Wellbeing: Political Discourse and Policy in the Anglosphere.

In recent years, policymakers have shown renewed interest in the notion of wellbeing, or happiness, which are often interchangeable terms in discourse. However, subjective wellbeing or happiness dates back to ancient times. For Aristotle (384-322BC), happiness could take two forms: eudaimonic happiness, the ultimate goal of one’s existence which could be reached by following a virtuous path and undertaking meaningful activities, and hedonistic happiness, linked to the pursuit of personal sati...

In recent years, policymakers have shown renewed interest in the notion of wellbeing, or happiness, which are often interchangeable terms in discourse. However, subjective wellbeing or happiness dates back to ancient times. For Aristotle (384-322BC), happiness could take two forms: eudaimonic happiness, the ultimate goal of one's existence which could be reached by following a virtuous path and undertaking meaningful activities, and hedonistic happiness, linked to the pursuit of personal satisfaction and emotional comfort.
2 Wellbeing as we understand it today mostly stems from Western sources. 'The pursuit of happiness' was in fact included as a 'human unalienable right' among others on the American Declaration of Independence on July 4, 1776, whilst that same year British philosopher Jeremy Bentham recommended happiness as a social measure to promote 'utility' or the 'greatest happiness of the greatest number' (Bentham, 1776: 142). Political and economic changes such as the independence of the United States of America (USA), the French Revolution and industrialisation in 19 th century England brought about unprecedented and large scale democratisation which had a deep impact on the lives of citizens. The increase in wealth and spread of democracy led to an improvement in the quality of life in general, even if it failed to prevent wars and eradicate poverty from all spheres of society. As the political structure of European countries went through the process of 'state and nation building, mass democratization and the rise of different types of welfare systems' (Glatzer and Kohl, 2017), the material wellbeing and happiness of society became a concern for public institutions for present and future generations.

Measuring Wellbeing for Policy 4
Yet attempts at expressing the nature of wellbeing have mainly focused on the implementation of measures and monitoring rather than definitions. For instance, since 2003 Eurofound (European Foundation for the Improvement of Living and Working Conditions) has undertaken four surveys on the quality of life in Europe. Many recent measuring initiatives were also taken after the publication of the 2009 study on alternatives to measuring growth, commissioned by French President Nicolas Sarkozy and led by the economists Jean-Paul Fitoussi, Amartya Sen and Joseph Stiglitz (Stiglitz et al., 2009). The Council of Europe included the concept of wellbeing for all its members as part of a new strategy for social cohesion, which was approved by the Committee of Ministers in 2010. In 2011, the General Assembly of the United Nations adopted a resolution to encourage member countries to consider happiness and wellbeing in their measurement of social and economic development with a view to guiding public policy. This non-binding resolution further asserted that the 'pursuit of happiness is a fundamental human goal' (UN, 2011). The Organisation for Economic Cooperation and Development (OECD) (2011 Better Life Index), European Commission (2016 European Social Progress Index) and Organisation of the Islamic Cooperation, based in Saudi Arabia (Islamic Inclusive Growth Index) now all undertake measurement of social progress going beyond conventional economic measures like GDP per capita. In 2010, the British Office for National Statistics (ONS) was asked by Prime Minister David Cameron to create a 'UK happiness index' as part of a £2m-a-year wellbeing project. Other indicators include the 'Happy Planet Index', created by the London-based think tank New Economics Foundation (NEF), ranking countries according to happy life years and particularly focusing on environmental goods and bads (NEF, 2008). 5 Diener and Ryan (2006) developed the most common way of measuring wellbeing based on a bounded scale to evaluate experience from 0 to 10 or 1 to 7 called the Cantril Self-Anchoring Scale, invented by pioneering social researcher Dr. Hadley Cantril.
According to this scale, there is considered to be a minimum and maximum value to one's happiness. The problem is that it is thus assumed that there is a limit to maximum happiness. But should subjective wellbeing or happiness be bounded or unbounded? It is difficult to analyse whether there are limits, which raises problems for such evaluations of subjective wellbeing. However, very few surveys report 10/10 (the average in the United Kingdom (UK) for example is 7/10), which would suggest that such boundaries are not exceeded.

