Developing Wellbeing for All Developing Wellbeing for All People – A “Systems Approach”People – A “Systems Approach”

Using a Genuine Progress Index Using a Genuine Progress Index in New Zealandin New Zealand

22

Growing InterestGrowing Interest

Growing interest in measurement of Growing interest in measurement of quality of life and wellbeing quality of life and wellbeing internationally.internationally.

OECD World Forum on “Statistics, OECD World Forum on “Statistics, Knowledge and Policy” – Korea, Oct Knowledge and Policy” – Korea, Oct 2009 attended by 1000 people.2009 attended by 1000 people.

Work ongoing in New Zealand Work ongoing in New Zealand

33

Purpose of PaperPurpose of Paper

Set out to explore a “systems approach” Set out to explore a “systems approach”

to overall wellbeing – how it can lead to to overall wellbeing – how it can lead to

more effective adoption and commitment more effective adoption and commitment

by policy and decision makers – to achieve by policy and decision makers – to achieve

the results we seek. the results we seek.

44

Gross Domestic Product (GDP)Gross Domestic Product (GDP)

Growth in GDP considered a Growth in GDP considered a prerequisite for a healthy economy prerequisite for a healthy economy and a healthy society.and a healthy society.

““Dark” side of 4% growth paDark” side of 4% growth pa

Unsustainable resource depletionUnsustainable resource depletion

Unsustainable social consequencesUnsustainable social consequences

55

GDP Growth CorrelationsGDP Growth Correlations

Growth in GDP leads to growth in Growth in GDP leads to growth in social economic inequities (rich poor social economic inequities (rich poor gap)gap)

Unequal societies create poor health, Unequal societies create poor health, more social conflict, crime and more social conflict, crime and violence – that money can’t fix violence – that money can’t fix

66

Systems ThinkingSystems Thinking

A system is defined by the A system is defined by the components and the linkages components and the linkages between the componentsbetween the components

An excellent example of how a An excellent example of how a system works can be found in the system works can be found in the health sectorhealth sector

77

Health SectorHealth SectorImproving public health has little to do Improving public health has little to do with the Ministry of Health, but everything with the Ministry of Health, but everything to do withto do with

Growing rich poor gap, social status, Growing rich poor gap, social status, quality and safety of the food we eat, quality and safety of the food we eat, obesity, housing, life styles, the obesity, housing, life styles, the environment - a key but unacknowledged environment - a key but unacknowledged cause of many diseases such ascause of many diseases such as

cancer, Alzheimer’s and cardiovascular cancer, Alzheimer’s and cardiovascular diseases, etc. diseases, etc.

88

Health and the EconomyHealth and the EconomyOne of greatest economic challenges One of greatest economic challenges today is becoming the today is becoming the unaffordabilityunaffordability of of health. health.

Treating patients at “bottom of cliff” with Treating patients at “bottom of cliff” with costly high tech – accelerating costscostly high tech – accelerating costs

Transnationals delivering hi tech are Transnationals delivering hi tech are driven exclusively by profit motive driven exclusively by profit motive

Few resources going into prevention, Few resources going into prevention, healthy life styles, natural health, healthy life styles, natural health, community approachescommunity approaches

99

The Makings of a System The Makings of a System ProblemProblem

• Trying to “grow the economy” to Trying to “grow the economy” to accommodate this burgeoning health accommodate this burgeoning health budget is not a sustainable strategybudget is not a sustainable strategy

• It is self-defeating – it feeds the It is self-defeating – it feeds the problem not the solutionproblem not the solution

1010

Measuring OutcomesMeasuring Outcomes

What we measure is what we valueWhat we measure is what we value

A good way to measure an economy A good way to measure an economy is by what it produces in social, is by what it produces in social, environmental and personal environmental and personal economic outcomes economic outcomes

1111

Simon KuznetsSimon Kuznetsarchitect of the GDP saidarchitect of the GDP said

““the welfare of a nation can scarcely the welfare of a nation can scarcely

be inferred from a measurement of be inferred from a measurement of

national income as defined by the national income as defined by the

GDP …. goals for “more” growth GDP …. goals for “more” growth

should specify “should specify “of whatof what” and “” and “for” for”

whatwhat”?”?

1212

Jose Manuel BarrosJose Manuel BarrosEuropean Commission PresidentEuropean Commission President

““GDP is unfit to reflect many of GDP is unfit to reflect many of today’s challenges, such as public today’s challenges, such as public health, climate change, and the health, climate change, and the environment. We cannot face the environment. We cannot face the challenges of the future with the challenges of the future with the tools of the past”tools of the past”

1313

Robert Kennedy saidRobert Kennedy said

The GNP does not allow for the health of our The GNP does not allow for the health of our children, the quality of their education, or the children, the quality of their education, or the joy of their play. It does not include the joy of their play. It does not include the beauty of our poetry or the strength of their beauty of our poetry or the strength of their marriages; the intelligence of our public marriages; the intelligence of our public debate or the integrity of our public officials. debate or the integrity of our public officials. It measures neither our wit nor our courage; It measures neither our wit nor our courage; neither our wisdom now our learning; neither neither our wisdom now our learning; neither our compassion nor our devotion to our our compassion nor our devotion to our country; it measure everything, in short, country; it measure everything, in short, except that which makes life worthwhile. except that which makes life worthwhile.

