Americans Value Happiness, But Block Required Policies

In his book “The Politics of Happiness” Derek Bok argues that happiness should be a goal in public policy. He presents an inventory of social problems in the US with negative effects on happiness, like inadequate education, chronic pain, sleep disorders, depressions, divorce, single-parent families, and financial hardship. He presents interesting options to deal with these problems. He also pays attention to some more general happiness-issues for US-policymakers, like the question of economic growth without happiness and the reputation of the US-government. Bok’s findings are consistent with available data about the high levels of negative feelings in the US: stress, depressions, sadness, anger and worry. His message is quite clear: policy-makers can use the findings of happiness-research to improve their decisions.


Introduction
Derek Bok is the 300th Anniversary Research Professor at Harvard University. From 1971 to 1991 he served as Harvard's twenty-fifth president, and served again as interim president from 2006 to 2007. He is the author of ''The State of the Nation'' and ''The Trouble with Government'', and co-author of ''The Shape of the River''.
His latest book ''The Politics of Happiness'' is about happiness in the sense of life satisfaction. He finds that happiness research has come to a reassuring conclusion for the US: the conditions associated with people's happiness are approved of heartily, like strong marriages, close friendships, acts of charity, and a stable democracy with a responsive and accountable government. Happy people tend to do more for others and gain satisfaction by doing so. It is therefore attractive to use happiness as a goal, but certainly not the only goal, in public policy.
In this book he uses happiness as a standard to identify some specific social problems with negative effects on happiness for US-citizens, and some more general happinessissues for US-policy-makers. In the next paragraph I summarize his views on six specific social problems, and in paragraph 3 his views on two more general happiness-issues. I present some comments in paragraph 4 and conclusions in paragraph 5.
2 Bok's Views on Six Social Problems with Negative Effects on Happiness

Education
Education has become very job-oriented in the USA. In Bok's view this is regrettable because education should try to cultivate a wide range of interests and prepare students for a variety of pursuits. One step might be to impart the knowledge, interest, and commitment required for active and informed civic involvement. A second component of a broad education is a greater understanding and appreciation of the arts. Exercise and sports afford still further examples of unrealized opportunities to help students acquire interests that could contribute to a full and satisfying life.

Chronic Pain
Many Americans live with chronic pain (Reddy 2006) and Bok observes that many sufferers do not get adequate help because the most effective medications are morphine-based drugs, or opioids. Such drugs are also a source of addiction and abuse and are classified as controlled substances. Doctors who provide these medications are subject to strict regulation and oversight. If they are found to have violated the law they can lose their license to practice medicine or be forced to pay a fine. Even if a doctor is eventually vindicated he may have his practice disrupted along with negative publicity. Faced with such possibilities many doctors refuse to dispense pain-killing drugs at all or prescribe very low doses in order to minimize the risk of legal difficulty. This inhibiting effect is exacerbated by the vagueness and confusion that many doctors face in trying to interpret what the rules mean. In addition many medical schools have no required course in pain management. Several steps are needed to resolve these problems, e.g. medical schools should give pain management a more prominent place in the curriculum and drug enforcement officials should likewise receive appropriate training.

Sleep Disorders
Bok observes that many people in the USA live with some form of persistent sleep disorder that robs them of the restful nights they need to function effectively during the day (Institute of Medicine 2006). Attempts to remedy the situation require action on several fronts, e.g. government would need to mount an educational effort to inform the public about the possibilities for effective treatment. Medical schools should spend more time in teaching medical students and residents. Practicing physicians need more education about causes, diagnosis and treatment.

Depression
Some 16 % of Americans will suffer from at least one major depression during their lifetimes and half or more of these will experience repeated episodes . Roughly speaking, of every six Americans who suffer such a depression only one is treated correctly, two are treated incorrectly, and three are not treated at all (Wang et al. 2003). Bok presents several reasons for these disappointing results, like a lack of funding and inadequate training of medical personnel. Another reason for undertreatment is that those who seek help are often bewildered by the multiple agencies and offices. Poor and uneducated sufferers tend to be unaware of existing opportunities. Such findings suggest that governments should do more to inform individuals.

