"Happiness: The True Measure of a Successful Society" | Talks at Google

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Thanks. Everybody for coming my name is Andrew Rubin I work, for NYU Langone health I'm the vice president of, clinical affairs, for, the Health System, basically. That means I run their outpatient, clinical, operations, I also. Host a weekly radio. Show on Sirius XM called, healthcare connect I'm really excited to be here today I was asked by a good, friend of mine from the Danish consulate in New York to host, moderate, panel. On, happiness. Which. I think is a topic, that everybody in this room wants. To hear more about and, I think that the the, team at the consulate. Put together probably one of the best, panels you could ever find probably. In the world to talk about it so I'm gonna I'm gonna introduce people and I'm gonna start with Jeff Sachs who, personally. I've never actually met but it's a privilege, to get to meet today because he's. Pretty much at the forefront of. Many. Things and sustainable. Development economic. Policy he's. The director for sustainable, development at the earth Institute, at Columbia University. He, is a university, professor at, Columbia University, and for people who work for academia, that's. Pretty much the highest rank you can have as a professor, in, the world certainly certainly, at Columbia as well and he's, a special, adviser at the United, Nations and. He's known as a world leader in economic, and sustainable, development, am. I right here this, guy's pretty cool. What. Can I do Mike. He. Has a very, interesting background he's, the founder and CEO of the happiness. Right. So who gets to spend, all their day running. A foundation, where you're talking about being happy this guy does and. To prove, it he is a New, York Times bestselling, author who. Wrote. I had to practice, this actually, I did have to practice this wrote a book it's, called The Little Book of, hygge. And if, you're Danish you can make it sound much better than I just did but, it. Hygge is essentially, a form of happiness I'm going to let him explain, it to you and I'm excited to tell you I'm getting autographed. Copy on the way out there's some books on the table on the way out so I encourage you all to pick it up it's, printed, in 30. Languages, around the world, million, copies it's a it's it's a it's a pretty cool book and then. I know this is Google but I still use no cards I'm sorry they offered me an iPad they just don't they don't work in this form last, is Catalina, Seneca she. Is a project, director for the, health and happiness studies at the, Leo Innovation, Lab we. Have a lot of guests. Again, on my left from the Leo Innovation, Lab it's a part. Of an organization. Which. Is part, of the Leo Foundation. Which. Is a very, large, philanthropic. Organization. Based in Denmark they fund a lot of research in healthcare they, are independent. Of Leo, Pharmaceuticals, which is a huge derma to logic form a suitable company in Denmark around the world and. They their mission I'm gonna, I'm gonna let Catalina talk a little bit more, about that but let's just get started and I'm.

Gonna Start with you Mike because, I think this is a question, it's. Not as obvious to everybody as, it sounds but you know what is happiness, how do we define, happiness and, who better than you to answer that question so. I, think one useful. Definition, of happiness is, the. Experience, of joy, contentment. Satisfaction. With life combined. With the. Sense. That our life is good worthwhile, and meaningful, now. As of course a very wide definition. And. Complex. So. Usually what we do when we work with happiness is we break it down and look at the different components that happiness consists, of and it's, also what we do with other complex. Phenomenons, if we talk about how, is the US economy doing we, also break, that down and look at different components, we talk about GDP we talk about growth we talk about inflation unemployment rates, and that, gives us a language to talk about how is the US, economy doing so that's also what we need to do with, happiness so when. We look, at happiness we look at sort of overall life satisfaction to. Step back looking, at your life considering. The worst possible life you, could live the best possible life you could live, and. Where you feel you stand right now. Another. Dimension, is what kind of emotions, do people experience on a daily basis both positive and negative ones, and. Thirdly there is a. Dimension. That sort of covers what Aristotle, believed the good life was and he believed the good life was the meaningful life so, that that, gives us the ability to to, sort of dissect, happiness. And and. All of those things are of course very subjective. And. I think that's, not a challenge that's a good thing we, study other phenomenons, that are subjective, we study depressing. Depression. We study stress we study loneliness, all, of those things about how we as, individuals, experience, the world so, the same way with happiness and I, don't think it's more difficult to study positive, emotions compared to negative emotions and, also, I mean to, me the only person here that can tells us whether Catalina, is happy or not is Catalina, so, it is a metric, that is. Person. Centric, or patient centric that. Allows Catalina's. View on her life to be the core of what we're trying to understand so, Jeff why, are we, talking. About this now I mean it's it's I know the UN has you which are a co-author on puts out a world report on happiness for many years Denmark, was was, number. One on the list I think you slipped in number two this year still, a very, good ranking. Considering.