6
But how do these measures translate into wellbeing or happiness policies? Proponents of using measures to inform policy have suggested measuring subjective wellbeing or happiness by using these happiness indexes and then, after looking at the drivers of happiness, trying to increase the values of the index through appropriate policy interventions. For some researchers, the value of such measures is not necessary to create new happiness policies but to reflect on whether we are currently happy with our lives and establish the determinants of happiness. Diener et al. (2009) suggest that policymakers and other stakeholders might ultimately use this information to decide, in the utilitarian tradition, whether policies influencing those determinants really result in a higher level of happiness for the greatest number. Such values could also be used to assess and value goods that cannot really be expressed in monetary terms, that is a non-market goods such as health care, social services, transport, environmental policies and government action (Diener and Ryan, 2006). Measuring wellbeing in this way might also provide crucial information on what people value most and therefore which policy goals should be chosen by governments. When resources are limited, it might help to decide which area or areas should be given priority, bringing the ethics of wellbeing into play (Diener et al., 2009: 54-63). Richard Kraut, for example, in his publication What is Good and Why. The Ethics of Wellbeing analyses what causes human beings to flourish: that is, what is good for us. He argues that what is good for complex organisms is the maturation and exercise of their natural powers (Kraut, 2009). The essential problem is coming to an agreement on the politics of happiness and whether happiness politics or wellbeing policies should be developed.

7
While there is a dispute on the role of government in formulating policy specifically to enhance subjective wellbeing or happiness, some proponents on increasing happiness, such as Layard (Layard, 2005), claim that they do have a role in ensuring that misery is avoided. Other advocates of happiness politics besides Layard have argued that happiness or wellbeing should guide policy (Donovan and Halpern, 2002;Veenhoven, 2002Veenhoven, , 2004Diener and Seligman, 2004;Marks, 2004;McAllister, 2005). Research has found that happy people tend to be more sociable, interesting and creative-minded (Argyle 2001). They also tend to have reduced stress levels and choose healthy lifestyles (Veenhoven, 2004). Overall happy individuals can have a positive overall effect on society. Indeed 'if we want a happier society, we have got to approach our own lives in a way that prioritises the things that really matter-including happiness of those around us' (Wilkinson, 2011). McAllister (2005 thus argues that policies to enhance the happiness of the population can only be beneficial. Those who promote happiness research and measurement also contend that it can have some use in public policymaking because it supplements macro-economic information (Frey and Stutzer, 2007). 8 However, detractors argue that it is difficult to increase happiness or wellbeing because of the woolly definition of both terms (Schoch, 2006;Wilkinson, 2007;Johns and Ormerod, 2007). Moreover, knowledge about the determinants of happiness still remains at the experimental stage (Donovan and Halpern, 2002). Measuring happiness and wellbeing and assessing its drivers to ultimately increase happiness is also based on normative political and ethical assumptions that presume, in the philosophical tradition of utilitarianism of Jeremy Bentham and John Stuart Mill, that happiness as the basic principle of ethics should be the ultimate goal in life; the greatest happiness of the greatest number. However, even though happiness may be intrinsically good, as 'a universally understood and desired goal' (Duncan, 2010: 11), it does not necessarily follow that maximising happiness should be an ethical or political goal.

9
Happiness remains a complex and contestable notion, so as Duncan underlines 'any liberal-democratic polity would [...] need to consider how the ideal of happiness may be expressed within diverse communities' (Duncan, 2010: 7). As individuals and cultures have different values and policy priorities, how people can achieve happiness or a good life may be questioned in the realm of policy-making (Duncan, 2010). 10 A number of detractors also claim that the pursuit of happiness can actually result in misery, especially if it involves trying to achieve material wellbeing Gruber et al., 2011;Ford et al., 2017). Diener et al. argue against the maximization factor but defend action to enhance happiness not just for the present but also for future generations (Diener et al., 2009). Indeed overemphasis on growth, markets and individual identity has led to systematic imbalance and may actually result in social costs which can exceed the private benefits in affluent societies where resources are allocated to meet citizens' basic needs (Howard, 2012), especially if specific environmental and social policies are not implemented.
