The world is experiencing multiple intersecting urgent and existential crises, which have profound and inequitable implications for population health. Arguably, the design of the current, dominant economic system and its antecedents is the root cause of these crises, as it externalises impacts on nature, climate and population health, exacerbates inequalities, and rewards extraction, rent-seeking and social hierarchy.
A ‘wellbeing economy’, which aims to achieve social justice within planetary boundaries, has been proposed as an alternative approach to economic design. Many governments, businesses and organisations have expressed interest or commitment to this, but not at the required scale or with the required urgency. Indeed, there is the risk now that the radicalism of a wellbeing economy approach is undermined in its delivery thus far as it has either only been adopted in rhetoric or nascent form; or implemented only as isolated components rather than as part of a comprehensive shift.
We, therefore, propose a series of criteria by which judgement can be made on whether progress towards a wellbeing economy is occurring: 1) Is the economy explicitly viewed by relevant actors as serving social, health, cultural, equity and nature outcomes, rather than the reverse?; 2) Is there a comprehensive and plausible pathway to design the economy in a way that achieves these outcomes?; 3) Is there a clear commitment to transitioning away from socially and ecologically damaging economic activities and doing so in a just way?; 4) Are there clear mechanisms that extend democracy over all sectors of the economy, including economic strategy and policy design, and in ownership of economic assets?; 5) Are negative externalities between policy areas or populations assessed and avoided, and positive externalities identified and promoted?; and 6) Are all the measures of economic success focused on social, health, cultural, equity and nature outcomes?
We then apply these criteria using a series of examples to show contrasts between genuine wellbeing approaches and wellbeing economy ‘window dressing’.
We live in a time of rapid change presenting profound challenges for population health, already exemplified in some contexts by stalled life expectancy trends1, widening health inequalities2, and worsening mental health.3 Climate change and nature loss present nothing short of an existential threat to human life.4 Digital media is driving a consumptive and individuated culture, wherein our time and attention have been commodified5 and political polarisation has been promoted.4,6 Economic, social and health inequalities within and between countries are wide, and on some measures continue to diverge.4
These challenges are a direct consequence of how the current economic system is designed.7-9 Climate change and wider ecological damage have been driven by an economic system that classifies greenhouse gas emissions and damage to nature as “externalities”, which are too often unmeasured and deemed inconsequential. 7-9 This system has been built upon exploitation and domination of particular social and economic groups (for example, working class, women, the Global South, First Nations), originally through colonialism and more recently through globalisation and the treatment of people as economic inputs (and sometimes as ‘just-in-time’ inputs, as is the case in the ‘gig’ economy).9,10 The resulting skewed economic ownership patterns and power relationships have led to widening social and economic inequalities, simultaneous overconsumption and poverty, alienation from others, work and nature.9.11
Fostering a ‘wellbeing economy’ has been proposed as a response to these challenges, with a focus on improving population and planetary health.12,13 A wellbeing economy exhibits social equity (perhaps evidenced by, for example, equity of wealth, income, power and access to services), lives within planetary boundaries, and supports a high degree of human flourishing (evidenced by long and healthy lives, vibrant cultures, and high levels of subjective wellbeing). It is defined by the Wellbeing Economy Alliance (WEAll) as “a broad term designed to be inclusive of the diverse movement of ideas and actions striving towards this shared vision: an economy that delivers social justice on a healthy planet”.14 (As discussed later in this article, alternative definitions of wellbeing economy illustrate the tensions within this agenda and the potential for ‘window dressing’). A wellbeing economy has been characterised in terms of outcomes (dignity, nature, connection, fairness, participation) and design features (purpose, prevention, predistribution and people-powered) as described in Box 1.15,16
Box 1. Characteristics of a wellbeing economy15
The aims of a wellbeing economy as outlined by the WEAII are:
In addition, the necessary changes for developing a wellbeing economy have been described across four domains:16
As the definition of a wellbeing economy is deliberately intended to avoid over-prescription, to be sensitive to contexts, and to be locally developed rather than imposed, it will be operationalised in many different ways. This strength is also a risk because it can allow a wide range of policies to be ‘badged’ as part of a wellbeing economy program which, in fact, may not be closely aligned (or may even be in tension) with the intended direction. As a result, people in different sectors (e.g. politicians, government officials, industry, media) may use the terms loosely, leading to confusion and a lack of coherent policy change.
