how the Rwandan government has shifted towards working alongside its people as a collective in order to create homegrown solutions to solve for their local, provincial and national issues—thereby creating a

Moderator Ilana Ron Levey, Managing Director, Public Sector, Gallup.

Photo by Daniel Perez.

national collective that people without family members or who have lost loved ones can lean upon.

Rwanda uses different integrated approaches to improve wellbeing. In order to increase wellbeing, Rwanda uses several different policy approaches. Rwanda’s Performance Contract, for example, is a decentralized program that begins from the local village level and extends all the way to the government. Through this, the Rwandan government is able to set up agendas and look at tools that can be used to help communities develop—and more importantly, it creates a platform where citizens can share their ideas and aspirations as well as let leaders know what needs to be done.

Rwanda also uses its own index to assess levels of wellbeing. Another way Rwanda is focusing more attention on wellbeing is through the Rwanda Score Card, an index that assesses things such as transparency and accountability, rule of law, participation in inclusiveness, safety and security, investing in human and social development, and anti-corruption at both the local and national levels.

We need to look at several metrics—including wellbeing—to figure out what needs to be done. In order to achieve wellbeing, people don’t want to be micromanaged—they want to be empowered and encouraged to solve their problems. On a policy level, therefore, Lisa Gable, Former Ambassador to World Expo Japan, explains that if we remove barriers to innovations, people will move towards solutions much more quickly.

HE Lisa Gable, Former U.S. Ambassador to World Expo Japan. Photo by Daniel Perez.

We may not be far from solving some of the issues related to unhappiness. However, in order to solve these issues, we need to begin analyzing some of these problems from a different perspective. For example, when it comes to diet-related diseases, it is important to shift our focus away from blaming emotional reactions such as stress, anxiety and isolation and instead turn our focus towards understanding the underlying causes that are creating these chronic emotional reactions in people in the first place.

The concept of wellbeing in healthcare and disease is changing. In healthcare, personal advocacy is becoming an important way to ensure that both healthcare practitioners and policymakers understand the day-to-day life of the individual in order to create more comprehensive and inclusive ways to empower and support everyone. Similarly, while just decades ago people died from diseases early on, advances in medicine have created an environment where people now live through diseases—and in order to make a successful journey back to health, it is important that support systems be created.

Global Health Diplomacy Panel. Photo by Daniel Perez.

ACCESS TO HEALTH AND ADVANCING EQUITY

How can we provide better access to health as well as advance health equity? With many structural inequities and societal barriers barring an alarming percentage of the population from being able to gain and maintain health, creating universal access to health may seem daunting. However, by defining health not only as physical but along multiple dimensions, tackling health inequities through coalitions and multi-sector partnerships, and understanding that health equity is critical to the future of our economy and society, it is possible for individuals to become the healthiest versions of themselves—and thereby fulfill their potential.

Health is not merely the absence of illness, but the complete state of mental, physical, and social wellbeing.

How exactly does health happen? While many equate good health primarily with medical care that is high quality, accessible, affordable and culturally competent, many hospital and healthcare institutions today still see a high rate of readmittance despite competent care. Unfortunately, the rise of structural inequities has exacerbated poor conditions in neighborhoods, schools and homes, and poor health outcomes continue to persist, revealing that healthcare alone is clearly not the answer. In order to understand health better, the World Health Organization has defined “health” not only as the mere absence of disease or injury, but as the complete state of physical, mental and social wellbeing—demonstrating that health is a much broader and nuanced concept that requires a multipronged approach.

Dr. Lauren Smith, Chief Health Equity and Strategy Officer, CDC Foundation. Photo by Daniel Perez.

Health is something we create as societies and communities.

While at the individual level we may be able to exercise autonomy and make choices that affect our own individual health, these choices and behaviors exist within a context—and it is ultimately the responsibility of the shared institutions and systems we develop as a society to create an ecosystem that fosters health equity. In healthy communities, there is a landscape of options where health is made readily available to individuals, such as safe and decent housing, clean air, safe drinking water, safe places to be physically active, an abundance of healthy and affordable food, and reliable transportation to living-wage jobs.