11 There can be negative consequences in maximising happiness. For example, an obligation to be happy may make one unhappy because of unrealistic expectations (Bruckner 2000;Buss, 2000, Nettle, 2005, De Pryckner, 2010, or stigmatise unhappy people (Bruckner 2000). Specifically, in the policy domain, there may be a misuse of happiness indicators. For example, different interest groups may try to distort or manipulate figures. It might mean individuals misinforming on their happiness levels to influence policymakers and policymaking (McMahon, 2005;Frey and Stutzer, 2007). Happiness data may also be used selectively to fit the political agenda: for example showing that freedom is an important factor in happiness to support a liberal programme.
12 So there would seem to be two essential problems in putting happiness on the agenda in public policy. First, policymakers will often promote happiness if it coincides with their own objectives and the likelihood of being elected. Second, if people know that their answers are to be used for happiness policies, they may misreport their answers to avoid manipulation by policymakers or provide a supportive response, as in some cultures feelings are not easily expressed. Finally, policies aimed at increasing happiness are not difficult or impossible to implement, but they may have a negative impact on social welfare as illustrated by Bhutan's attempt to adopt nationwide Gross National Happiness (GNH) policies, which neglected other aspects such as chronic unemployment, poverty, education and corruption. Indeed, Bhutanese Prime Minister Mr Togbay claimed upon his election in 2013 that 'the concept was overused and masked problems with corruption and low standards of living' (BBC News, 2013). He went on to criticize the GNH as distracting the government away from delivering basic services.
Wellbeing: Political Discourse and Policy in the Anglosphere. Introduction Revue Interventions économiques, 62 | 2019 13 Indeed, the emphasis on subjective wellbeing and, in particular, 'deliberative' utilitarianism moves the focus away from other more objective concerns linked to inequality or welfare (Blanchflower, 2004;Gadrey, 2012). Many of the current wellbeing measures and wellbeing policies that have been developed take very little account of structural inequalities or social relations between communities, which are also significant key drivers of wellbeing. Moreover, subjective wellbeing is close to the sense of economic utility, relating to 'personal benefit gained by an individual from a particular interaction or a particular behavior' (Eichhorn 2013). The resurgence of 19 th century laissez-faire economic liberalism since the 1980s is thus a key to the current context of wellbeing, which favours less general social welfare and a greater need to measure individual wellbeing and apply measures related to improving this (Scott, 2012;Eichhorn, 2013, Coron andDalingwater, 2017).
14 Another drawback of measuring subjective wellbeing is that it is looking at individual satisfaction rather than social content. It is not gauging improvements in quality of life or human progress (Eckersley, 2013). Diener and his co-researchers who were pioneers in developing measures of subjective wellbeing remain very cautious about how these measures could be actively used to inform policy and practice. At the same time, the authors show that alternative measures provide useful supplementary information and give citizens' views on how well or badly they perceive changes in society . The question of reliability of data is very important to bear in mind. For example, Diener et al. (2013) reported that when political questions were raised after asking people to evaluate their life satisfaction, people tended to view the questions from the perspective of satisfaction with their personal lives and not related to the societal and political affairs context. This might mean that individuals are happy with their own lives, but dissatisfied with society-wide conditions. Americans have been said to be losing confidence in the nation, but still believe in themselves and it is mainly the latter evidence (happiness with their own lives) which is measured by the most recent subjective wellbeing indicators. If you ask Americans whether they are happy, from an individual perspective they will probably give positive answers. However, two thirds of Americans also believe that the past decade is one of decline, not progress. They consider the future to be bleaker for their children (Eckersley, 2013).