1414

Key QuestionsKey Questions

How can we improve the wellbeing How can we improve the wellbeing and quality of life of all people across and quality of life of all people across a wide spectrum of themes (as a a wide spectrum of themes (as a systems approach to wellbeing) and systems approach to wellbeing) and attract the interest and commitment attract the interest and commitment from national policy makers and from national policy makers and decision makers to assist in decision makers to assist in achieving the results we seek? achieving the results we seek?

1515

Possible Answer #1Possible Answer #1The NZ local government initiative “The NZ local government initiative “Quality of life Quality of life of 12 Largest Citiesof 12 Largest Cities” measures the following ” measures the following themes:themes:

PeoplePeople Knowledge and skillsKnowledge and skills HealthHealth Safety HousingSafety Housing Social ConnectednessSocial Connectedness Civil and political rightsCivil and political rights Economic Standard to livingEconomic Standard to living Economic DevelopmentEconomic Development Natural EnvironmentNatural Environment Built Environment Built Environment

1616

QoL Report QoL Report Health multiple indicatorsHealth multiple indicators

Life expectancyLife expectancy

Low birth weight babiesLow birth weight babies

Infant mortalityInfant mortality

Teenage parentsTeenage parents

Communicable diseasesCommunicable diseases

Access to general practitionersAccess to general practitioners

Mental health and emotional wellbeingMental health and emotional wellbeing

Self-reported health statusSelf-reported health status

Modifiable risk factorsModifiable risk factors

Recreation and leisureRecreation and leisure

1717

Answer #2Answer #2

Systems approach measures Systems approach measures interconnected relationships within the interconnected relationships within the systemsystem

Horizontal determinantsHorizontal determinants Vertical determinantsVertical determinants Social networks, supports, volunteersSocial networks, supports, volunteers

1818

Horizontal DeterminantsHorizontal DeterminantsLinkages across indicators, as Linkages across indicators, as illustrated earlier in Healthillustrated earlier in Health

Some health determinants (linkages)Some health determinants (linkages) Rich poor gap / Social statusRich poor gap / Social status Personal incomePersonal income HousingHousing EnvironmentalEnvironmental Quality / safety of our foodQuality / safety of our food AbestityAbestity Life style Life style

1919

Vertical DeterminantsVertical Determinants

The relationship between outcomes The relationship between outcomes

and government programmes and and government programmes and

policiespolicies

2020

Social networks, supports, Social networks, supports, volunteerismvolunteerism

According to Health Canada:According to Health Canada:

““The caring and respect that occur in The caring and respect that occur in social networks, as well as the resulting social networks, as well as the resulting sense of wellbeing, seem to act as a buffer sense of wellbeing, seem to act as a buffer against social problems. Indeed, some against social problems. Indeed, some experts in the field believe that the health experts in the field believe that the health effect of social relationships may be as effect of social relationships may be as important as established risk factors such important as established risk factors such as smoking and high blood pressureas smoking and high blood pressure””

2121

Answer #3Answer #3Objectivity / SubjectivityObjectivity / Subjectivity

NZ Quality of Life report uses subjective NZ Quality of Life report uses subjective evaluation in a biannual Quality of Life evaluation in a biannual Quality of Life survey to measure the perceptions of survey to measure the perceptions of wellbeingwellbeing

Some people believe that only objective Some people believe that only objective indicators should be used to form policiesindicators should be used to form policies

Others believe that they are central to the Others believe that they are central to the development of quality of life indicatorsdevelopment of quality of life indicators

Both are required Both are required

2222

Answer #4Answer #4Full Cost Accounting (FCA)Full Cost Accounting (FCA)

As advocated by Dr. Ron Colman, CanadaAs advocated by Dr. Ron Colman, Canada

A “full cost accounting” cost benefit analysis is A “full cost accounting” cost benefit analysis is performed on each indicatorperformed on each indicator

FCA enables policy makers to understand FCA enables policy makers to understand externalized and internalized costs, externalized and internalized costs,

FCA is a key mechanism for capturing the FCA is a key mechanism for capturing the attention and commitment of policy makers. attention and commitment of policy makers.

This is a primary strategy to curtail the misuse This is a primary strategy to curtail the misuse of the GDP. of the GDP.

2323

Answer #5Answer #5Use a Genuine Progress IndexUse a Genuine Progress Index

A GPI which uses the first 4 answers.A GPI which uses the first 4 answers.