Divorce and Single Parents
There is a positive correlation between being married and happiness. Divorce has a negative effect and can cause serious problems for children (McLanahan and Sandefur 1994). Many children grow up in single parent households. Although young people can flourish under these conditions, the odds of encountering problems increase (Wilson 2002). Bok finds such findings worrisome because the percentage of children living with a single parent increased in the US from 8 % in 1960 to 28 % in 2005 (Amato and Maynard 2007). Many young people with single parents live in low-income inner-city neighbourhoods (Holzer 2009). The effects of these trends on black communities have been devastating (Western and Wildeman 2009). Some options to strengthen marriages and families: reduce premature pregnancy, improve parental skills, facilitate parental leave and part-time work. 1

Financial Hardship
Studies furthermore suggest that the financial conditions of most Americans are reasonable, but there are high levels of insecurity. There is substantial anxiety about the possibility of bankruptcy by retirement, medical costs, or unemployment. According to the National Opinion Research Center (2007) only the death of a child is considered more painful than declaring bankruptcy or losing one's home and having to live on the street. As global competition has increased, American workers are worried they may lose their job. The US does less than any other wealthy nation to cushion the shock of unemployment. Fewer employees have the right to receive advance notice before being laid off and existing requirements are very poorly enforced. Employers are not required to consider work-sharing arrangements or reduced hours to minimize layoffs. Many Americans, children included, are underinsured. In theory it is possible to save enough money to reduce financial insecurity, but for ordinary people this is difficult. How to estimate the likelihood of being laid off, the time it will take to find a new job, the risk of having to settle for a lower wage? How can people know how long they will live? Whether they will have to go to a nursing home, how many years they will be able to work, or how strong or weak the stock market will be when they retire? Some forms of insurance, such as for nursing home care, are simply too expensive, while policies for other risks, such as unemployment or the effects of inflation, are either non-existent or hard to find. Some options: maximum healthcare costs for families, arbitration for workers unjustly discharged and assistance for the unemployed in finding new jobs.
See Table 1 for an overview of six social problems in the US.

The Question of Economic Growth Without Happiness
Bok pays attention to the well-known Easterlin-paradox (Easterlin 1974). Even though rich people tend to be happier than poor people, average happiness in nations does not rise when national income goes up. The economic growth in the USA in the last decades did not create more happiness. Bok pays attention to social comparison and adaptation as potential explanations. By social comparison any satisfaction by additional income tends to be eroded if other incomes are rising just as fast. By adaptation people get used to higher incomes and raise their expectations. This creates a hedonic treadmill. 2 These explanations may account for the failure of happiness to rise by economic growth, but do not explain how richer people became happier originally. Bok suggests that the added happiness does not come from money, but from related benefits, like feeling more successful or having a higher status. Another benefit could be the greater challenge and independence associated with the jobs wealthy people tend to hold. Since there are always hierarchies, one should not be surprised if the related differences in happiness are unaffected by growth.
Bok believes nevertheless that economic growth should be appreciated for several reasons. Absence of growth creates substantial risks of recession and unemployment with negative effects on happiness. Absence of growth would also produce more cutthroat competition since growth of one company can only occur at the expense of competitors. One additional reason is that growth creates more revenues for the government, which makes it easier to finance new government-programs without additional levies. In his view economic growth is also essential for the dominant American way of life. However unjustified, many Americans feel that more money and possessions are needed for future happiness. Continuous growth will remain important, until a majority of Americans are persuaded that growth no longer makes sense. 3 The fact that economic growth does not really contribute to happiness in rich nations does not lead to any specific policy-proposals by Bok. He suggests however a general implication: economic growth deserves a lower priority than policies that clearly contribute to happiness, e.g. the promotion of parental leave and the protection of the environment.