Wellbeing Policies and Political Spectrums 15
The use of wellbeing for political ends depends, of course, on which side of the political spectrum wellbeing is being considered. The 'political left' for example is inclined to put emphasis on social wellbeing and the creation and maintenance of welfare states, whereas 'right wing' governments might focus on economic wellbeing, whereby the market is prioritised in order to create prosperity (Atkinson and Morelli, 2012). Although 'left' and 'right' have less meaning today with the rise of centrism, both political leanings claim that their philosophies are the best way forward for the country in both economic and social terms and ultimately for the wellbeing of its citizens. 16 The debate is therefore whether subjective and objective wellbeing varies depending on a particular type of policy implementation (De Prycker, 2010). Veenhoven (1997) and Diener et al. (1995) found that countries that were considered to be more individualist than collectivist reported greater mean levels of happiness. They argue that this leaves individuals scope for more choices to lead their own lives or seek their own happiness. This is in contrast to earlier research. Lindblom (1977: 82) argues that pursuing a market-led political approach leads to greater insecurity for the population. Esping-Andersen (1990) contends that in a market economy, individuals are also captive to power which is not within their control, which then results in greater stress levels.
Economically liberal governments argue that too much intervention of the state can make individuals powerless because of intrusive governmental bureaucracy and can also result in too much dependency and complacency, which is negative in terms of self-respect and autonomy. To what extent governments should be intrusive is a very significant question. If it is to ensure security and safety, intervention is crucial. However, neoliberal theory 3 would contend that too much intervention of the state may be detrimental to individual wellbeing. This can be linked to a more general reflection on the role of the welfare state.
17 The objective of the welfare state is to reduce inequality and poverty. However, there is a debate about the extent to which this purpose is served. Economically liberal governments tend to accuse excessive state intervention and a tight welfare state of crowding out the private sector because of excessive public spending (Bacon and Eltis, 1976) while encouraging dependency on the state of the unemployed. Collectivism can also have negative effects on individual privacy, freedom and autonomy. So whether welfare is good for society and ultimately makes it happier is often linked to the debate around entitlements and the market. Too much welfare and decommodification 4 might result in inefficiency and wastefulness, which will impose costs on society that will ultimately reduce overall levels of happiness.
18 However, is there any proof that either increasing or decreasing welfare can have any effect on subjective wellbeing or happiness? Veenhoven (2000) in a comparative study of 41 nations from 1980 to 1990 studied the link between levels of wellbeing and the size of the welfare state and concluded that there was no link. The only justification for increasing or decreasing welfare would be according to political ideologies. Radcliffe (2001) on the other hand found a strong positive connection between life satisfaction and welfare. He concludes that 'subjective evaluation of life is enhanced by the extent to which the state reduces market dependence through the decommodification of labour and, in general, adopts a social democratic welfare regime.' However, Pacek and Radcliffe (2008) contend that neither study is ultimately convincing because of poor design. In order to measure the impact of welfare on happiness, some have concentrated on the level of expenditure, but as Esping-Andersen (1988) underlines this is not necessarily very relevant or even perhaps misleading, because it does not sum up the state's commitment to welfare.
19 Esping-Andersen (1990) delves deeper into the question of the quality of the welfare state in The Three Worlds of Welfare Capitalism. He examines the role of decommodification and how this reflects the quality as well as quantity of social rights and entitlements. Decommodification for him means that individuals can opt out of work if necessary and it will not impinge on their overall welfare. They are thus not dependent on the market. Emancipation from market dependency is measured by the level of pensions, income allowance for ill health or disablement and unemployment benefits. Generous welfare states will have a higher degree of decommodification.
Another measure that Esping-Andersen uses to compare levels of welfare is in terms of the social wage; that is the share of national income that is distributed according to social need rather than by market distribution.
