Developing Wellbeing for All People – A “Systems Approach”

1. Developing Wellbeing for All People – A “Systems Approach” Using a Genuine Progress Index in New Zealand

2. Growing Interest Growing interest in measurement of quality of life and wellbeing internationally. OECD World Forum on “Statistics, Knowledge and Policy” – Korea, Oct 2009 attended by 1000 people. Work ongoing in New Zealand

3. Purpose of Paper Set out to explore a “systems approach” to overall wellbeing – how it can lead to more effective adoption and commitment by policy and decision makers – to achieve the results we seek.

4. Gross Domestic Product (GDP) • Growth in GDP considered a prerequisite for a healthy economy and a healthy society. • “Dark” side of 4% growth pa • Unsustainable resource depletion • Unsustainable social consequences

5. GDP Growth Correlations • Growth in GDP leads to growth in social economic inequities (rich poor gap) • Unequal societies create poor health, more social conflict, crime and violence – that money can’t fix

6. Systems Thinking • A system is defined by the components and the linkages between the components • An excellent example of how a system works can be found in the health sector

7. Health Sector • Improving public health has little to do with the Ministry of Health, but everything to do with • Growing rich poor gap, social status, quality and safety of the food we eat, obesity, housing, life styles, the environment - a key but unacknowledged cause of many diseases such as • cancer, Alzheimer’s and cardiovascular diseases, etc.

8. Health and the Economy • One of greatest economic challenges today is becoming the unaffordability of health. • Treating patients at “bottom of cliff” with costly high tech – accelerating costs • Transnationals delivering hi tech are driven exclusively by profit motive • Few resources going into prevention, healthy life styles, natural health, community approaches

9. The Makings of a System Problem • Trying to “grow the economy” to accommodate this burgeoning health budget is not a sustainable strategy • It is self-defeating – it feeds the problem not the solution

10. Measuring Outcomes • What we measure is what we value • A good way to measure an economy is by what it produces in social, environmental and personal economic outcomes

11. Simon Kuznetsarchitect of the GDP said “the welfare of a nation can scarcely be inferred from a measurement of national income as defined by the GDP …. goals for “more” growth should specify “of what” and “for” what”?

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

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

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

15. Possible Answer #1 The NZ local government initiative “Quality of life of 12 Largest Cities” measures the following themes: • People • Knowledge and skills • Health • Safety Housing • Social Connectedness • Civil and political rights • Economic Standard to living • Economic Development • Natural Environment • Built Environment

16. QoL Report Health multiple indicators • Life expectancy • Low birth weight babies • Infant mortality • Teenage parents • Communicable diseases • Access to general practitioners • Mental health and emotional wellbeing • Self-reported health status • Modifiable risk factors • Recreation and leisure

17. Answer #2 Systems approach measures interconnected relationships within the system • Horizontal determinants • Vertical determinants • Social networks, supports, volunteers

18. Horizontal Determinants Linkages across indicators, as illustrated earlier in Health Some health determinants (linkages) • Rich poor gap / Social status • Personal income • Housing • Environmental • Quality / safety of our food • Abestity • Life style

19. Vertical Determinants The relationship between outcomes and government programmes and policies

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

21. Answer #3Objectivity / Subjectivity • NZ Quality of Life report uses subjective evaluation in a biannual Quality of Life survey to measure the perceptions of wellbeing • Some people believe that only objective indicators should be used to form policies • Others believe that they are central to the development of quality of life indicators • Both are required

22. Answer #4Full Cost Accounting (FCA) As advocated by Dr. Ron Colman, Canada A “full cost accounting” cost benefit analysis is performed on each indicator FCA enables policy makers to understand externalized and internalized costs, FCA is a key mechanism for capturing the attention and commitment of policy makers. This is a primary strategy to curtail the misuse of the GDP.

23. Answer #5Use a Genuine Progress Index A GPI which uses the first 4 answers. Three examples are given here: Original GPI by Clifford Cobb Improved GPI by Dr. Ron Colman A NZ programme in formative stage, “What Matter Most to New Zealanders”

24. Original GPI • Designed to replace the GDP with a “green GDP” – adjusted for omissions and + value (designed on GDP “terms”) • Therefore structured specifically to do that task- which limits its use • Uses an aggregated single number • Qualified economic components as costs and benefits + adds new components left out of GDP (inflexible) • One basic difficulaty is that it includes private and public consumption as a “benefit”

25. Graph of GDP vs GPI

26. Original GPI Developed for NZ • Massey / Landcare contract with FRST produced a GPI for NZ modelled after the original work of Clifford Cobb • Massey also created this form of GPI for Auckland and Waikato regions

27. Nova Scotia GPI • Addresses difficulties associated with original GPI • Created by Dr. Ron Colman • Does not aggregate into a single number • Instead uses “Full Cost Accounting” • Uses “determinants” to analyze and report • Being considered to be adopted by Nova Scotia • Only GPI system that is being considered internationally by any government

28. Nova Scotia GPI ComponentsSocial • Time use • Value of civic and voluntary work • Value of unpaid housework and child care • Value of leisure time • Paid work hours • Living standards • Income and its distribution • Financial security – debt and assets • Economic security index • Human and social capital • Population health • Costs of crime • Educational attainment

29. Nova Scotia GPI ComponentsEnvironmental • Human impact on the environment • Solid waste • Ecological footprint • Greenhouse gas emissions • Transportation • Natural capital • Soils and agriculture • Forests • Fisheries and marine resoures • Energy

30. Star DiagramVisual Demonstration of Dist. GPI

31. GPI used now in NZ The Greater Wellington Council is now developing and using a GPI system modelled after Dr. Ron Colman’s work in Nova Scotia

32. “What Matters Most to NZers” • Only comprehensive, integrated wellbeing and sustainability bottom up indicators • Uses all 5 Solutions given, which include the • Principles developed by Ron Colman • Uses community / public inputs to create a vision for NZ and develop the indicators to measure this vision • Two target destinations: Inform policy makers and Stimulate community action • Has behaviour change as an objective • www.anewnz.org.nz

33. Conclusions Extensive work in NZ in process in NZ • Includes the Quality of Life Report, the Social Report, and GPI work • This fine work can be extended by using the systems approach and applying Full Cost Accounting • This is being prepared in “What Matters Most to New Zealanders” (Full paper on www.anewnz.org.nz)