Health equity is when everyone has a fair and just opportunity to obtain their highest health.

Unfortunately, much like how we as a community can create health, we can also collectively create health inequities. When there is a lack of vital community conditions, issues such as toxins in the soil, contaminated water, lack of green spaces, food deserts and food swamps, scarce transportation and low-wage jobs create an ecosystem where becoming healthy can prove extremely difficult. Contrary to popular belief, these conditions are not merely a matter of bad luck or the inevitable requirement of the human condition; they exist because of choices made in the past and present as societies decide how vital community conditions should be distributed.

What is health equity then? According to the Center for Disease Control, health equity is when everyone has a fair and just opportunity to attain their highest level of health. However, achieving this will require focused and ongoing societal efforts to address historical and contemporary injustices, overcoming economic and social obstacles to health, and eliminating preventable health disparities.

Health inequity is costing us a fortune—and potentially our future.

Not only is health inequity affecting individual and community wellbeing, but the economy as well. The reality is that our social and economic wellbeing are inextricably linked, and the social and economic costs of health inequity are experienced by all of us. But how exactly can we tackle these inequities to increase economic wellbeing? In Kellogg’s 2018 report “Business Case for Racial Equity,” the study found that the U.S. could save $93 billion a year in excess medical costs and $42 billion in untapped productivity if we eliminated racial disparities in health. Indeed, with data revealing that by 2050 the majority of the U.S. population will be people of color—as well as a decrease in the number of working age people—it is of the utmost importance that we tap into the productivity of the people we do have in order to tackle inequities that lead to poor economic outcomes.

MEASURING THE COST OF POOR WELLBEING

It is important for leaders and organizations to understand how people feel, and measuring the wellbeing of their workforce in particular is critically important. Indeed, with a cost of 7.8 trillion dollars in lost productivity alone due to low worker engagement in the workplace, the cost of poor wellbeing is tremendous. In order to increase wellbeing, it is important to measure outcomes not only at work, but across all five dimensions of wellbeing for individuals. It is crucial that cohesion between providers and services be established in order to fully support patients throughout their mental healthcare journey and ultimately lead them back to wellness.

Greater wellbeing in the workforce yields greater outcomes for organizations.

Leaders have a big role to play in wellbeing. Wellbeing is important because it affects not only the decisions that people make at the individual, organizational and societal levels, but the decisions of those around them as well. It is especially important in organizations, therefore, that leaders—especially managers—understand the wellbeing of employees in order to create an engaged and thriving environment, ultimately leading to more productivity and profitability.

There are mechanisms in every organization that can be used to increase employee wellbeing. By focusing on work culture, for example, leaders can create an environment based off of Gallup’s Five Elements of Wellbeing. Such an environment can increase the probability that an organization’s workforce has good health outcomes, helping them to thrive and to become more resilient.

Measuring the Cost of Poor Wellbeing Panel. Photo by Daniel Perez.

Similarly, managers can aid in the wellbeing of their workforce by working directly with employees to understand each individual’s situation and create regular conversations surrounding their goals.

Care providers have a responsibility to support wellbeing in patients.

Healthcare providers play a critical role in wellbeing. When trying to make an appointment with a mental health clinician today, the average wait time is two to four months—and even then, it takes time to find the right match and build a trusting relationship. Unfortunately, most psychiatrists don’t measure clinical outcomes of patients or follow them throughout their journey, causing patients to restart with each new care provider they see. Therefore, it is important that the healthcare industry focus on measuring and keeping track of outcomes for mental health patients, and that doctors be held accountable for measuring these outcomes.

There is a need for a more coherent experience in behavioral and mental health. While there are a lot of solutions available for behavioral health and wellness, there is a lack of communication between services. From therapy services to medication management to independent apps for meditation, the variety of services can become overwhelming—so it is important that a more cohesive, all-encompassing experience be implemented in order to create a more effective mental healthcare system.