The Reputation of the US-Government
Americans are very negative about their own government. According to opinion polls in 2007 less than one-third of Americans trusted the federal government to do the right thing all or most of the time. In Bok's view these negative judgements are only partially justified. The quality of the US government is acceptable, and only somewhat lower than the quality of governments in comparable democracies. 4 In Bok's view the negative attitude of the Americans has more to do with inaccurate perceptions and unrealistic expectations. Most people believe that over half of every dollar collected for Social Security is spent on overhead and administration, while the actual figure is only slightly more than 1 % (Kelman 1987). People also believe that the federal government wastes half of every dollar it receives, while serious research has never established such inefficiency (Ladd and Bowman 1998).
As a result of inaccurate perceptions Americans have less trust in politicians and government agencies than citizens in democracies with high levels of happiness, such as Denmark, Holland or Switzerland. 5 An important negative effect of the low regard for government is the gap it creates between the functions people expect the state to perform and the taxes they are prepared to pay. This mismatch between expectations and resources creates high budget-deficits. As Bok puts it on page 202: ''Pressed by constituents for new services and benefits, yet constrained from raising taxes, Congress often responds by creating more programs than it can pay for. It then makes up the difference by incurring deficits that burden future generations, or by shifting expenses to hard-pressed states through unfunded mandates of one sort or another, or by underfunding programs so that they cannot possibly deliver their promised benefits.'' Bok believes that the media and 3 Bok observes some change in attitudes. Already 89 % of Americans believe that their society is much too materialistic and 84 % agree that too much emphasis on money is a serious problem (Source: Harwood group 1995). Many Americans are even acting on their concerns. From 1990 to 1996, 19 percent of American adults reported having made a voluntary lifestyle change that reduced their earnings, such as working fewer hours or taking a less stressful job (Source: Schor 1998). 4 Bok considers ratings for Government Quality by the World Bank (Kaufmann et al. 2008) and the progress made toward common goals from 1960 to 2000. He concludes that the US-Government has done relatively well compared to all countries of the world, but the performance is below average if measured against the record of a sample of comparable democratic nations.

High Scores for Negative Feelings in the US
We may assume that the social problems in Bok's analysis contribute to the high levels of negative feelings in the US (Table 2). These high levels can possibly explain why the US is  (44) and other negative feelings (10,18,16,34). The negative feelings in terms of depressions, sadness, anger and worry have negative relations with happiness. As demonstrated by Ng et al. (2009) the relation between stress and happiness is different and more complicated. Stress at individual level is in a negative way related to happiness, but at national level in a positive way. At individual level stress is a negative marker of affective well-being, but at national level it reflects life-style differences associated with affective and cognitive well-being. The US has a relatively high score for positive feelings (78). This combination of high scores for positive feelings, stress and other negative feelings is remarkable, but consistent with the nature of the US as a dynamic society; apparently producing relatively high rates of positive and negative emotions simultaneously.

