How to Measure Well-Being

So much of a flourishing life is irreducibly personal and subjective. How can we quantify the joy we feel at our children’s smiles or the satisfaction we find in our work?

It would seem impossible that we could measure this kind of flourishing. Nonetheless, those of us at the Human Flourishing Program at Harvard are endeavoring to investigate this elusive reality, in part through our own flourishing measure, which captures core aspects of well-being, such as health, happiness, meaning, character, and social relationships, but also with other approaches.

In 2018, we, along with our colleagues at the Center for Health and Happiness, hosted an interdisciplinary workshop — including psychologists, sociologists, public health researchers, philosophers, theologians, economists, policymakers, and foundation leaders — to reflect on how we might better assess well-being in all its multifaceted richness and across a variety of settings. The workshop participants have continued to pursue and write about these questions, three years following that symposium, we have published an edited volume on Measuring Well-Being.

Our Prior Measurement Work: The Flourishing Index

To date, much of our empirical research on well-being has incorporated the flourishing index that was proposed in a 2017 paper in the Proceedings of the National Academy of Sciences. That paper also included a working definition of flourishing as living in “a state in which all aspects of a person’s life are good.” Defined so broadly, flourishing might seem to be unmeasurable. Moreover, what is considered good will of course vary across cultural, religious, and philosophical traditions.

So, can any progress on measurement be made? Granted that conceptions of flourishing will vary across traditions, nonetheless we would argue that any reasonable conception of flourishing will also, at the very least, encompass the following five domains of human life:

1. Happiness and life satisfaction
2. Physical and mental health
3. Meaning and purpose
4. Character and virtue
5. Close social relationships

The argument is not that flourishing is reducible to these five domains, but that any reasonable conception of flourishing — whatever else it might include — would include these five domains as well. Each of these is arguably (i) nearly universally desired, and (ii) constitutes its own end (it is sought for its own sake, not only as a means to some other end). These two criteria — of being nearly universally desired and being an end — might help shape consensus around what to measure.

Our flourishing index assessment includes two well-being questions (principally drawn from the existing, validated well-being literature) in each of these five domains. We also typically supplement these 10 questions with two additional questions on financial and material stability, since these are important means to sustaining the various other ends. To date, we’ve used this flourishing index assessment on over 100,000 individuals in settings including workplaces, hospitals, secondary schools, universities, long-term care facilities, and national surveys.

Data on the flourishing index will also be included in the next round of data collection for the Nurses’ Health Study — a major cohort study run at Harvard for decades, which has provided the data for many of our analyses on topics ranging from religious service attendance to purpose in life to deaths of despair to forgiveness to healthy aging. Having the flourishing index questions in the Nurses’ Health Study data will help empower the creation of a “positive epidemiology,” aimed at understanding the determinants of a flourishing life. The flourishing index questions will also constitute an important subset of the well-being questions in our upcoming Global Flourishing Study.

Well-Being

Source: AbsolutVision/Adobe Spark

Recommendations for Well-Being Measurement

Nonetheless, while this flourishing index is versatile and has many important uses, it is not the right tool for all circumstances. In some studies, one might desire a far more substantial assessment of well-being, using more questions with greater nuance. However, in other contexts, even 10 or 12 questions might be considered a lot. In major national surveys, perhaps fewer questions can be included. Moreover, a survey that works well for a multi-use cohort study might not be appropriate for a workplace or clinical context.

Given these various and competing needs and constraints, the participants in our workshop also helped formulate an interdisciplinary set of recommendations regarding potential questions and kinds of assessments that might be most suitable for different purposes. We acknowledged that these recommendations were provisional, as our knowledge and understanding of well-being measurement is advancing rapidly, but they provide some guidance for those new to the field, or for those who perhaps wanted to begin to collect well-being data in surveys designed principally for other purposes. For a brief but broad assessment, our flourishing index is a useful approach, but it is not the right tool for all contexts.

Health Essential Reads

The Patient Safety Risk Model

Is Vitamin D Supplementation an Evidence-Based Practice?

As with any set of recommendations, these too are also subject to critique, and critique did indeed follow. Carol Ryff and colleagues put forward a dissenting view and also expressed particular concern about brief well-being assessments, perhaps especially single-item well-being assessments, arguing that they trivialized the field of well-being research.

In our response, we in turn argued that even brief single-item well-being assessments can be informative, and that a brief assessment is better than nothing at all. It is of course important to be aware of what is being missed — of what is not being assessed — with any measure. Nevertheless, short measures can still arguably be helpful. What we measure shapes what we discuss, what we know, what we aim for, and the policies put in place to achieve it. To not measure well-being at all is, in many contexts, to leave it out of the discussion. Even a brief assessment can often be useful.

Exploring New Frontiers

However, if flourishing is indeed to be understood as living in “a state in which all aspects of a person’s life are good,” then we must again acknowledge that no measurement — no assessment — is going to be fully adequate. Moreover, any well-developed understanding of flourishing will almost certainly include additional aspects of life that extend beyond happiness, health, meaning, character, and relationships. For much of the world’s population, some notion of spiritual well-being will also be highly important — sometimes the most important — and its specific content will of course vary across the world’s diverse spiritual and religious traditions. There may be other culturally specific aspects of well-being that are not adequately captured by more universal assessments. Moreover, the notion of well-being or flourishing extends beyond the individual and also includes communal well-being.

Our book Measuring Well-Being explores these frontiers of well-being assessment. It brings together social scientists, biomedical researcher, philosophers, theologians, and policy-makers to begin to push the frontiers of well-being assessment into these other areas. A more adequate approach to measuring well-being will likely combine generic, universal assessments (around which we can obtain consensus) with culturally or religiously specific assessments, communal well-being assessments, and, when resources allow, more nuanced, assessments of the more granular elements of well-being.

In addition to these contributions and debates, our book also offers policy reflections on well-being; provides various contributions from the humanities; and surveys how different aspects of psychological well-being relate to physical health, and how different aspects of well-being relate to each other. It also includes new measures of meaning, of peace, of spiritual well-being, of community well-being… and much else besides.

We very much hope that Measuring Well-Being, along with the ideas, conversations, debates, and new approaches that may arise from it, will help shape new and more complete approaches to measuring well-being — to measuring the unmeasurable. And we hope that by better measuring and studying well-being, we may be able to better promote it, and to bring about a better world.

Tyler J. VanderWeele, Director

Human Flourishing Program

Harvard University