Focusing on wellbeing in vulnerable communities is especially important. With the stigma of depression and suicide still heavy, those struggling with these issues comprise one of the most vulnerable and silent communities in the U.S. today. In order to get people struggling with suicide and depression the help they need, it is critical to provide easier access to treatment. Telehealth is an online service that has the ability to provide more privacy to their patients. Another organization, Cerebral, uses a machine learning algorithm to scan text messages and detect with ninety-nine percent accuracy whether there is suicidal intent with a text message. Using this technology, a crisis response team then reaches out proactively to the patients to ensure they are okay.

Left, Dr. David Mou, CEO, Cerebral. Right, Jim Harter, Chief Scientist, Gallup. Photos by Daniel Perez.

THE OPIOID CRISIS

In 2021, there were 107 thousand deaths due to the opioid crisis—a drastic increase since the beginning of the crisis in the late 1990’s. The question is, then: despite the U.S. having been aware of opioid addiction for over 20 years, why and how are these numbers increasing? COVID-19 may have revealed a potential reason why. With opioid overdoses tied to the much larger societal problem of addiction, the conditions created by the COVID-19 pandemic led many people to turn to opiates as a way to self-medicate issues such as isolation, loneliness, and unemployment brought on by the pandemic. In fact, contrary to popular belief, the opioid crisis and addiction in general is not an indication of a moral failing or a behavioral issue, but instead a condition that stems from an attempt to self-medicate deep pain, trauma and abuse. Therefore, in order to combat this crisis, it is important to not only begin addressing larger societal issues around loneliness and trauma, but also to both view addiction through the lens of mental health and to destigmatize addiction—and more importantly, to create an environment of support and recovery for those struggling with substance use disorders.

There are several major barriers to the opioid crisis.

Most doctors are under-educated about addiction. According to Dr. Lipi Roy, an addiction medicine physician and news medical contributor, most doctors never learn about addiction, and

Understanding the Opioid Crisis Panel. Photo by Daniel Perez.

there is still very little known about pain management—which is why when Purdue Pharma began marketing oxycontin to healthcare professionals, doctors had their gaps in knowledge around addiction exploited. They were told that treating pain with opioids was evidence-based and wouldn’t be addictive—which is misinformation that has led to the opioid crisis as we know it today.

We don’t invest enough in treatment, rehab, or harm reduction tools for addiction. While the U.S. has become good at treating health issues such as heart attacks with full support teams and treatment plans, those with substance use issues do not have nearly the same access to care. In fact, of the 21 million Americans with a substance use disorder, only 10 percent have access to treatment. It is critical, therefore, that we not only create better access to treatment, but also that we begin looking at the living situations and support systems of those struggling with addiction as these can be a first line of defense against substance use issues.

Stigma is the biggest barrier to getting help. According to WHO, drug addiction is the most stigmatized social problem today, with medical professionals, policy makers and law enforcement often highly misinformed about the issue. Similarly, healthcare providers are often too cautious about asking patients important questions such as how much they’ve drunk or if they have issues at home, which prevents many of people from being identified as someone who may need care. However, it is important to realize that everyone knows someone who is experiencing addiction, and that de-stigmatization is critical to allowing people to feel comfortable enough to ask for help.

Moderator Rebecca Bagley, President & CEO, The Kennedy Forum.

Photo by Daniel Perez.

Expectations around treatment are a barrier. With a general misconception that substance care treatment consists of entering into an expensive rehab center for 90 days and going home “cured,” the probability of relapse remains extremely high. In reality, opioid and substance use disorders are a chronic condition that require a long-term treatment plan with an expansive support system.

There is a shortage of workers in the healthcare workforce. In order for people to truly engage in their mental health or substance use care, they need to feel comfortable with their provider—but with a lack of diversity in an already limited amount of healthcare providers, matching patients with providers they can relate to in terms of race, gender, sexuality and other factors can prove difficult. Additionally, the need for an expanded care team to address the needs of substance use patients—not only medically, but also mentally and socially—will require an increase in the number of healthcare professionals.