The The US continually. Falls towards. The bottom why, are we talking about this and and how are we even measuring, something like this, well. We've been talking about happiness for, at. Least two thousand, three hundred years since. Aristotle wrote. Nicomachean. Ethics where, he said. Demonio. Or happiness, is is the highest goal, of individuals. And he, wrote another book very, good book called, the politics, where he said. Abdomen. He is the highest goal of our, community. Life also, that's what politics, should be about let. Me ask you as politics, making you happy these days. Or. Is it making you incredibly. Depressed. It's. Making me. Probably. Crazy at. This point, and. That. Was, one of the insights of Aristotle, that your. Well-being depends, on your, social. Conditions. Not. Only your personal income. And. Personal. Conditions, but whether your president, is a nut or whether the, government, is honest or corrupt or other. Things, like that so, talking, about happiness is a quite natural thing. But. For a. Hundred. Years especially. In this country, we. Stop talking about happiness, and we talked instead, about gross. Domestic product. We. Talked about money and, the, assumption, was at, various, levels of sophistication, from unbelievably. Crude to a little more sophisticated, that. Your money was, the measure of your. Happiness and that has been American, culture, as. Well, then. It was noted. Around. 1984. By, a, very. Pioneering. Professor. At Penn Richard, Easterlin that. When, people were asked, about their happiness. Compared. To their per capita incomes. The. U.s. had been increasing. Per capita income for decades, but didn't, seem like happiness was rising, and. That. Basic. Idea is. What. Motivates. The kinds, of studies that are underway. That we, have to get beyond, money. Is the measure of all things and, in. The United States it's, pretty clear we have declining, happiness. And rising. Income at the same time so there's a real, puzzle. And challenge, in this country, and more. Generally, it's pretty clear what, the inventor, of gross. Domestic product. Said. Repeatedly. Was one of my teachers also, Simon, Kuznets Nobel. Laureate. It's. Not a measure of well-being, stop, it. Stop using and it's a measure of economic, output it's, not a measure of well-being.

But. We're, obsessed in our country, we'll GDP, rise three point one percent or two point nine percent and so we've gone a little mad in. The United States way. Overboard, on this and we haven't asked about happiness. Well it turns out you can ask about happiness, you, ask are you happy and you do that with various, levels of sophistication, and, you. Find out all sorts of interesting things so, that's why was it when you find out and I'm sorry I was gonna hold, I have a question for you but when you find out the, answer to that question in this UN, report, that. Americans. Are actually not happy, and Danes, are, relatively. Speaking much happier, what do you do about that I mean to. Me the data is great the reports, extremely. Useful but what are we going to do with that I mean it can't be as simple as getting a new president, well. Now. I'm happy. Now. We're talking I was, topical, I was a song ok. Gallup. Has done a really. Wonderful job. Over, the last. Dozen. Years or so of doing. An annual survey, and they asked a very specific question, that Mike. Referred, to, it's. Called the Cantrell ladder so the question, which each of you can now, take in, your minds, is. Imagine. That life, is a ladder and the. Zero, rung on the ladder is, the worst life you can imagine for yourself and, the, top, rung the tenth rung is the best life you can imagine for, yourself where, do you stand on that ladder of life so. Gallup does that. Question. Asked. That question to about a thousand, people, each. In, 150. Countries so, about 150, thousand people and, we. Report that once, a year and that's where Denmark's. Always at or near the top and the, social, democratic, countries. Of northern Europe are, always. At, the top the. United States is by no means at the bottom, we are 19th. In the ranking, out of 150, countries this year for. The us these days hey that's pretty good we're. Still in the top 20, maybe. Not for long but we're still in the top 20. But, we've been going, down and clearly. The, mood is. Bad. And. We also found this, year by the way that. Tabulating. Mood which, is were. You worried, yesterday, were, you anxious yesterday. Were, you angry yesterday. That, is soaring, in the world right now over, the last 10 years that's really about, the most alarming, finding. Of the report in my view of, this. Year so, each, year we do an analysis. What. Accounts, for this, ranking, can we find the correlates.