20 According to Pacek and Radcliffe (2008), welfare states contribute to human wellbeing and if welfare is reduced, people are forced to act as commodities to survive. Albert Einstein (1949) argued that socialism was the best way of structuring society to make human life as satisfying as possible. He also contended that capitalism encourages one to see society not as a positive asset but as a threat to natural rights. Pacek and Radcliffe support his theory: 'market economies tend to make individuals prisoners of their own egotism', so that 'they feel insecure, lonely and deprived of the naïve, simple, and unsophisticated enjoyment of life' (Pacek and Radcliffe, 2008). The political debate on the role of the market and state intervention thus plays a significant role in the development of wellbeing policies. It is particularly relevant if we look at the set of countries which make up the Anglosphere. These countries have adhered quite strongly to neoliberal policies and given a significant role to the market even in the public policy domain.

Reflecting on Wellbeing Policies in the Anglosphere
21 But how might we define the Anglosphere and why might it be relevant to consider this sphere in relation to the political economy of wellbeing? The Anglosphere 5 can be defined as "the countries of the world in which the English language and cultural values predominate" (Merriam-Webster). Apart from sharing the same language, these countries also have common institutions inherited from the colonial past with democratic parliaments largely based on the British political system and legal system of common law. The creation of political parties in these countries was largely inspired by British bipartism and to some extent its welfare state. Since the 1980s, the neoliberal model 6 and/or the so-called 'Anglo Saxon model' has also been a common feature in much of the Anglosphere. 22 The Anglosphere would seem to share a number of values and beliefs which are important in the context of wellbeing. The World Values Survey, a global network of social scientists studying changing values and their impact on social and political life, identifies the Anglosphere or English-speaking sphere, as they refer to it, as one of eight significant cultural spheres. A series of publications by this think tank 7 aims to show that people's beliefs play a major role in economic development, the emergence and flourishing of democratic institutions, equality and effective government. These factors are also inherent ingredients of wellbeing. The common historical, cultural and language connections mean that comparisons within the Anglosphere may be more consistent than wider comparative studies of wellbeing.
23 Indeed wellbeing remains a complex notion and means different things to different people across cultures. Blanchflower and Oswald's study (2004) for example found that errors might have occurred when analysing wellbeing in Australia with too general and universal a comparison. Their study questions the UN Human Development Index's reporting where Australia now ranks 3 rd in the world. The authors report on their own study of a sample of English-speaking nations which places Australia much lower in the ranking, claiming that their re-evaluation of subjective wellbeing in Australia is perhaps more reliable because of the choice to focus on countries with a common first language and historical ties. A similar approach was taken by Olafsson (2013)  analysis of Nordic countries. It is for this reason that a number of comparative studies have chosen to concentrate on sub-samples where a common language, similar cultures and/or heritage can make wellbeing analysis more reliable. 24 The same reasoning is behind our decision to compare wellbeing policies within the Anglosphere. We felt that illustrating policies in a sub-sample of English-speaking nations would produce more reliable outcomes for debate. Some of these countries have also been pioneers in the creation of wellbeing measures as we have already illustrated. For this reason, we chose an international team of researchers and experts with particular knowledge of one or several countries of the Anglosphere.

in his
25 While literature on the notion of wellbeing and measurement has been fairly extensive in the Anglosphere and beyond, produced by both researchers and policy institutions alike over the last decade, there would seem to be relatively less literature on how such work has contributed to the emergence of wellbeing policies, with the exception of a few studies produced for example by the NEF or the highly contested Legatum Institute.
