Health & Health & WellbeingWellbeing ~ ~

from the Personal to the from the Personal to the Collective Collective

Professor Carol Professor Carol MorseMorseDirector, Director,

Health & Wellbeing Health & Wellbeing ResearchResearch

Monash Peninsula CampusMonash Peninsula Campus

The State of WellbeingThe State of Wellbeing

• Incorporates Incorporates healthhealth and positive and positive psychological, emotional psychological, emotional and and spiritual spiritual experiences and characteristicsexperiences and characteristics

• A A positive statepositive state brought about through brought about through the simultaneous the simultaneous satisfactionsatisfaction of of personal, relational and collectivepersonal, relational and collective needs of individuals and communitiesneeds of individuals and communities

Quality of LifeQuality of Life

• SatisfactionSatisfaction with one’s life with one’s life experiences – past, currentexperiences – past, current

• PerceivedPerceived ImportanceImportance of one’s of one’s attributes, achievements, possessionsattributes, achievements, possessions

Subjective WellbeingSubjective Wellbeing

The Synergy of The Synergy of WellbeingWellbeing

relationalrelational

collectivecollectivepersonalpersonal

WellbeingWellbeing

Personal WellbeingPersonal WellbeingArises from and is maintained byArises from and is maintained by::

•Sense of controlSense of control

•Sense of competenceSense of competence

•Self-esteemSelf-esteem

•OptimismOptimism

•Physical and mental healthPhysical and mental health

•Feeling cared for and valuedFeeling cared for and valued

Relational WellbeingRelational WellbeingArises from and is sustained byArises from and is sustained by::

• SupportSupport

• BelongingBelonging

• CohesionCohesion

• CollaborationCollaboration

• AffectionAffection

• RespectRespect

• Democratic opportunities & Democratic opportunities & participationparticipation

Collective WellbeingCollective WellbeingArises from and is sustained byArises from and is sustained by::

• Economic prosperityEconomic prosperity

• Adequate housingAdequate housing

• Clean environmentClean environment

• Social justiceSocial justice

• Adequate health and social servicesAdequate health and social services

• Low crimeLow crime

• Support for community structuresSupport for community structures

Health and Wellbeing Health and Wellbeing

PromotionPromotion in Synergyin Synergy

• Work in partnerships to identify key Work in partnerships to identify key issues with and through engagingissues with and through engaging

~ individuals~ individuals~ families~ families~ community~ community~ society~ society

• Develop interventions that are Develop interventions that are matched to the target’s stage of matched to the target’s stage of development, need and changedevelopment, need and change

Considering the Considering the Social Social Determinants of Health & Determinants of Health &

WellbeingWellbeingThe Top 10 ~The Top 10 ~• The social gradientThe social gradient [what you do and earn, where you live, who you are][what you do and earn, where you live, who you are]

• Manageable stressManageable stress• Early life conditionsEarly life conditions [ [personal, interpersonal, environmentalpersonal, interpersonal, environmental]]

• Social inclusion OR exclusion and isolationSocial inclusion OR exclusion and isolation• Employment statusEmployment status• Work conditionsWork conditions• Social support and networksSocial support and networks• Health promoting OR addictive behavioursHealth promoting OR addictive behaviours• Food and nutritionFood and nutrition• Transport & housing policiesTransport & housing policies

Excess and/or lack of these are linked to physical and mental ill-health and Excess and/or lack of these are linked to physical and mental ill-health and higher mortalityhigher mortality

[WHO: The social determinants of health: the solid facts][WHO: The social determinants of health: the solid facts]

Research Opportunities Research Opportunities Addressing Addressing

Health & Wellbeing at Health & Wellbeing at PeninsulaPeninsula

• Understanding the Biological Bases of HealthUnderstanding the Biological Bases of Health

• Promoting and Maintaining HealthPromoting and Maintaining Health

• Injury Prevention and RehabilitationInjury Prevention and Rehabilitation

• Intervening in Ill Health and Promoting RecoveryIntervening in Ill Health and Promoting Recovery

• Life TransitionsLife Transitions

1. 1. Understanding Understanding the the Biological Bases of Health Biological Bases of Health & Wellbeing& Wellbeing• Metabolism and metabolic mechanisms Metabolism and metabolic mechanisms

[molecular biology; disorders ~ allergies, diabetes, [molecular biology; disorders ~ allergies, diabetes, obesity]obesity]

• Physiology and physiologic functions/ Physiology and physiologic functions/ dysfunctions dysfunctions [analysis and enhancement][analysis and enhancement]

• Nutrition across the life course Nutrition across the life course [interventions and evaluations; food safety; dietetics][interventions and evaluations; food safety; dietetics]

• Reproduction Reproduction [pubertal onset to mature aged [pubertal onset to mature aged

offset]offset]