Can We find the. Variables. That seem to explain, the. Differences, and that's where. Something. Can, be done. John. Halliwell, professor, at university British Columbia, leads that analysis each year does a wonderful job and, very. New. Speaking, you know very. Succinctly. I hope, I, the. Factors, that count are your per capita income that definitely, matters higher. Income better but. With what, we call a declining. Marginal. Utility, of income more. And more doesn't. Help that much after a certain point second. Is your health both mental, and physical, third. Is your, social. Support you have friends by. The way Aristotle, chapter, 8 Nicomachean, ethics, 2,300. Years ago we said have friends, to be happy smart. Man a good. Advice that makes, a big big difference. Fourth, do you feel you have your, life in your hands that you have the freedom to make important, life decisions. On. A fifth. Are you, and is, your society, generous, so, various, indicators. Of generosity. Sixth. Can you trust, your. Government is. It corrupt or is it honest one. Of the reasons. Why Denmark. Rate so high is that, Danish. People trust, their government and, I would say the government, delivers. And I. Was saying. Earlier that to. My mind the metric. Of this if you've watched the, wonderful. Television, series Borgan, which. Was the, house of cards version. For Denmark of Danish, politics, the, worst thing that happens, in Borgen is that. The, Prime Minister uses. His office, credit card for a personal, expense. He. He ends up losing, office, whereas. Of. Course in. House, of cards the, president. Among many other things pushes. The young reporter, in front of a train, which. As. Donald, Trump already said he could do in broad daylight someone, on Fifth Avenue when, his, supporters, no doubt would love him for it so. That's. The difference of politics, we don't like our government very much it's pretty clear in the data where the Danes like the government, and they're happy about it and I'm, unhappy, about it so that's, that's so, when. You ask what can you do about it probably. The main message, of this, study is that social democracy. Is really a good. System, it. Provides, security it, provides a, measure. Of decency, it keeps inequalities. Low and America's. Winner-take-all. Money's. Everything. Society. Is really. Going. Overboard. Catallena, you have. Done a lot of research on, patients. Living with, chronic. Conditions so. Based on you, know what you've just heard from from Jeff and Mike how do, you think how would you define happiness how would the people you study, define, their happiness knowing that they're. Facing potentially. Huge obstacles, in their life and I think the data that you're going to talk about shows some some pretty interesting results, I think. There are two layers to to. This answer because. From individual. Perspective, health, is a. Massive. Driver of happiness. So, if, you have. To live with a chronic condition and in our case we started with, Dermatology, conditions, like psoriasis, or eczema. Your. Happiness, is defined. By. How, you manage your condition and the impact that condition, has on your everyday. Living so, we see that. Stress. Loneliness. Are really, impacted, by living with with. A skin condition and, it. Is definitely. Having. A big impact on your mental health but, I think what. Is interesting in, our work is that. Like. You said I work, for for. An Innovation Lab within. A pharma company and, healthcare. Systems don't. Like subjective. You. Know they, don't care if Catalina, is unhappy, I will say your blood pressure is fine go, away so, we like objective. Stuff what, we do we want to actually. Challenge that and say get, inspired by the. Work of our, own happiness and say what if we apply, in. Health. Care what are we going to learn and to, give you an example and, think about how you would answer this. Question, a, clinically. Driven. Quality. Of life survey. For. People living with but, a skin condition will ask the question, has. Your skin, impacted. Your. Leisure or, social. Activities in. The last four weeks, or. If. You look at overall, well-being methodologies. You, will ask have. You felt alone, or are. You lacking companionship. Which. Actually, breaks down the, this kind of focus on has your skin, or your. Diabetes. Or other chronic condition, has an impact on your on, your life or just trying, to understand, people's, lives and then. Analyze, the data and see what is, income, and what is living with a chronic condition or, the power of your of, your community, and that, that, will in that way we, actually challenge the way we look at classic. Health related. Measures. And we want to bring happiness, related, measures into. Healthcare you, know being, in. In a u.s. audience you. Can imagine a lot of people might be confused why, a. Pharmaceutical. Company as you. Described would be because, it's not its litleo, Innovation Lab is actually separate. From the pharmaceutical company but why are, why.

Are Why, is the foundation, doing this kind of work what's what's the goal of this of this group and is this something that, you're going to be trying to apply it other, conditions, in, us a big problem mental health addiction. Areas. Where our population, here, in the United States is struggling is is there a role for this and and and what is the foundation actually trying to do I think. It would be great if, you, know we will start looking at health care policies, the same way were subtly looking at other policies and, actually. Bring these well-being measures, to. Influence, our decisions. Our our. Work so it's kind of like, you said you know I am part of the, Innovation, Lab and, because. We are owned by a pharma company who. Is under, Leo. Foundation like mentioned, we, are quite, lucky because we, really, have a patient, centric approach, and we, can look. For. The long term investment, not the immediate investment, so, that's one, factor the, other factor is that my. Boss is here so I have to be careful. With. This answer. It. Is that funny. Enough our project, started as a small internal, exercise, because. We focused. In your innovation, up in what you would call developing, digital, therapeutics. So. We're looking for measures of how, we can measure, the impact of, our specific. Digital, projects, on the, well-being of people living with chronic conditions and, that's how we ended up developing this, this. Project but as. I said because we are very, much focused on doing, what's right for the patient's we. Saw the potential, of the project and we just say okay let's, see if we can publish. Our own world. Happiness, report for. People living with psoriasis, and then start from there and what, we're trying to do now is actually set. Up an independent, foundation. That is going to take this work, further and. We advocate for looking, at the health of people in a different way and bringing, well-being, you know the scariest objective. Stuff. Into. How we manage health or you can say Mike one. Of the reasons one I'm, excited, about the. The studies, also that we're starting to use happiness. Metrics, within healthcare yeah and I, think one of the issues we have in.