26 Our analysis differs from these studies in its outreach and considers the establishment and development of wellbeing policies in several countries and regions of the Anglosphere (Australia, Hong Kong, New Zealand, the UK and the USA) in particular policy domains: social policy, health, housing and education, from a historical and political perspective. It is interesting to explore whether these countries and regions of the Anglosphere, with similar cultural roots and strong adherence to neoliberal policies have developed similar policies to improve wellbeing. The contributions of this volume assess how policymakers are influenced by the specific national setting in the creation of a framework for wellbeing in various policy domains. 27 The debate on the role of the state in enhancing both material and subjective wellbeing is a theme which brings the articles together, and some common paths to wellbeing are illustrated in the collection of articles. Both Rodd's and Ewens's contributions show how New Zealand and Australia were pioneers in the creation of legislation and social policies to enhance wellbeing. New Zealand was the first country in the world to introduce public old age pensions in 1898, and the first country in the Anglosphere to establish a welfare state. Australia quickly followed suit in the wellbeing-throughwelfare approach by introducing a minimum wage and a whole number of welfare reforms to increase safety, which is identified as one of the key drivers of wellbeing by Ewens. In stark contrast, Costantini describes how Hong Kong, which was under British rule until 1997, suffered from a deeply fragmented health care system until the 1990s and it was not until December 2000 that citizens could enjoy a statutory retirement pension scheme. Yet the author claims that Hong Kong has now developed one of the most advanced health and education systems in the world, which has driven improvements in the quality of life of its citizens. In his article, which analyses the link between health and wellbeing, Holdsworth contends that if political trends in the US regain the momentum that surrounded the Affordable Care Act, legislation would increasingly be able to provide health care to help people not only to get well, but also to live well and achieve greater happiness.
28 Several articles illustrate the move from collective welfare to individual wellbeing after the introduction of neoliberal policies in the 1980s. Indeed, Rodd describes the radical shift of policies in New Zealand centred on the 'people's wellbeing' to 'individual' wellbeing promoted by an 'enabling state' from the 1980s onwards. Dalingwater's contribution shows how, in the UK, connecting health and wellbeing has led to a strong individualist approach, centred on the 'self' and personal entitlements within the framework of self-improvement rather than enhancing collective actions to improve the health of nations. Smith's paper highlights the limits to the neoliberal form of intervention in the USA. Economic policies implemented in the 1980s, which focused on individual ownership as a way to happiness, were in part responsible for the subprime mortgage crisis of 2007, causing misery for many Americans. He thus questions the state's emphasis on homeownership as a way to happiness. Fée also shows how the increase in the role of the market in the provision of housing for British citizens has led to a decline in home ownership and social housing. 29 The way in which wellbeing measures have an influence over policy is also illustrated in a number of papers in this special issue. In post-crisis, austerity-driven Anglosphere economies, the papers show how the publication of the results of wellbeing measures is a way in which governments may well justify policy choices or actually retreat from intervention. Costantini suggests that wellbeing measures in Hong Kong have been formulated in order to reflect favourably on the government which has witnessed its initial autonomy further been reduced especially in the political sphere. But, to be fair, wellbeing indicators can be a way of directing policy to improve the quality of lives of its citizens. Dalingwater's contribution for example shows how significant use can be made of personal wellbeing data in terms of cost-benefit analysis of policy appraisals. Fée's article underlines that cost-benefit analysis is already used in the realm of housing. Both Dalingwater's and Fée's contributions show how statistics on personal wellbeing can inform governments about which areas of spending are likely to lead to the largest increases in personal wellbeing. However, such indicators may well be used to provide support for policies that already exist rather than to develop new policy directions or initiatives.
30 There has been an increasing emphasis on discourse to improve the wellbeing of citizens. Yet, some of the papers in this special issue show how political discourse on wellbeing, wellness or happiness may be a way of detracting from the shortcomings of the state. Holdsworth's paper shows how the focus in American health policy on wellbeing and wellness fails to solve the most fundamental problem of unaffordable health coverage. Many Americans are unable to get or pay for the clinical care they need. Smith's contribution contends that while American policymakers have consistently used happiness rhetoric and a specific notion of virtue to promote an ownership model of wellbeing, this may well have the opposite effect and make citizens feel unhappy if they fail to achieve accession to ownership. Fee's article underlines the disconnect between discourse on wellbeing in the UK since the 2008 financial crisis and effective policies to ensure decent housing for all. 31 Analysis of the implications of policy directions of the state, the use of measures to drive policy and policy discourse is thus at the heart of the contributions which show common trends across the Anglosphere, but also point to how wellbeing policies and practice are influenced by the specific national setting.