There are potential solutions to help tackle the opioid crisis.

Health plans and healthcare providers may be able to help decrease access to opioids. Dr. Doug Nemecek, Chief Medical Officer at Cigna, describes how after an escalation in opioid prescriptions in 2013, his company began to look more closely into the overdose claims they received and began setting targets to decrease opioid prescriptions through their health plan by 25 percent within three years—and has already seen an 18 percent decrease in the last two years.

Understanding the Opioid Crisis Panel. Photo by Daniel Perez.

We need to change our vocabulary around substance use. Using terms such as “substance abuser” or “drug abuse” can lead to patients becoming less likely to seek care due to perceived discrimination, especially if it is healthcare providers who are using that language. Instead, changing the language to more neutral terms such as saying “a person with substance use issues” can improve the therapeutic relationship and lessen stigma around addiction.

We are starting to see positive changes in how we treat substance use issues. Recently, federal regulations have been eased when it comes to methadone prescriptions, creating easier access by allowing for 30-day doses. Similarly, mandatory urine screening is no longer required before starting people on buprenorphine or naloxone. In terms of expanding and diversifying the workforce, the American Society of Addiction Medicine is beginning to train doctors and nurses on substance use disorders and addictions, as well as reaching out into underrepresented communities to train a more diverse workforce.

MENTAL HEALTH AND SUICIDE PREVENTION

According to the Surgeon General, the average time it takes to receive care after the onset of a mental health issue is 11 years—a period during which a child with mental health issues could go their entire school career without receiving any of the care they might need. With a severe shortage in school psychologists and child psychiatrists, however, the vast majority of children lack access to proper treatment and services that may otherwise help prevent their mental health from worsening. Anne Brown, president and CEO of the Cook Center for Human Connection, describes how providing mental health support in schools and resources for parents may be the answer to increasing good mental health and preventing suicide in adolescents. By focusing on schools, not only does access to mental health services become equitable for everyone by removing financial and geography barriers, it also creates a team of parents, teachers and counselors that can provide a larger support system for their children.

While we don’t have a right to healthcare, every child in the U.S. has a right to education, and through it, mental healthcare may be obtained.

Anne Brown, President & CEO, The Cook Center for Human Connection.

Photo by Daniel Perez.

. However, every child in the U.S. has a right to education and through it, mental healthcare may be obtained. With schools having become not only institutions of education but also a unique place where an increasing number of societal problems are being addressed—such as fighting childhood hunger with school lunch programs—it may be possible to address mental health problems within the school setting as well. Unfortunately, in the United States it is estimated that there is currently one school psychologist for every 1,500 kids, with rural areas showing one school psychologist for every 10,000 kids. Yet with a staggering 1 in 7 children experiencing depression, anxiety or ADHD, it is apparent that there is a drastic need for more mental health services beyond what schools can currently offer.

Through the Cook Center for Human Connection, a number of resources have been created, which are available for free to schools and parents alike. Through parentguidance.org, for example, parents are provided a resource that can help inform them on how to say the right things to children in order to not only help them deal with issues such as anxiety and depression, but also help them to become successful in multiple areas of life. Similarly, the Cook Center’s animated series, titled “My Life is Worth Living,” aims to show stories that can demonstrate to adolescents that they are not alone in their mental health struggles—and more importantly, that help is available—through platforms such as YouTube, TikTok, and the National Suicide Prevention Lifeline.

Much like a first aid class, these resources aim to assist parents in becoming the first line of help when a child is struggling with their mental health. By educating parents on how to deal with issues such as bullying, anxiety and suicide signals, it is possible to not only free up services provided by school psychologists so they can focus on adolescents with more complex issues, but also prevent a lot of mental health issues from happening altogether.