A Lot of countries is that we've been using the. Wrong metrics, that leaves two wrong decisions, and wrong priorities, and. I think that's why we see in a lot of countries that we have gotten richer without getting happier and, I think the core question, now not. Just for the US but also for countries like Denmark is. How do we convert wealth into well-being how, do we invest into. Quality, of life and I think we get some answers where we start to map. Inequalities. In well-being so. The, world happiness report usually. Focuses. On the, average. National. Averages and, usually Denmark and the unloader countries come out on top when we look at a national, average but. The 2016. Report I was, really, happy with because for the first time there was a global ranking, looking. At the, distribution, in well-being the, inequality. In well-being and I think that's where we need to address. Challenges. In the coming years to, bridge the happiness gap we've seen a lot of countries because obviously if. You, have a disease you are less happy than the average citizen in that given country but, why do we see so large variations. In that happiness gap when we look at a specific certain. Disease I think that's where the study is really exciting what, would what, would it, looked like in this country to you and I'm setting you up because I saw an interview that you had done where you said someone. Asked you what would America, look like if. As. Compared, with Denmark some of these concepts, and you give an interesting answer I'm gonna see if you get I'm going to tell you which I'm not sure which which answered, was but. Maybe, I, said something, like. What. You said was imagine, Bernie. Sanders, right yeah, as your president that's what that's what some, of the concepts you're describing would look like in distribution. Of income distribution of healthcare services and things of that nature so. Maybe. Was, a good. Point by the way could I jump in just wrong because. I think maybe what I said and this, might have to be edited out but I think I said Denmark is is Bernie Sanders wet dream yeah, and. In. Denmark it's interesting to see because here Bernie Sanders, is progressive. He's. A socialist, in a o'seas a socialist, in. Denmark. Their common sense they're, not progressives. They are. Talking. Sense. And. Also in a probably, in the same interview at least a lot of merit American journalists will ask me you know how can you be so happy in the Nordic countries you pay so high taxes, and say, maybe we are happy because we're paying a lot in tax because, nine out of ten Danes will. Say we're happy to pay our taxes. Because, we see them as investments. In quality, of life we see them as investments in health, care in mental health care in great infrastructure, in education that, brings. Happiness. To citizens. And I, think it's. Interesting to look at the, average relationship, there, is as Jeff described before between GDP.

Per Capita and. Happiness. And, there is those diminishing, marginal returns but, there is also countries that are above the line countries, that are relatively, good at converting. The wealth into. Well-being Denmark. Has a lower GDP per. Capita than, the US but higher happiness levels because there is investment in healthcare. In mental health care in infrastructure. In education so. That I, mean I get, it Bernie Sanders is more than welcome yeah, Jeff. What were you gonna say. It's. Exactly. Right, every. Word you said our. Discussion. In the United States is really messed up in. Part because we have really, nasty people, leading, it like, the. President, I'll leave him aside but Rupert. Murdoch and the. Business press so, The Wall Street Journal, is a really deranged, newspaper, and. Today. You'd brand another story Bernie Sanders. Create. Socialism. What a socialism. Mean Venezuela. This. Is this. Is the meme of this. Election, cycle, it shows, how. We're. Living in a kindergarten, world. By the way these people are idiots I'm sorry to say their. Their level of knowledge is, infantile. But. Bernie, Sanders, represents. Basically. Mainstream. Social democratic, ideas, so you put Bernie Sanders, in, Denmark. Like you said it's completely, the. Mainstream. Is it Venezuela, no it's not Venezuela, by the way the United States is trying to destroy Venezuela. Probably. As a campaign, prop, so. It's, not just that Venezuela, is collapsing, the United States has put every. Sanction. Possible, closing. Grabbing, reserves. And so forth I know I'm taking us away from this just a little bit but but the real but but the reason, is. We're. In a mind game in this country, where. The. Richest. Nastiest. People, are, trying, to tell the American, people you, will, not be happy, do, not be fooled, having. Guaranteed. Health care that would make you unhappy, do not be fooled, having. Access to quality education that would not make you happy do, not be fooled that's, the route to, disaster. And what, Bernie Sanders is these are one politician, in this country, that just speaks, mainstream. Social. Democracy. Which. Is the mainstream. Of Scandinavia. Which is the mainstream, of why Scandinavian. Countries, are, so. Happy, because. Life, is not insecure, everyday, because. People aren't at the edge of falling off the cliff, because. If you've had an experience like, I did, when I had. An eyelash, stuck, I had to go into duck. Into a clinic, in Sweden a couple. Of years ago when they. Plucked. Out whatever they had to do and and I said, where, do I sign my, insurance no no, no it's free go go. Don't, worry. It's, a different, kind of life it's not anxiety. That. You're just rubbish. Or. You're disposable. Or, your. Anxieties. Are your own problem, don't bother us I'm mr., Trump don't bother us don't bother me I'm. In it to make money for my family this. Is how. Our. Politics, are so, terribly. Distorted. Right, now and why this is a very relevant. Discussion. Because. Unhappiness. Is coming, from high inequality. From. A lot of anxiety. From. Poor. People not being taken care of at all in fact, toll literally, go. Away, we. Don't want you there's, no room and. Of. Course it's making, everyone. Really. Very. High anxiety and. We. Have many, many symptoms. Of it rising, suicide, rates rising, depressive. Disorder. Rising. Addiction, rates it's. Actually. Not just a footnote right now it's a serious, matter but. What bothers, me is, how, the, truth is, so. Infant. Highly, distorted, now.