2.2. Promoting and Promoting and Maintaining Maintaining

Health & WellbeingHealth & Wellbeing• Approaches to enable individuals, groups and Approaches to enable individuals, groups and

communities to increase control of and enhance communities to increase control of and enhance their health statustheir health status

• Approaches to maximise health status Approaches to maximise health status even when even when irreversible disabilities co-exist irreversible disabilities co-exist

~ infants, children and youth~ infants, children and youth

~ young and mid aged adults~ young and mid aged adults x genderx gender

~ older adults to the very old~ older adults to the very old ethnicityethnicity

~ special needs groups~ special needs groups culture culture

3. Injury Prevention & 3. Injury Prevention & RehabilitationRehabilitation• Health promotion, health education and Health promotion, health education and

intervention programs designed to overcome the intervention programs designed to overcome the ‘diseases of opulence’:‘diseases of opulence’:

~ ~ musculo-skeletal fitnessmusculo-skeletal fitness

- slips, trips, falls - slips, trips, falls ~ occupational health and wellbeing~ occupational health and wellbeing~ diabetes management~ diabetes management~ weight control~ weight control~ chronic diseases management~ chronic diseases management~ addictive behaviours moderation~ addictive behaviours moderation~ built environment and safety~ built environment and safety

4. Intervening in 4. Intervening in Illness & RecoveryIllness & Recovery• Heroic surgery in cardiac, orthopaedic, sensory, Heroic surgery in cardiac, orthopaedic, sensory,

thoracic and systemic illnessesthoracic and systemic illnesses

• Post illness care for recoveryPost illness care for recovery • Post trauma reconstruction and rehabilitationPost trauma reconstruction and rehabilitation

• Quality care givingQuality care giving

• Evidence-based practice and Standards for Evidence-based practice and Standards for practice practice

• Responding to needs of special groups Responding to needs of special groups [mental [mental illness, disabilities across the life course]illness, disabilities across the life course]

• Health and Illness economicsHealth and Illness economics

5.5. Life Life TransitionsTransitions• Early childhood development and educationEarly childhood development and education

[cognitive, educative, emotional, physical, psychological, social]• Transition to puberty and adolescenceTransition to puberty and adolescence – – interaction

with education and socio-emotional development and psychosocial parameters

• Education to work Education to work • Work – home balancesWork – home balances• Achieving career aspirationsAchieving career aspirations• Post-career adjustmentPost-career adjustment [retirement from the workforce, from [retirement from the workforce, from

major life roles, in elite athletes & professional sports people]major life roles, in elite athletes & professional sports people]

• Becoming a parent – partnering- parentingBecoming a parent – partnering- parenting ~ Relationship break up, break down, reconciliation, family ~ Relationship break up, break down, reconciliation, family

coercioncoercion~ Serial partnering and blended families~ Serial partnering and blended families

• Post-parenting separation and mid-lifePost-parenting separation and mid-life~ Physical challenges – natural and unnatural~ Physical challenges – natural and unnatural~ social relationships challenges~ social relationships challenges

• Ageing in the third and fourth ageAgeing in the third and fourth age

Virtual Centre for Virtual Centre for Health & Wellbeing Health & Wellbeing

ResearchResearch

Injury PreventionInjury Prevention& Rehabilitation& Rehabilitation Life TransitionsLife Transitions

Biological BasesBiological Bases

Health Health &&

WellbeingWellbeing

HealthHealthPromotionPromotion

Ill HealthIll Health&&

RecoveryRecovery

Making a Case for Making a Case for Research on Research on AgeingAgeing: Key : Key IssuesIssues• 1 mill. over 65+ Australians by 2025, 1 mill. over 65+ Australians by 2025,

• Lifelong focus on issues for research is imperativeLifelong focus on issues for research is imperative• Key starting points: Key starting points: childhood, young adulthood, midlifechildhood, young adulthood, midlife

• Ageing as a significant issue ignored by government? Ageing as a significant issue ignored by government? fertility assumed to remain @ 1.7fertility assumed to remain @ 1.7

• Housing and public transport issues ignored; influences of Housing and public transport issues ignored; influences of neighbourhoods ignoredneighbourhoods ignored

• Myth that research is actually rarely multi-disciplinaryMyth that research is actually rarely multi-disciplinary• Funders’ rhetoric - multi-disciplinary research Funders’ rhetoric - multi-disciplinary research requestedrequested yet yet

rarely funded by major bodies (NHMRC, ARC)rarely funded by major bodies (NHMRC, ARC)

[WHO: The social determinants of health: the solid facts][WHO: The social determinants of health: the solid facts]