THE ECONOMICS OF WELLBEING

Across the globe, people with high levels of wellbeing consistently outperform those with lower levels of wellbeing. In addition, studies have shown that people with high wellbeing have lower rates of disease and are less likely to readmit to hospitals. In terms of mental health and emotional wellbeing, those with high wellbeing have lower rates of depression and anxiety and designate a higher overall life satisfaction rating in polls. On the community and state levels, communities with higher wellbeing have increased high school graduation rates and lower rates of crime. And in terms of work, those with an overall high wellbeing have lower rates of absenteeism.

With the terms “health” and “wellbeing” often defined primarily along the lines of physical health, most large organizations today offer programs and incentives—such as gym memberships, diet plans and yoga classes—that focus on the physical wellbeing of their employees and not so much on other aspects of wellbeing. While physical wellbeing is an important keystone to wellness, other key elements of wellbeing, such as social wellbeing, financial wellbeing, community wellbeing and work wellbeing, are also essential to creating holistic wellbeing in the individual—and through them, increased wellbeing in an organization.

Gallup polls have revealed that only 7 percent of adults are thriving in all five dimensions of wellbeing, with a mere 4 percent thriving in physical health alone. Interestingly, comparing the two subgroups—

Dan Witters, Research Director, Gallup National Health and Wellness. Photo by Daniel Perez.

those with holistic wellbeing and those who only have high physical wellbeing—revealed that employees with high physical wellbeing still missed 68 percent more work due to poor health than employees with holistic wellbeing, as well as being three times more likely to suffer accidents and twice as likely to change jobs. Ultimately, if organizations continue to invest solely in the physical wellness of their employees and ignore other aspects of wellbeing, they will be missing out on the untapped potential of their workforce.

Through studies that have tracked employees over a multi-year period, Gallup has found a highly reciprocal relationship between employee engagement in the workplace and an employee’s overall wellbeing. In other words, the more an employee felt engaged, the higher the employee’s wellbeing became and vice versa. In fact, Gallup found that employees with both high engagement and high wellbeing outperformed everyone else across an array of outcomes.

In order to increase both engagement and wellbeing, it is best to begin with employee engagement. Studies by Gallup have found that by first increasing employee engagement, engaged employees are 79 times more comfortable talking about wellbeing with their manager, and much more likely to be aware of and participate in wellness programs and offerings in the workplace—thereby leading to an increase in their holistic wellbeing, reinforcing their willingness to engage in the workplace.

By asking workers to answer the statement “my organization cares about my overall wellbeing,” Gallup found that while throughout the mid-2010’s only 20 to 29 percent of workers agreed strongly with that statement, during the peak of the COVID pandemic in 2020—a time when mitigation policies such as mandatory masks, social distancing and washing hands routinely became the norm—49 percent of workers strongly agreed that their organization cared about their overall wellbeing. Unfortunately, recent polls have found that only 21 percent of workers today feel that their organization cares about their wellbeing, demonstrating that while this bump wasn’t necessarily artificial, it also wasn’t sustainable.

In order to start increasing the percentage of workers who agree that they feel cared about in the workplace, there are four practices organizations can put into place. First, providing easy access to healthy foods for their employees; second, providing financial wellbeing services such as retirement planning, 401k and budgeting planning; third, including family members in wellbeing programs; and lastly, soliciting opinions from employees on what their organization can do to increase wellbeing amongst workers. By focusing on workers’ wellbeing, organizations will see that workers miss less work, experience less burnout, become better advocates for their organization, and increase their overall wellbeing.

INNOVATING FOR A FUTURE OF HEALTH THAT IS INTEGRATIVE AND EQUITABLE

With the future of health arriving quickly, it is important to ask: how can we help health arrive well for everyone? In health industries around the world, old models and ways of thinking are beginning to decay, and innovations both big and small are helping to transform the healthcare system from one that focuses on sick-care to one that is based on well-care. Unfortunately, issues surrounding access to basic health necessities still affect half the population of the world, and a lack of a universal definition of what “wellbeing” means due to cultural and language differences makes it difficult to come together to co-create equitable health systems. Despite these challenges, however, the future of health appears bright, and it may not be so long until we see a world of health that is truly integrative and equitable.