By. The. Uber-rich. Mega. Rich. Nasty. Right. Wing in this country and that's where, we're, really falling down and where, we really have a big crisis. Anyway. Bernie's the only one that gets it really, right but, it's completely, mainstream. So the under appeal will, talk to the Google, team on the way out yeah well you know we'll debate Bernie's health care platform and it different, oh I've had I'm ready to debate it right now if you want. Medicare-for-all. Exactly. Right so just. In case anyone has any questions, about that and. So am i but we're not going to do that all right, because. It'll. Take away from the happiness I. Think. It would raise it, no. Certainly certainly, we would we would both fully, agree, and, I know you've studied this having read a lot about you that finding. Middle ground is how, consensus. Building and finding a middle ground Obama, care other things like that or how you actually move an agenda forward. One comment. Because I think, health. Inequality, is a very important, subject no matter the country oh great, I live in London you know we have NHS it's free. For everybody but, we still see that you know patients or people living with chronic conditions are not necessarily, happy and we. Have to understand, and from, now our data you know living in Denmark if you have psoriasis, is not going to make you happy actually, and we have a modest. Start, we have 21, countries in our own happiness. Report and actually Denmark and Norway are. Mid-table. UK. Is, next. To the bottom you, know it's really hard to live with a chronic condition like, psoriasis. Or eczema in, in. The UK and we, have to ask the question why you know actually people living in Mexico, could you substitute. Any illness. Do you think from the data from that or you think it's unique it has to run it has to run you, know specific. Research, for, specific, chronic conditions we do know that it creates inequality regardless. The, chronic. Condition will event is that what we call happiness gaps that, are that are different but it's definitely a very good. Question. To ask I know and actually. Challenge, the systems, why is it that you know if you live with a, chronic, condition in, in Denmark or rather happy, country otherwise you.

Feel Isolated, it's almost like you know the long tail that, it gets very long and we kind of like lose people. In the society to, their to their illness you, also see a. Difference. Between men. And, within those countries as we massive, which, is which, is very interesting because we actually learn and this is kind, of like going, to closer from the government, to the, health. Institutions. Like what what actually, you. Know trying, to do to understand, well-being, we, talk a lot about preventative. Medicine these days but, we're. Kind of and when we talk about well-being we're. All thinking of gym and diet and, that's, it you know and cool gadgets. But, we're not thinking about you know well-being, as a holistic. Definition. Of your life. What. You do with your with. Your health and with your social. Health. And, all the aspects, so it's. It's very important, to say okay so let's, start looking at it and ask the questions and the same way the world, happiness. Report ask questions and say why why, are, women. Much, less. Unhappy, than men when, they live with a chronic condition is, it because the you, know the classic, pressures, you have to look pretty you have to look good all the time is it because we, actually react differently, we were talking about but, at, the beginning about you know the the. Positive and the negative effects. That you, have in, research. Of well-being and we see that, women are much. More responsive. To, the negatives, but our. You know 99%. Of media talks about how, you should be positive, and how you should focus on the three steps to whatever, achieve. Happiness. While. The, data actually shows that for women living, with a chronic condition will, be probably more effective to, acknowledge, that, you will feel down and stressed, and your self-esteem is going to be affected this, is how you can manage. It better and by, the way it is true from all the dial is that men, are most affected, by pain, that's. What I. Know. Yeah yeah you know all the emotional, stuff if it's pain it's really, bad. I thought. Another interesting pattern in in the data was. One. Explanation for four for happiness gaps so. When when patients, are severely, less, happy, than the, average citizen we.

