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Interview
A Unique Short
Course To Be Offered On Exploring The Linkages Between Mental
Well-Being And Physical Health Outcomes
Course Now Planned
for Next Year
A new and unique short
summer course on positive well-being and physical health is being
planned in collaboration between the Harvard School of Public Health
and University College London. The course was to be presented next
summer but has now been postponed to 2021.
There is growing
interest in taking a well-being approach to health as opposed to
focusing primarily on disease, deficits, and problems. To better
understand why and how this new course was created and what prospects
it offers to epidemiologists and other health professionals, we
interviewed
Laura
Kubzansky,
professor of Social and Behavioral Sciences, and co-director of the
Lee Kum Sheung Center for Health and Happiness, and director of the
Society and Health Laboratory at the Harvard T.H. Chan School of
Public Health.
EM:
How did the idea
originate and evolve for this course?
Kubzansky:
Andrew
Steptoe and I first started discussing this idea in the Fall of
2018. Andrew is a founding member of the Scientific Advisory Board for
the Lee Kum Sheung Center for Health and Happiness and has been a
supporter and partner in the development and growth of our Center over
the past four years. A key goal of the Center is not only to build a
rigorous and interdisciplinary science of positive health and
well-being, but also to build capacity for doing this work.
We began
discussing the idea for the course, entitled
Exploring the Linkages between Mental Well-Being and
Physical Health Outcomes, as a
way to reach a wider audience and because there seems to be a growing
interest in the topic.
Both Andrew and I are
doing research in the field and teach related courses at our
respective institutions, but we see the summer short course as a way
to broaden our reach to more scholars and policy makers who might want
to either contribute to knowledge production or use the evidence base
for decision-making. We also saw this as a good way to consolidate and
streamline material we’ve been developing into a five-day educational
opportunity. Ideally, we would like to explore ways to grow and
transform the course in the future – possibly making more material
available online or creating additional advanced courses for students
to take after they have completed this initial course offering.
EM:
Why now? Is there something special about the timing?
Kubzansky:
This field
of study is relatively new but we are entering into a period where
there is sufficient evidence and for the key questions under study
that we can begin to address major topics in the field by presenting a
foundation of knowledge and also discussing methodological issues
relevant for this work. We see this course as an opportunity to grow
the field by reaching the next generation of scholars. We specifically
target doctoral students and early career researchers and policy
makers because we hope to build a network of scholars who will lead
the next generation of research in this area.
EM:
Are there similar
courses elsewhere? If so, how does this one differ?
Kubzansky:
As far as
we know, there are no other courses that focus specifically on
exploring the linkages between mental well-being and physical health
outcomes. There are certainly other courses that look at different
aspects of well-being or that target different audiences, but ours is
the only one that focuses specifically on providing up-to-date,
state-of-the-art knowledge on the linkages between mental well-being
and physical health, as well as on providing skills with which to
critically evaluate research in this field.
The course will introduce the next generation of scholars to
the cutting-edge science that sits at the nexus of epidemiology,
social science, psychology, and medicine with the goal of stimulating
novel, interdisciplinary work. Through their involvement with the
course, participants will gain concrete skills on the different ways
of measuring well-being and evaluating linkages between mental
well-being and physical health. In addition, they will gain knowledge
related to the social and biological processes that are relevant to
these linkages.
EM:
Is it possible to give a general impression about the state of the
discipline now regarding well-being and health? Do you have a working
definition of well-being and is it different from health?
Kubzansky:
At our
Center, we like to use the WHO definition of health: Health is a state
of complete physical, mental and social well-being and not merely the
absence of disease or infirmity. So in this way, well-being is a key
part of health and not separate from it. That said, we also note that
there may be value to considering mental and physical health
separately, while understanding that there are bidirectional
relationships between them. A greater understanding of these
inter-relationships will provide important insight into potential
strategies for prevention and intervention to improve population
health. Part of our Center’s vision, and one that Andrew and his
colleagues at UCL are also working toward, is to achieve a
transformation from solely focusing on deficits, disease, and dying to
creating a broader understanding of well-being, incorporating a focus
on health assets and resources. We see this new course as a way of
working toward this vision. This requires broadening how we think
about what health means and how we think about population health.
EM:
Are you interested in exploring both the causes of well-being
considered as psychological well-being and separately
psychological well-being itself as a cause of physical health?
Kubzansky:
Increasingly, people are making the case that we should take a
well-being approach to health – this requires a broadening of how we
think about what is health and how we think about population health.
To take a well-being approach, we would need to think about not only
alleviating misery but also how to create conditions for well-being at
the positive end of the continuum and for advancing well-being all
along the continuum at the population level. When you dig into what we
know about positive health, you realize that much of what we know
regarding which factors matter, comes from studies of disease,
deficits, problems. We do not currently have a strong understanding of
the distribution and determinants of positive health, and as a result,
we need to further explore what we do know, and what we might like to
know. This includes exploring both conditions that make well-being
possible (or more likely) as well as understanding whether, when and
how psychological well-being is a causal contributor to physical
health outcomes.
EM:
Is achieving psychological well-being a worthwhile outcome of its own
whether or not it causes better physical health?
Kubzansky:
Yes,
psychological well-being is very important in and of itself. Referring
back to the WHO definition of health, psychological well-being is a
key component of overall health. In addition to any benefits it may
have for physical health, positive psychological well-being has
benefits of its own, including reduced risk of depression and anxiety,
positive benefits to relationships, improved moods, and a greater
sense of calm.
EM:
Do you believe there is a reason why epidemiologists in general should
be interested in this topic area?
Kubzansky:
Epidemiologists are interested in understanding the risk factors for
and determinants of disease, and social epidemiologists have focused
on social structural factors in this equation. However, the
traditional factors epidemiologists have studied are largely oriented
to understanding deficits, disability, disease and death. This work
does not facilitate gaining greater understanding of the full spectrum
of health. Though there was a time when people thought studying
happiness or positive mental well-being and physical health might not
be a valid area of study, increasingly there is recognition that the
absence of poor health is not synonymous with the presence of positive
functioning; thus, if we only ever study factors that relate to being
sick/dead or not, we may never gain appreciation either for what
functioning well truly looks like or for factors that relate to
functioning well. Studying positive mental health may provide
important new insights into health at this end of the continuum as
well as giving us a new window on health more broadly.
Readers seeking more information can contact the organizers at:
centerhealthhappiness@hsph.harvard.edu
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