The Question of Economic Growth Without Happiness
Bok concludes that economic growth deserves a lower priority, but he believes that economic growth has to be appreciated for several good reasons. One of his reasons is that economic growth creates extra tax-revenues to finance new government programs without additional taxation. This view is pragmatic but somewhat debatable: why is useless growth better than raising taxes to finance new programs? Such views can easily lead to 'private wealth in the middle of public poverty': high and rising levels of private disposable income in combination with poor collective facilities and services. In terms of happiness this might be a bad policy.
In earlier research I found that the quality of government is a crucial factor: if the quality of government is high then there is a positive correlation between average happiness and the size of governments (Ott 2010a). This finding is obviously no excuse to accept bigger governments with more taxation uncritically, but in terms of happiness any dogmatic anti-taxation or anti-government attitude is equally unwarranted.
In my view there is a better but more modest reason to appreciate economic growth. The traditional appreciation is based on the assumption that human needs are unlimited and that additional goods and services always contribute to happiness. The dominant assumption in happiness-research is that happiness depends on the fulfilment of some limited needs or motivations. 7 This difference in assumptions is less dramatic than it seems to be, since one of the needs people have is the need to develop their capabilities and to accept new challenges (stimulation-seeking-or intrinsic motivation). Accepting new challenges may result in economic growth, if it goes together with the production of additional goods and services. The pursuit of happiness can therefore lead to economic growth. 7 A well-known typology of needs is presented by A. Maslow: 1. physiological, 2. safety, 3. love/belonging, 4. esteem, 5. self-actualization. The first four needs are related to deficiencies, self-actualization is related to growth. Ryan and Deci (2000) posit that happiness drives on three growth-needs: the need for autonomy, competence and relatedness. An alternative typology, not in terms of needs but in terms of motivation, is presented by Wentholt (1980): 1. Organic basic motivations, 1a. based on homeostatic principles (physiological regulation, hunger, thirst, sexuality and the emergency motivations aggression and fear), 1b. based on stimulation-seeking (intrinsic motivation and affection). Wentholt additionally presents (2) some complications in the actual dynamics of such motivations by our consciousness, like consciousness of our emotions, cognitive discordancies, existential conditions and individual identity. Maslow's growth-needs and Wentholt's stimulation-seeking motivations are based on the observation that people need stimuli, excitement, and challenges. Idleness is a bad recipe for happiness, but there is no innate need or motivation to produce goods and services to be sold on the market! .
In Bok's view economic growth deserves our appreciation because it is an alternative for taxation. I appreciate economic growth for a different reason: economic growth in rich nations is no longer a condition for the pursuit of happiness, but rather a consequence of this pursuit. The implication is that economic growth deserves indeed a lower priority in terms of happiness.

Happiness-Research and Democracy
We may agree with Bok that happiness can be a prominent public goal, but it should not be the only one. Politicians and policy-makers can use the findings of happiness-research to improve the quality of their discussions and decisions. I would like to add a more specific argument: policy-makers can protect democracy by using the findings of happiness research as a countervailing power, if lobbyists are too zealous in their promotion of specific interests. Policy-makers should at least be familiar with the finding that economic growth ''as such'' has hardly any impact on happiness in rich nations.

The Capability of the US-Government to Deal with Happiness-Problems
The quality of government is a crucial factor for happiness in nations: directly in direct contacts with citizens, and indirectly for the establishment of conditions that contribute to happiness (Ott 2010b). The quality of the US-government is acceptable, as observed by Bok, but the US-government has nevertheless, in my view, a serious problem. Rothstein and Uslaner (2005) coined the phrase 'inequality trap' for situations in poor nations with a high level of social-economic inequality, without any justification and beyond any moral standards. In such nations poor people have no trust in government and are unwilling to cooperate with government-agencies. This leads to a vicious circle, or 'inequality trap': no trust, no effectiveness, and vice versa.
In my view the US-government has to deal with a similar situation, but with different roots. Bok makes it very clear that inaccurate and negative perceptions have created a lack of trust in government. This lack of trust is not directly related to income-inequality, because income-inequality is in general accepted. Unfortunately this income-inequality has produced two alternative and less acceptable forms of inequality: inequality in political participation and power, and inequality in social-economic opportunities. 8 As a consequence wealthy anti-government-groups have ample opportunities to organize negative publicity about government-activities, and government agencies have no adequate means to counteract. The situation for the US-government can therefore be qualified as a 'marketing trap', with a negative impact on the capability to deal with social problems.

Conclusions
Bok observes that, if we accept happiness as a standard, economic growth deserves a lower priority in rich nations like the US. The implication is that governments in rich nations have some room to reconsider their priorities and to put more priority on alternative goals.
If we accept happiness as a standard we may suggest two alternative goals: more priority for the interests of unhappy people, in and outside the US, and more priority for sustainability and the happiness of future generations. Such strategies will only work however, if the position of the US-government can be substantially improved.
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