Could See if patients. Felt their doctor, didn't fully understand, the mental impact, psoriasis. Have on their well-being there was a happiness gap of 21% yet if. The doctor understands, the. Mental impact then the happiness gap was only 3% and. I think this. Is one of the reasons why I really like, happiness. Metrics, is that, it I think, honors the definition. Of health that the World Health Organization. Is using so, health is not, just the absence of disease but, health, is. Good. Physical. Mental and social, well-being and, I think we address that and we capture, that with, happiness metrics. And also, coming back to what you said earlier across, different diseases I think that's the real strength, of happiness. Metrics, like the Cantrell ladder that, we can use it as a common, currency to look across different diseases, and see how, do we. Address. The different happiness gaps that we see one. Of the things we know also from the data is that people, with. Mental. Illness problems do not get treatment period. Maybe. Only a quarter, or a third in, the, US actually. Will, find their way to professional. Treatment, and worldwide, it's, absolutely. A dismal. Dismal. The low proportion. And the. Way that healthcare is delivered here. Is it's, delivered, for specific, symptoms, for specific, diseases for. Specific. Events. Not a holistic. A. Holistic. Approach to life so if, you're in a poor community in in, this city. You. May have. Many. Many social, challenges. That, will never be attended, to you. May find your way to an emergency room fairly. Frequently, and have, an acute. Episode. Addressed. But. The underlying. Human. Needs. Are not addressed, and we. Don't have a health care system that. Actually. Builds. Out something, more holistically. By. Design it's very much an intervention. Based, specific. Acute, response, system. Yeah that's. My favorite, insight. From the from the report and you're absolutely right even you know in, England they'll tell you you don't you feel a to be sad go have a tea come back in two weeks that's. The pretty much treatment. But. It's presented. You know but the insights from our health. And happiness studies for a couple of years now and every time I, talk, about if. People think, that their doctor understands, the impact a chronic condition has, on their mental health they're going to be happier the, reaction I get from the doctor is like but it's not my job to make them happy my. Job is to treat them so. It is it is it is as I said a very big challenge to the system if we're are serious, you know about getting. More holistic. And more, wealth. Being led and not just disease leads that is that will require a, massive, change is not, only about the health care you know the hospitals, but it's also your community, social services, we, have in Europe so we you know here in the United States we we. Had to take a pause for. The past two years we you know the the previous government. Previous administration. Probably. Not in the most articulate, way did launch attempt. To launch a massive transformation, of our health care system in the United States and it. Was starting to take hold. With, all the inherent.

Inefficiencies Of, something so massive in the United States our health care systems twenty percent of the close to twenty percent of the economy so, twenty cents of every dollar it's. Not spent, on you, know fuel, or food it spent on health care that so that's a lot so you. Know Obama. Care, electronic. Record transformation. There's a lot of new things happening in this country and candidly, we've lost. The. Past two years of momentum, and and. We have two more years to get through hopefully until. There'll be an opportunity to, start. This back up but everything jeff has said and your about, you. Know what our doctors are actually able to do I mean we put so much pressure on them to, you, know see as many patients, as they can through the day that. We don't give them time you don't give that I'm the administrator, I'm the bad guy I don't give them time, to. Ask that question, are you happy what can I do for you today, other than treat, this. Underlying, diagnosis, and then send you on your way because the next patients in the room and I got to go see them you, know they're, the promise, of health care reform in this country was to change some of that and. It stopped, it's just you know all these pilot, innovation, projects, the government sponsor, is New York State some. Of the largest innovation. Projects in the country are in New York State in California, and they're. Going they're literally going nowhere. Unfortunately. So again a healthcare, is. We've, lost the momentum and we're gonna have to see how this plays out over, time we certainly have the infrastructure. In place and, I know many many Danes, and and and people. From London who still view our healthcare we certainly have some of the best technology, in the world many, European, physicians, you. Know come to the United States to do their research more, healthcare research is done in the United States than any other place in the world combined, so. There are a lot of good things about our, healthcare system but we we've. Lost our we've certainly lost our way I think, you raised a very good point that's. Also worth worth. Discussing, which is we've. Talked about happiness, in the context, of doctor. And a patient there's. Happiness generally. In work. And. Some. Places are happy. Happy. Places to work I hope that's true where we are and. Some places are quite miserable, places. To work and since we spend a lot of time, in. In. Work. Per. Day that's, a big deal. So. All. Of these metrics and, this evidence is actually something, for work organization. As well. My. Wife's a physician. And. At. One point several. Years ago when the. University, practice, she was in they. Put a kind, of time in motion, person to follow, her around I, don't. Do that to determine. That, it was eight. Minutes, per. Patient and, how, many times to the restroom, and to go to the lab and so she quit. It, was, so. Unpleasant, so deep deep, professionalizing. They. Were told these, are not patients, they're your clients, now is, really. Bizarre. But. It. Was as. A more general point. That. When, we look at happiness. It's not only a direct. Indicator. To, Minister. Of Finance or something, but. It is how, healthcare. Is organized, it's what how our kids are.