There are many old systems and ideas that are decaying

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Health. Healthcare systems are decaying. As the COVID-19 pandemic has revealed, healthcare systems both locally and globally appear outdated and inefficient. Unfortunately, it could take anywhere from 20 to 60 years to update these systems to serve the health needs of everyone. At the same time, numbers show that half of the world’s population today doesn’t have access to basic healthcare and essential health services—and therefore

Innovating for a Future of Health that is Integrative and Equitable Panel.

Photo by Daniel Perez.

do not have twenty to sixty years to wait. Daniella Foster, SVP and Global Head of Public Affairs in Science and Sustainability at Bayer’s Consumer Health Division, posits that it is crucial that we start looking for pragmatic solutions that can be implemented as soon as possible.

The traditional bio-psycho-social model is decaying. In health, we often put physical wellness first, mental wellbeing second, and social wellbeing last. Dave Allman, Chief Growth Officer at Wellbeing at Work, describes that in order to solve for health issues that the traditional bio-psycho-social model has not been able to rectify, flipping the model on its head and focusing on life first, the mind second, and the body last could lead to new ways of thinking about health and wellbeing.

Existing ways of doing things that are proving not to work are decaying. In terms of psychology, a lot of the field has been driven by Western-centric ideas—and with most of the field being conducted in English, psychology is limited by concepts available in English, the ideologies and values embedded in English, and the culture of English speakers more generally. Dr. Tim Lomas with The Human Flourishing Program explains that conversations are becoming much more global and inclusive, leading to new insights, theories, knowledge and perspectives on the person and wellbeing.

Stigma is decaying. While the decay of stigma is making room for new conversations, the challenge for organizations today is to figure out how to respond to this change. Sara Pierce, Senior VP of Strategy at Magellan Health, explains how working on flexibility and responding to the different views of customers as well as stakeholders will be crucial to creating change, becoming thought leaders, and challenging the status quo.

Daniella Foster, SVP & Global Head of Public Affairs, Science and Sustainability, Bayer’s Consumer Health Division. Photo by Daniel Perez.

There are a multitude of innovations that are transforming the future of health.

Self-care has become a critical part of healthcare. After the advent of the COVID-19 pandemic, greater emphasis has been placed on caring for oneself, one’s family and even one’s community. Science-based, preventative self-care has become essential to health today, with self-care even acting as the first and last line of care in health deserts where people lack access to basic health services. Ultimately, while there are conversations surrounding the healthcare system transitioning from a system that is based on sick-care to one that is based on wellcare, it is important that innovations continue to trend towards preventative care.

There are innovations that are leading towards transformations that help us rethink where health happens. In terms of basic access to healthcare, technologies such as QR codes are being used to help underserved communities, and last mile delivery services are being put into place for areas that lack access to broadband. In terms of high-end personalization, there are companies that have begun focusing on personalized nutrition and AI technology that is now capable of creating individualized assessments based on an individual’s symptoms. Through these sorts of innovations, health is becoming more convenient, and the individual is becoming more empowered in taking charge of their own health.

We can credential wellbeing and resilience. While we are beginning to have conversations about wellbeing, it is important that we also begin viewing wellbeing as something actionable—and therefore, begin to understand that it is something that can be

Dr. Tim Lomas, Scientist, The Human Flourishing Program, Harvard University. Photo by Daniel Perez.

learned, practiced and mastered. By viewing wellbeing as a competency, it can become something that is credentialed and put on peoples’ resumes—something that both demonstrates selfcare and self-awareness on the side of employees. It can also demonstrate how investing in credentials dealing with wellbeing and resilience would be beneficial for employers.

There are several things we need to keep an eye on as we work towards creating a more equitable healthcare system.

