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Wellbeing is not just the absence of disease or illness. It’s a complex combination of a person's physical, mental, emotional and social health factors. Wellbeing is strongly linked to happiness and life satisfaction. In short, wellbeing could be described as how you feel about yourself and your life. Factors that influence wellbeingEvery aspect of your life influences your state of wellbeing. Researchers investigating happiness have found the following factors enhance a person's wellbeing:
The factors that influence wellbeing are interrelated. For example, a job provides not just money but purpose, goals, friendships and a sense of belonging. Some factors also make up for the lack of others. For example, a good marriage can compensate for a lack of friendships, while religious beliefs may help a person come to terms with physical illness. Wealth is not the keyMoney is linked to wellbeing because having enough money improves living conditions and increases social status. However, happiness may increase with income but only to a point. Many people believe that wealth is a fast track to happiness. But it's not true. Various international studies have shown that it’s the quality of our personal relationships, not the size of our bank balance, which has the greatest effect on our state of wellbeing. Believing that money is the key to happiness can also harm a person's wellbeing. For example, a person who chooses to work a lot of overtime misses out on time with family, friends and leisure activities. The added stress of long working hours may also reduce a person's life satisfaction. Research shows that people who chase 'extrinsic' goals like money and fame are more anxious, depressed and dissatisfied than people who value 'intrinsic' goals like close relationships with loved ones. Wellbeing can be elusiveWellbeing is important, but seems a little hard to come by. One American study into mental health found that, while one in four respondents was depressed, only one in five was happy – the rest fell somewhere between, neither happy nor depressed. An Australian consumer study into wellbeing showed that:
Measuring national wellbeingMeasuring wellbeing in a population is difficult because the interpretation of wellbeing is so subjective – how you feel about your life largely depends on the way you see it. Like the saying goes, one person's problem is another person's challenge. Australian researchers try to measure wellbeing to keep tabs on living conditions. A typical approach to measuring wellbeing is to count the number of individuals affected by a particular factor. For example, it is helpful to keep track of how many people:
Keeping track of a population's wellbeing helps governments to decide on particular policies. For example, knowing the average weekly income of a population helps to set the 'poverty line', which may then influence decisions on social welfare reform. Results depend on what is measuredSurvey results tend to differ depending on what was measured. For example, an Australian survey of young people found that eight in every 10 reported feeling satisfied with their lives, including how they felt about their work, studies, income and relationships. However, this positive picture is contradicted by another survey, which found that about half of all young Australians are grappling with a difficult problem such as depression or alcohol abuse. Wellbeing is an unclear concept that is hard to pin down with graphs, charts and statistics. How to achieve wellbeing
Where to get helpFor most people, the first two things that come to mind when thinking about how to improve their health are eating better and improving fitness levels. Physical activity and balanced nutrition are cornerstones of our health and wellness. But, food and exercise aren’t the only things that matter when it comes to our health. In fact, for some people, other factors, several of which they have no control over, may have a greater influence on health and wellbeing than food and exercise. While some nutrition and fitness coaches may naturally be focused on working with clients to build lifestyle habits that will help them gain a better sense of wellbeing, it is important to be aware of the several factors that influence a person’s health and wellness that are unrelated to lifestyle factors. In this article, we introduce you to the internal and external factors that may be influencing your client’s health and wellbeing. We also introduce you to objective and subjective measures of health and how they can work together to gain a better understanding of a person’s health status.
Factors that Affect a Person’s Health and WellbeingThe factors that affect a person’s health and wellbeing can be broadly placed in three interconnected categories: biological and genetic factors, environmental, and behavioral factors. Biology and GeneticsFrom even before a person is born, their genes hold secrets for their predisposition to certain conditions. Genes are essentially the “instructions” for how your body needs to function. You inherit your genes, which are made up of DNA, from your biological parents. Genetic makeup is one of the biggest factors when it comes to a predisposition of the development of conditions and diseases, just as they can also be protective against them. When a gene increases your risk of developing a health condition, it is referred to as a genetic risk factor. Individual biology and genetics influence:
Keep in mind that even if you have a gene that increases your vulnerability to developing a disease, it doesn’t necessarily mean you will develop it. For example, research has demonstrated that people who have one or more of the genetic markers HLA-DQA1, HLA-DQB1, or HLA-DRB1 are at risk for developing type 1 diabetes. While having these genetic markers increases your risk of type 1 diabetes, scientists have identified people with these genetic markers who never develop the condition. This is because a person’s environment has a fundamental role in whether a person develops the condition or not. The same is true of the BRCA1 and BRCA2 genes in breast cancer. EnvironmentEnvironmental factors are complex and vary widely. The environment refers to where individuals live, work, and through which people move. Sometimes, these factors are called the “health ecosystem.” Some environmental factors include:
All living things, not only humans, are called “plastic,” especially in the early stages of development. Extensive research has been carried out on how adverse childhood events, like experiencing abuse, being affected by natural disasters, and living in areas where violence is predominant, not only affect a person’s psychological development but also their physical development, to the point where they have a significantly greater probability of developing chronic disease. Other environmental factors that have a direct effect on a person’s health and wellbeing include access to safe outdoor spaces, access to low-cost and nutritious food, and access to well-paying jobs with time for recreation. In the US and many parts of the world, there are significant disparities between access to health-promoting environments for people of different races. Black and Brown people often experience environmental racism, where they are more likely to live in environments that have a negative impact on their health and wellbeing. The environment has a significant, often overlooked, influence on our health. Unfortunately, there are limited things people can do on an individual level to modify their environment, which is why advocates like health coaches and public policy are so important. Behaviors and LifestyleWhat we do, out of choice or not, is another complex factor that influences our health. Nutrition and exercise usually fall into this category. However, it is incorrect to assume that lifestyle and behaviors are completely in a person’s control or determined solely by choice. While personal likes, dislikes, values, knowledge, and desires impact our behaviors, they are not the only things. Sometimes, environmental and biological factors are much stronger forces for people than what they actually desire to do. There are entire research groups and schools dedicated to health behavior change theory. You can learn more by reading these articles: Objective vs. Subjective Measures of Health and WellnessHealth is multifaceted and complex. While some aspects of health can be measured, more importantly, health is experienced. The different factors that affect our health and wellbeing that we mention above may be able to be detected and improved when health professionals value and utilize both subjective and objective measures of health. Subjective Measures of Health“Measures” is, perhaps, too technical a word to describe how we feel about our health since it implies a specific numerical rating related to different indexes. From a subjective perspective, health is felt, not weighed, timed, or analyzed in a lab. Subjective measures of health are based on individual awareness and experience. Dr. Howard Koh wrote in his article “The Ultimate Measures of Health” in the Journal of Public Health Reports, “Health arises not just from a doctor's office, but also from our homes, jobs, schools, communities, and places of worship—in short, where we live, labor, learn, play, and pray. All of these conditions determine whether we can fully be healthy…” How you feel may be is just as important, if not more important, than what your lab tests say. In fact, research has demonstrated that general perceived health predicts for morbidity and mortality, even after controlling for health problems. In other words, regardless of your “measurable” health status, how healthy and well you feel is an incredibly good predictor of whether you are sick and how long you have to live. Some of the challenges of depending on subjective measures of health are:
Keep in mind that some subjective measures of health and wellbeing may be translated into numerical measures that could give health professionals an idea of the best way to move forward in a coaching or treatment plant. Indicators of trauma, such as the Adverse Childhood Events (ACE’s), is a great example. Objective Measures of HealthObjective measures of health are those that can be tested or numerically measured. In general, results are compared to a standard or a range that is considered healthy. Some of the gold standards in objective measures of health from a clinical perspective include those related to preventative and diagnostic health screenings.
Tests are vital for detecting several chronic diseases and other conditions early on, such as cancer, pre-diabetes and diabetes, osteoporosis, STDs, polycystic ovarian syndrome, depression, high blood pressure, multiple sclerosis, and high cholesterol. In most cases, physicians, psychiatrists, and nurse practitioners can only give a person a prescription for pharmaceutical medication after having the lab work as evidence to demonstrate that the prescription will likely be effective to treat what is going on in the body. While objective measures of health are useful to understand what is going on inside the body in ways we can’t see to determine an effective line of treatment, they have several drawbacks.
Finally, in some cases, objective measures of health may be misguided in their use. Below we provide one example of a potentially misguided measure of health. Case Study: BMI as a Misused Objective Measure of HealthOne of the drawbacks of objective measures of health is that they may be misguided. For example, the use of body mass index has been used for generations as a way to indirectly determine a person’s health risk. However, there are numerous flaws with the use of BMI, especially when a person seeks support for their health on a personal level such as in a health coaching or physician setting.
As Stephen Humphreys points out in a rather famous article published in the British Journal of General Practice in 2010, “In short, it was designed with Belgians in mind, and does not work so straightforwardly on such populations as Bangladeshis, Botswanans, or boxers.” BMI may sometimes be useful for public health approaches because you don’t prick anyone with a needle or spend money on labs. However, there are more direct and accurate measures of body composition, and without a doubt, of health. On an individual level, BMI has poor sensitivity and is inaccurate when body composition is relevant. And, while there may be a correlation (not causation) between BMI and some measures of health on population levels, there are still significant gaps in the understanding of those relationships. What are the alternatives to BMI? For athletes, body composition may be important, in which case more accurate tools like skinfolds, hydrostatic weighing, bod pods, and bioelectrical impedance analysis may be considered. For most people, however, body composition isn’t as important as are more specific measures of health, like blood pressure, cholesterol and triglyceride levels, blood glucose levels, and subjective measures of health. Main TakeawaysImproving nutrition and fitness tend to be what first comes to mind when we think about “getting healthy.” However, while food and exercise habits both have an important role in lifestyle factors that affect our health, these are only two of the multiple, complex factors that determine someone’s health status—something that can be measured using both objective and subjective measures of health. Additionally, just as physicians and health coaches can work together to support people on a path to health and wellness, subjective measures and objective measures of health can be complementary in understanding what is going on inside a person’s body and how to provide bodies and minds with tools to establish balance and support people in feeling well.
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Factors influencing fitness, health, and wellness over which you have little control are called
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