In School what. They learn what. What the classroom, is like it's. Actually, specific, mind training, meditation. Or mindfulness, or, compassion. Training. And so forth that can make a big difference how, a workplace, is organized. How a city, by, the way is designed, so that people can be together I know. In, New York were just the luckiest in the world to be able to be in a wonderful, city where you walk you. See outdoor, cafes, you have. Central Park this is a fantastic. Part. Of our well-being in, this city and some, cities are so. Polluted. Dangerous. To walk no. Sidewalks. No green of course people are going to be incredibly, unhappy and when you're in Copenhagen, it's, incredible, how the city has been reclaimed, has. Reclaimed, itself, from the automobile so. Now it's a walking, it's. Walking, everywhere, and by, the way the density. Of coffee. Shops in Copenhagen, is like I've never seen before because. Every. Block is at least three or four coffee, shops which. To my mind is, a definition. Of happiness, almost, almost, tautologically. But. It does, mean we should be thinking about this in all of these different aspects, of our social organization. We. Spend 20% of our GDP on coffee. So a. Lot. Of things. We've. Only been talking about that the one. Way of the relationship between health and happiness because you say why should the doctors care whether they're happy or not they, should because we can see it also impacts, longevity, when. We look at longitudinal. Studies where we follow people over time and there's a lot of studies on this we, can see that people that are happier, also. Have a lower mortality rate, even when we control for health status and a lot of other factors, from the beginning of the study and I, completely agree with with with. What Jeff is saying in terms of for, example urban design I mean, happiness. Metrics, when, we know what we know from happiness research the, questions, are how. Do we design our health care systems differently, how do we design our policies, differently how do we sign workplaces. Differently, in our cities differently I have. A, very. Similar experience to what you do in terms of how, urban. Planning, impacts, happiness, and. One. Of the cities that invests. A lot in infrastructure. But, forget to invest, in infrastructure, for people but only for cars in, my experience, was Kuala, Lumpur in Malaysia I was there a couple of years ago and, I was staying 200, metres from the Botanical, Garden and I wanted to go over there you couldn't and gave up halfway because there is no pavement, and and. So. You invest, to, create cities. For cars, and not people and what you're essentially, telling your citizens, is that, if you do not own a car you are a second-rate, citizen, now.

What I like about Copenhagen, where, the majority of people cycle. To work majority, of students cycle to university majority. Of all, so the cost of bone but also the real-life politicians. Cycle, Department the reason they do that is there, is investment in infrastructure. For pedestrians, for cyclists, that feel that makes you feel like you're king and queen of the road that's. What it it needs, to get done in. Terms. To create a city with high mobility I'd be remiss if, I didn't put this question out to all three of you with the few minutes that I have left. Technology. Were at Google right the, center of the the technology, universe. The. I believe, it was a UN World Health Report, happiness, report but certainly, mature. As I've read has said that technology has had a negative, impact, on the, happiness, of children, in this country. Thoughts, on that, we. Have a chapter, in this year's report which. Is. Putting. Forward that as a as. An important hypothesis, I would, say it's unsettled, I've received a lot of responses. To, that, it's. Not my article but in, in the volume. But. Definitely. For, this. Was looking, at adolescence what we know in the United States is from, around. 2009. Onward, there is a real. Epidemic, of depression. And. Nobody. Knows, exactly what. This is coming from but one hypothesis. Is that that's when, the iPhone came, and. What, is clear, in the data is. Of. Course our, lives have been changed, unbelievably. In how we spend our day and the. Data from. This. Sample, of young, people was. Something. Like eight hours a day of, screen. Time on digital. Devices sleep. Collapsing. Time. With friends, collapsing. And. So having. Friends, is doing, this. Basically. You're, online with your friends perhaps, but not. Really. Interacting. With them face to face I don't. Know it's it's a very big deal because the. Digital. Revolution, is the biggest, change, on our planet I, don't. Think any of us has ever experienced. Anything like this you. Walk down the street you realize it is a completely. Fundamental. Change to how we live our lives every. Single person's, carrying their phone or with, headphones or, somehow. Plugged, in. Within. 10 years so. Is this good is it, really working, are we. Creating addictions. Is. This serving, our humanity. Or not I don't know you guys are in the forefront of it you you need to really study this. It's. No good just to, get, faces, on the screen to sell advertising this, is a disaster. We. Have to know whether this is really good potentially. It ought to open up lots of things for us but, is it really the way we're doing it I don't. Think we know. Where. We're actually working. Right now on a report on digital well-being. Which. Will come out in the fall and also, because we've been interesting, and interested, and concerned. And. I think what, we'll find is probably also that how. We use technology, has. Different, impacts if we use technology. To. Become. Addicted to. You. Know lose, sleep if we use technology. To become jealous, of the wonderful lives that all my friends are living on Facebook then, obviously that will have a negative impact on how I evaluate, my life if.