The contributions
health and social justice legislation. She shows that the nation has evolved under the influence of the notions of solidarity and civic-mindedness, so that Australian legal milestones have been instrumental in bringing about the greatest wellbeing (both objective and subjective) for the greatest number of Australians. She underlines two features specific to Australia in this domain. First, the country has had a pioneering role in collective wellbeing legislation (with the universal minimum wage, compulsory seatbelts for every person in a motor vehicle, random breath testing of drivers, ban on firearms, and ban on attractive cigarette cartons) or even complete singularity (as with the compulsory vote). Second, far from resenting these laws, which people in other countries in the Anglosphere might consider meddlesome or intrusive, the vast majority of Australians welcome them, as they tend to value equality and solidarity over individual rights.
33 Adrian Rodd examines New Zealand's quite radical social and economic policies. He first emphasizes that New Zealand was the first country in the English-speaking world to introduce significant public measures to improve working-class living standards, before setting up an unprecedented welfare state in the 1930s. He then shows that the dismantling of these policies half a century later was no less radical. His analysis is that the political conceptualisation of wellbeing, from collective to individual, is at the root of this evolution from Welfare State to 'Enabling State'.
34 David Fée analyses the link between wellbeing and housing in the United Kingdom.
Relying on a long tradition of official data collection, he traces the evolution of British housing conditions, which are components of objective well-being, over the long term. He then explains how housing has become a public policy and how the official discourse on housing has varied according to the government in place between 1890 and 2018. Finally, considering the degree of satisfaction of British people regarding their homes and neighbourhoods, he examines whether the policy choices made in the field of housing since 2010 can improve the subjective well-being of British people.
35 Bradley Smith presents a brief history of the use of happiness and wellbeing rhetoric to bolster political support for the expansion of homeownership in the United States.
After exploring the relation between the right to pursue happiness and the right to own property in the American founding documents, he studies the happiness discourse that accompanied the rise of the suburban model of homeownership in the 20 th century. He contrasts this discourse with that which accompanied the policy shifts implemented in the late 20 th century to conserve the model. 36 Max Holdsworth examines select US health care promotion campaigns and policies with reference to health, wellness, wellbeing and the social determinants of health. In particular, he looks at the health promotion campaign Healthy People and the Patient Protection and Affordable Care Act (ACA) of 2010. He finds these initiatives reveal some of the changing perspectives on the meaning of health that are becoming more prevalent in the USA. US contemporary health policies are evolving in new directions towards wellness that in turn extend towards wellbeing and happiness. Nevertheless, the fundamental problem remains that there are many Americans without health insurance who are unable to get or pay for the clinical care they need. More quantitative information and consideration of social and neighbourhood determinants of health could help wellness and wellbeing along with health care feature more highly on the health policy agenda.
Wellbeing: Political Discourse and Policy in the Anglosphere. Introduction Revue Interventions économiques, 62 | 2019 37 Louise Dalingwater considers the complexities of formulating and implementing joint health and wellbeing policies in the United Kingdom (UK). UK authorities have officially recognised a two-way relationship between health and wellbeing. Recent national publications and policy approaches in the UK have therefore incorporated wellbeing within almost all policy prescriptions. After analysing the origins of the health-wellbeing linkage, the author examines health and wellbeing policy articulation and prescriptions in official documents. She then reflects on the inherent difficulties of the joint framework approach.
38 Iside Costantini focuses on policy inputs in health and education in Hong Kong and their relationship with wellbeing. She examines the birth and the evolution of public policies in health and education and their wellbeing outcomes, and explores more recent developments and forthcoming challenges. She makes specific reference to the colonial legacy and Chinese cultural environment, and assesses how particular factors (geography, history and politics) may have influenced health and education policies.
which brought together 26 economists and liberal thinkers, it became a central part of government policy in many parts of the Anglosphere towards the late 1970s. 4. Understood here as an exit from the labour market with little or no loss of income.