Research Agenda on Ageing Research Agenda on Ageing for the for the

2121stst Century Century• Population ageing and the general economyPopulation ageing and the general economy• Determinants of healthy ageingDeterminants of healthy ageing• Advancing health and wellbeing into old & late old Advancing health and wellbeing into old & late old

ageage• Biological mechanisms and control of age related Biological mechanisms and control of age related

diseasesdiseases• Determinants of quality of life and deathDeterminants of quality of life and death• Life course ageing in differing cultural, socio-Life course ageing in differing cultural, socio-

economic environmentseconomic environments• Ensuring and examining effects of supportive Ensuring and examining effects of supportive

environmentsenvironments [[neighbourhoods]neighbourhoods]

• Maintaining material wellbeing across the life courseMaintaining material wellbeing across the life course• Older Australians remaining in the waged workforceOlder Australians remaining in the waged workforce• The changing nature of kinship ties and reciprocal The changing nature of kinship ties and reciprocal

fidelitiesfidelities [OWLS –’[OWLS –’Oldies Withdrawing Loot Sensibly’ and SKI – and SKI – ‘Spending the Kids Inheritance’ ideologies]‘Spending the Kids Inheritance’ ideologies]

Ageing Well ModelAgeing Well Model(Global Ageing Research Network – (Global Ageing Research Network –

GARNetGARNet))

AGEING WELL

PHYSICAL HEALTH

& DEVELOPMENT

SOCIAL & INTER-

GENERATIONS SUPPORT

COGNITIVE

& MENTAL

WELLBEING

EXERCISE, RECREATION

MATERIAL RESOURCES

& COMMUNITY

Issues to Inform a Research Issues to Inform a Research Agenda onAgenda on Ageing for the Mornington Ageing for the Mornington PeninsulaPeninsula• Over 65s higher proportion cf’d Melbourne – 15.4% vs. 10.4%Over 65s higher proportion cf’d Melbourne – 15.4% vs. 10.4%

projected to rise to 26% of the total M-P population by 2016 projected to rise to 26% of the total M-P population by 2016 [[i.e. in a i.e. in a decadedecade]]

• SES – 73.5% receive the Age Pension SES – 73.5% receive the Age Pension [ ?social inequalities][ ?social inequalities]

• Morbidity – Morbidity – >> 60y.o. over represented in all hospital admissions 60y.o. over represented in all hospital admissions65-74 y.o: W: illness, injuries; suicide; self-inflicted injuries; 65-74 y.o: W: illness, injuries; suicide; self-inflicted injuries;

depression; mental illness; traffic accidents depression; mental illness; traffic accidents M: substance abuses; CVD; fallsM: substance abuses; CVD; falls

75+ y.o: W: 75+ y.o: W: CVD; fallsCVD; falls M: alcohol dependence; suicide; mood M: alcohol dependence; suicide; mood

disorders; social disorders; social phobias; self-inflicted phobias; self-inflicted injuriesinjuries

SourceSource: The Elder Citizens Strategy, Mornington Peninsula Shire, : The Elder Citizens Strategy, Mornington Peninsula Shire, 20022002

Issues to Inform a Research Issues to Inform a Research Agenda on Agenda on AgeingAgeing for the for the Mornington PeninsulaMornington Peninsula• Elders’ ConcernsElders’ Concerns::

~ safety in and out of home~ safety in and out of home~ affordable housing~ affordable housing~ inadequate public transport~ inadequate public transport~ too few GPs and services~ too few GPs and services~ health information lacking~ health information lacking~ limited access to recreation ~ limited access to recreation

& leisure facilities& leisure facilities~ rural isolation/distance~ rural isolation/distance~ CALD and Indigenous ~ CALD and Indigenous

concerns overlooked?concerns overlooked?

• Services Constraints:Services Constraints:

~ ~ lack of low & high care bedslack of low & high care beds~ early discharges to community ~ early discharges to community

services -?overloadservices -?overload~ higher numbers of old people ~ higher numbers of old people

& oldest-old [85-90+]& oldest-old [85-90+]~ large areas of dispersion~ large areas of dispersion~ workforce challenges – ~ workforce challenges –

attraction, retention, skills attraction, retention, skills basebase

Issues in Fostering a Taskforce for Issues in Fostering a Taskforce for AgeingAgeing Research Research

• New academic staff on Peninsula campus, unused to working New academic staff on Peninsula campus, unused to working together as a teamtogether as a team

• Need to break out of discipline-based ‘silos’ in thinking and research Need to break out of discipline-based ‘silos’ in thinking and research conceptualisations to create a truly conceptualisations to create a truly multi-disciplinarymulti-disciplinary approach approach

• Need to marry together different research paradigms to examine sets Need to marry together different research paradigms to examine sets of issuesof issues

• Readiness to engage in community – academic collaborative Readiness to engage in community – academic collaborative partnershipspartnerships

• Need to acknowledge Need to acknowledge “the whole can be greater than the sum of the parts”“the whole can be greater than the sum of the parts”

The Centre for The Centre for Health & Wellbeing Health & Wellbeing

ResearchResearch

ExaminingExamining

UnderstandingUnderstanding

PromotingPromoting

InterveningIntervening