We, Use technology, to, connect, if we use technology. To. Connect. Across geography. Across generations, then there might be hope, for technology. And and well-being and. Also. Further down the line at one. Point we'll get to a a. Level. Where artificial. Intelligence. And emotional intelligence maybe. Will help us produce. Early. Detection when, it comes to suicide if my phone can pick up when. I'm depressed, or, if. FaceTime. Can, pick up, certain. Muscles in in my face that show signs of sadness or or. Suicidal. Thoughts combined, with me googling, suicide, methods and so on I think that area, is. Super, interested in in mental health. Technology. To to. Maybe. Not improve, happiness, but to reduce misery. For for those that are struggling with life interesting. Debate. I had so we're gonna open this up for. To the, audience if there are any questions so. Actually, have a first, of all. Great. Stuff and to be clear I'm a believer I think where, you guys are doing is this is, great. But. I have a bit of a challenge for you which is um I, feel. A little bit unsettled, being here in the audience that this feels mildly. Self congratulatory, in. As much as most. Of the people in this audience certainly, the Googlers. You've. Got really good health insurance there's. Free food right out there that, any of us could go and eat I, wonder. If you guys have thoughts of, how. To make this conversation. More. Inclusive, in the, sense of. People. Who actually work in the cafeteria and, who are working at the security desk that they're not in this room and how. To. You. Know bring everybody, into it and let everyone, benefit, from it actually. Because, I'm an optimist of Technology, I think technology, will help bring, everybody, into this conversation. To. Start with and I. Know it's a it's. A system, problem. But. I think it's also becoming, aware, of. The. Differences, we have in. Income. Or health, status or, all the biases, that we can get from from, technology, usage and actually. Make sure that everybody's, voice is hard. For. Me technology, actually, helps. Us talk. To people who, suffer from different, illnesses that. Normally wouldn't engage and, actually. Social media is helping us reach people who wouldn't otherwise, share. Their stories and we get to. Really learn and really, again. Kind of challenged, the, status quo what we think is, healthy. Or happy, or what, are your problems when you live with with a condition, by trying to to. Bring everybody's, voices. To. The table I think. It is the, essence. Of. One. Approach to life, that. Society. Should be inclusive for everybody. That's. Not. The libertarian. Idea. That's. Not the. The American. Idea, right, now, but. In Denmark. Or. Many. Other countries everybody. Has the. Guarantees, that allow, the inclusion. At. Least in a material, sense everybody. Has decent, pay, everybody. Has. Vacation. Time we. Don't have one day of guaranteed. Vacation, time in the United States other, than federal holidays but paid vacation, is. Normal. In, Northern. Europe and in the United States non-existent. As a right. And so. I think this, question that you're asking is, really a very basic. And important, one which is what, does it mean to be inclusive in the United States in theory. Inclusive. Means you're on your own so. Good luck and. If you make it that's great, and. If, not that's. Tough but don't bother me. I think. What, we are, all, saying is it's.

Not Really, a way to make anybody happy to. Have such a an. Unequal. High stress society, that, would, have. You ask a question a, very valid question like, that yeah. But. That is our society, it's not an inclusive society, thank. You so, much for coming, here and speaking with us today a, lot of the things, themes, you guys talked about today around happiness have to do with public. Policy politics. Urban, planning health care as. Individuals. What's. One, thing that we can do to increase happiness, for. Ourselves and, then what's one thing that we can do to increase happiness, for, others besides. Moving to Denmark. Mike, this is definitely your question, I, think. Aristotle. Or Geoff said, it earlier friends. I mean I think. One of the clearest, most consistent. Patterns. We see in. The. Data is the, importance, of our relationships, loved. Ones friends. Family. And. That's also what you can do for others you, know be a good friend connect, with people. I think. In the world, happen to support one of the questions. Collected, by Gallup is do you have somebody in your life you can rely on in, times, of need, yes. Or no that's. A very sort. Of, very. Simple question you can also use the, UCLA. Loneliness, scale twenty, different questions that tries, to capture what loneliness is. But. I think connecting. With other people creating. Strong, communities, creating, social, fabric caring, about, the. Ones that are at. The low end of the cantrell ladder, understanding. That perhaps we should focus our efforts on where well-being. Is most scarce, being, somebody, else this. Is the, person you they can rely on in times of need I think. That would be my my, best universal, advice. What. To do for yourself and what to do for the others is the same be, nice. Give. Something. Giving. Something is actually. Proven. To be. Enormous. Ly effective, and raising your own feelings. Of well-being and, doesn't. Hurt the receiver either, so. I think that. It's. Really a, powerful. Powerful. Antidote. To. The. Kind of. Aggressive. And. And, individualistic. Social. And cultural attitudes, that. Are pernicious. And, that have gotten out of hand. So. We're gonna have to stop here I do I'm, sure we could talk for hours and answer, hundreds of questions but Jeff, Catalina, Mike thank you a really good discussion, I'm Andrew Reuben thanks for, joining us. You.

2019-06-16 20:08

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