Well-being is complex, contestable and capable of being understood from numerous perspectives1. Some argue that ‘well-being’ is an ill-defined distraction for those concerned with promoting ‘health’2, 3 or that increases of mental distress in contemporary societies4 simply reflect changes in how these issues are dealt with at personal and professional levels.
Furedi5 and Williams6, for example, argue that such changes derive from the emergence of a ‘therapy culture’ which unintentionally promotes individual vulnerability. Figures indicating escalating problems may reflect modifications in diagnosis, the emergence of new categories of disorders7, 8 or even the rise of the ‘autotelic’ individual9.
Yet the topic of well-being has become ubiquitous in recent years in both public and political discourse10 and is increasingly a focus of research11. Many economists and psychologists are engaged in measuring subjective well-being12. Increasing attention is also being paid to psychological well-being13, incorporating domains such as autonomy, mastery and self-actualisation 14. Philosophers have long insisted that well-being is inseparable from any conception of the life worth living15.
These literatures and debates reflect the complex and contested nature of well-being but, in the context of people’s lives, ‘well-being’ may be as legitimate a priority as ‘health’16 whilst ‘health’ may not be a recognised goal at all17. Also, researchers have acknowledged that, in wealthy countries with long life expectancies, misery may be more important than much somatic disease18.
At the popular level, the concept of subjective well-being appears to be an important aspect of individual and social experience19. We might also note that arguments which deplore a focus on well-being seem at odds with the broad vision of health which underpinned the Declaration of Alma Ata20.
Few would deny that late modern societies have benefited from economic growth. Yet health and social inequalities still persist21. Levels of well-being in such societies are believed to be static or declining22–25 despite large rises in average incomes. Lasch26, Beck27, Sennett28 and Bauman29 have highlighted the interdependence between an increasingly globalised, capitalist economic system and contemporary cultural traits such as individualism, materialism and consumerism.
Contemporary consumer culture appears to corrode individual character and undermine social solidarity28, whilst economic conditions dictate that people work in a far less secure atmosphere30.
Rutherford31 argues that traditional working-class culture, which helped provide a sense of solidarity, has virtually disappeared whilst the ‘new’ middle classes appear highly individualised and increasingly isolated from any sense of community. The materialist desires of people in contemporary culture undermine any deeper sense of purpose and meaning in life32–33 while the search for happiness in consumer products and services – together with perpetual dissatisfaction in such products or services – is the prop on which the modern capitalist economy depends34.
People do not define their conceptions of the good life autonomously but in accordance with the requirements of the capitalist system34. Standardised consumption patterns, promoted through advertising become central to economic growth whilst commodification processes influence human self-development35. Consumption becomes a substitute for the genuine development of the self.
People construct their social identity via their consumption choices36–38 but this is fraught with risks around making the ‘wrong’ choices in life. For the poor, faced with limited choice, life can be particularly difficult. One consequence is that individuals can be spurred into debt in order to avoid shame39. In sum, late modern capitalist society is believed to have seen the emergence of an individualised and consumerist society in which the ‘new poor’ are stigmatised, whilst the more affluent also suffer30, 40.
This ‘diagnosis’ prompts a number of questions for health promoters. Does the cultural critique, and its implications for well-being, resonate beyond academic debates? This paper provides some reflections from Scotland, based on interviews with four groups of people, selected for their prior interest in and engagement with issues of health and well-being. Download PDF »