Three examples are given here:Three examples are given here:

Original GPIOriginal GPI by Clifford Cobb by Clifford Cobb

Improved GPIImproved GPI by Dr. Ron Colman by Dr. Ron Colman

A NZ programme in formative A NZ programme in formative stage, “stage, “What Matter Most to What Matter Most to New New ZealandersZealanders””

2424

Original GPIOriginal GPIDesigned to replace the GDP with a “green Designed to replace the GDP with a “green GDP” – adjusted for omissions and GDP” – adjusted for omissions and ++ value value (designed on GDP “terms”) (designed on GDP “terms”)

Therefore structured specifically to do that Therefore structured specifically to do that task- which limits its usetask- which limits its use

Uses an aggregated single number Uses an aggregated single number

Qualified economic components as costs Qualified economic components as costs and benefits + adds new components left and benefits + adds new components left out of GDP (inflexible)out of GDP (inflexible)

One basic difficulaty is that it includes One basic difficulaty is that it includes private and public consumption as a private and public consumption as a “benefit” “benefit”

2525

Graph of GDP vs GPIGraph of GDP vs GPI

2626

Original GPI Developed for NZOriginal GPI Developed for NZ

Massey / Landcare contract with Massey / Landcare contract with FRST produced a GPI for NZ modelled FRST produced a GPI for NZ modelled after the original work of Clifford after the original work of Clifford CobbCobb

Massey also created this form of GPI Massey also created this form of GPI for Auckland and Waikato regionsfor Auckland and Waikato regions

2727

Nova Scotia GPINova Scotia GPIAddresses difficulties associated with original Addresses difficulties associated with original GPIGPI

Created by Dr. Ron ColmanCreated by Dr. Ron Colman

Does not aggregate into a single numberDoes not aggregate into a single number

Instead uses “Full Cost Accounting” Instead uses “Full Cost Accounting”

Uses “determinants” to analyze and reportUses “determinants” to analyze and report

Being considered to be adopted by Nova ScotiaBeing considered to be adopted by Nova Scotia

Only GPI system that is being considered Only GPI system that is being considered internationally by any governmentinternationally by any government

2828

Nova Scotia GPI ComponentsNova Scotia GPI ComponentsSocialSocial

Time useTime use– Value of civic and voluntary workValue of civic and voluntary work– Value of unpaid housework and child careValue of unpaid housework and child care– Value of leisure timeValue of leisure time– Paid work hoursPaid work hours

Living standardsLiving standards– Income and its distributionIncome and its distribution– Financial security – debt and assetsFinancial security – debt and assets– Economic security indexEconomic security index

Human and social capitalHuman and social capital– Population healthPopulation health– Costs of crimeCosts of crime– Educational attainmentEducational attainment

2929

Nova Scotia GPI ComponentsNova Scotia GPI ComponentsEnvironmentalEnvironmental

Human impact on the environmentHuman impact on the environment– Solid wasteSolid waste– Ecological footprintEcological footprint– Greenhouse gas emissionsGreenhouse gas emissions– TransportationTransportation

Natural capitalNatural capital– Soils and agricultureSoils and agriculture– ForestsForests– Fisheries and marine resouresFisheries and marine resoures– EnergyEnergy

3030

Star DiagramStar DiagramVisual Demonstration of Dist. GPIVisual Demonstration of Dist. GPI

3131

GPI used now in NZGPI used now in NZ

The Greater Wellington Council is The Greater Wellington Council is

now developing and using a GPI now developing and using a GPI

system modelled after Dr. Ron system modelled after Dr. Ron

Colman’s work in Nova ScotiaColman’s work in Nova Scotia

3232

““What Matters Most to NZers”What Matters Most to NZers”

Only comprehensive, integrated wellbeing and Only comprehensive, integrated wellbeing and sustainability bottom up indicators sustainability bottom up indicators

Uses all 5 Solutions given, which include theUses all 5 Solutions given, which include the

Principles developed by Ron ColmanPrinciples developed by Ron Colman

Uses community / public inputs to create a Uses community / public inputs to create a vision for NZ and develop the indicators to vision for NZ and develop the indicators to measure this visionmeasure this vision

Two target destinations: Inform policy makers Two target destinations: Inform policy makers and Stimulate community action and Stimulate community action

Has behaviour change as an objectiveHas behaviour change as an objective

www.anewnz.org.nz www.anewnz.org.nz

3333

Conclusions Conclusions Extensive work in NZ in process in NZExtensive work in NZ in process in NZ

Includes the Quality of Life Report, the Includes the Quality of Life Report, the Social Report, and GPI work Social Report, and GPI work

This fine work can be extended by using This fine work can be extended by using the systems approach and applying Full the systems approach and applying Full Cost AccountingCost Accounting

This is being prepared in “What Matters This is being prepared in “What Matters Most to New Zealanders”Most to New Zealanders”

((Full paper on www.anewnz.org.nzFull paper on www.anewnz.org.nz))