We need to cultivate a systemic perspective while making sure to not lose sight of the person. While psychology often uses the metaphor of looking at the person as a container, Dr. Tim Lomas argues that it may be more useful to look at the person as a field. In terms of depression and anxiety, for example, psychology often explains depression and anxiety as occurring in the mind— but what if depression and anxiety weren’t a sign that something is wrong with the person, but were an indication that something is wrong with how we’re structuring our lives collectively as a society and planet? By viewing the person as a field, we can focus more on both the individual as well as their relationship with society and vice versa.

We need to keep focusing on social determinants of health as well as health education. It is important to continue to work towards removing barriers to healthcare for underserved communities, as well as working towards helping the rest of the healthcare system become more practical. From how clinical studies are being done to how we train doctors and how we are empowering community healthcare workers, it is critical that we continue to focus on the basics as these are key to building more equitability. Similarly, focusing on health education will empower people to better care for themselves and communicate their healthcare needs.

TO INFO WELLNESS

Just like how the food you eat affects your body, information you consume affects your mind—and in today’s world of clickbait and misinformation, how you inform yourself has become critically important, explains Mario Vasilescu, CEO and co-founder of Readocracy. Unfortunately, while we are good at talking about the problems, symptoms and outcomes of misinformation, we have yet to figure out how to have productive conversations around the structure and root causes of misinformation—and most importantly, how to create solutions. It is critical that not only do we become more mindful of the information we consume on a personal level, but that we also begin pushing for innovations that can help people regulate their content as well as put into place policies and legislation that can combat the spread of misinformation.

There is an important parallel between food consumption and information consumption.

We are currently experiencing infobesity. Studies show that on average, the individual spends seven hours a day consuming content in a system designed to encourage consumers to mindlessly gorge as much as possible. While both high-quality long-form content and clickbait exist on the Internet, there is no reward or consequence for picking one type of content over the other, and consumers are left to make the decision on what to read based on their own sense of responsibility. Unfortunately, with the Internet optimized for quantity of content and not quality, we are moving into a world rife with

Mario Vasilescu, CEO & Co-Founder, Readocracy. Photo by Daniel Perez.

digital addiction, depression, violence, threats to democracy and a fundamental pollution of truth.

Not long ago, food advertisements were full of misinformation—and solutions were created to combat this. Much like today’s confusing information landscape, our concept of food and what was considered healthy in years past was often solely dictated by advertising put out by food companies. This problem was ultimately solved in four steps: first, consumers and policymakers became more educated about food and nutrition; second, they put food into a mandatory context by creating nutrition and ingredient label laws; third, they made it count by quantifying the data; and fourth, they put into place laws on unhealthy influence—such as regulating food advertisements.

We can apply our solutions from food consumption to information consumption. As a result of regulating the system, we have now become more aware of food information, and consequently consumers are now conditioned to automatically consider information such as calorie count, nutrition, and how food affects the body. As this guided process has demonstrated, consumers can now instinctively make better decisions about the food they eat—and perhaps by applying this same concept to the consumption of information, we can begin to decrease the spread of misinformation and create better access to high-quality content.

We need innovations and regulations in order to combat infobesity.

We can fix the information system much like we fixed food information. First, we need to increase media literacy in schools not only through non-profits, but through other, larger avenues as well; second, we need to create mandatory context around the content we consume, such as filters that indicate whether the content you are consuming comes from a misinformation source or if it uses agitation tactics; third, we need to make it count by quantifying the data consumed; and fourth, we need to create laws on unhealthy influence.

What if there was a Fitbit that could track your information diet? Data shows that individuals will spend as much time-consuming content as they would studying for four college degrees. What if this information could not only be tracked, but also credentialed? Using Readocracy’s technology, a profile is created that can track how the information you consume affects your mood and your biases as well as reveals hidden patterns of influence and agitation triggers. If such a technology were to become more widely utilized, this intellectual portfolio could potentially be used not only as a credential that reflects what information you’ve learned in your free time, but could also combat misinformation by indicating on social media platforms who is or is not well-informed on topics they are posting about.