As we will show, there is some evidence that when some policy actors have utilised wellbeing economy framing, they have done so while still viewing people and the planet as inputs to economic goals instead of seeing the economy as working for people and the planet.7 On the other side, people motivated to progress towards a genuine wellbeing economy may not be sufficiently clear on what to do and how they can contribute. This article seeks to address both of these points. Firstly, we provide guidance on recognising whether stated wellbeing economy approaches ‘measure up’. Secondly, we compare and contrast approaches representing substantial progress towards a wellbeing economy with those that are merely ‘window dressing’.
A series of tests have been proposed by WEAll Scotland and Friends of the Earth Scotland (in collaboration with others) in response to the Scottish Government’s 10-year economic strategy to assess whether the Government’s plan truly represents progression towards a wellbeing economy, as stated.17 Here, we adapt and summarise those tests to address the issues highlighted above and incorporate key insights from recent critiques of the economic growth paradigm (Box 2).7–9
Box 2. Proposed criteria to judge strategies on progress towards a wellbeing economy
Building on the work of Wright20 and Schmelzer9, three different but mutually supportive strategic approaches can be implemented within the current dominant economic systems to create a transitionary movement towards a different economy. Firstly, strategies to build organisations and institutions, often operating at the local level, which exemplify the desired reality and provide hope, education, imagination and loci for experimentation (‘interstitial strategies’). Secondly, mutually reinforcing (symbiotic) cooperation among a range of social forces, institutions and movements (for example, between labour or environmental movements and the state) to achieve reforms and improvements. In particular, these aim to introduce ‘superpolicies’ – which simultaneously achieve positive outcomes across multiple domains18 or ‘non-reformist reforms’9,21, which change the trajectory of society. Non-reformist reforms are changes introduced through the state that enable a transition away from the status quo by creating the conditions in which genuine and long-lasting changes can occur, for example, investments in infrastructure that facilitate a low-carbon transition. Such reforms are often implemented through existing political systems (i.e. ‘symbiotic strategies’). Finally, some strategies involve mass movements to overcome the dominant social system and often involve revolutionary change (so-called ‘ruptural strategies’). These categories are similar to the multilevel systems thinking approach described by Geels.22 Of course, these strategies can also operate in the opposite direction, solidifying or extending the current dominant economic system, inequalities, and unsustainable greenhouse gas emissions, and even creating space for toxic, negative forms of politics to exist and expand.
Table 1 contrasts examples of a genuine wellbeing economy approach across these three strategic approaches with examples of wellbeing economy ‘window dressing’, where the rhetoric is in marked contrast to the actual changes in policy direction. As the ‘window dressing’ examples cannot be grouped by Wright’s typology, they are grouped according to the most likely locus of action (local, national, international). However, the examples cover the range of strategies described by Wright.20
Table 1. Contrasts between a genuine wellbeing economy approach and wellbeing economy ‘window dressing’
|Likely main locus of action||Examples of wellbeing economy ‘window dressing’||Examples of a genuine wellbeing economy approach|
|Local||“Democratisation” of the economy is dominated by a model of transferring state-owned assets to arms-length, community or voluntary organisations, often without sufficient funding or to reduce tax payments, rather than democratising control of privately-held assets
Use of community-led organisations to provide welfare support to decrease the responsibilities of government.
|Creation of workers’ co-operatives
Provision of high-quality shared goods, services and spaces in place of privately-owned resources, creating the means to move from private luxury and public sufficiency to private sufficiency and public luxury.
|National||Renewable energy infrastructure increased but continued fossil fuel extraction
Energy efficiency measures not accompanied by measures to ensure a decrease in overall consumption (rebound effects)
Decreased transport emissions dominated by electrification of private transport rather than a modal shift to active or public transport
Creation of ‘wellbeing economy’ strategies that do not involve changes in economic ownership, the retirement of fossil-fuel dependent sectors, and which rely on ‘trickle-down’ economic strategies to address poverty.
|Creation of citizens’ assemblies and participatory democracy structures to determine key economic decisions
Expansion and coordination of democratically-owned and -run firms (including state-run, local government-run, workers’ co-operatives, community organisations) to work together across sectors and geographies to ‘crowd-in’ economic democracy
Bringing most of the ‘foundational economy’ (the provision of essential goods and services23) into public ownership and instigating deep democratic processes across workers, users and government into its management
Expanding free public transport to create a modal shift away from individualised transport
Using public borrowing to retrofit all housing stock towards ‘passivhaus’ standards (energy efficient design standards to control temperature), and ensuring that all heating/cooling uses renewable sources
Labour or rent strikes with demands for economic democracy and rapid decarbonisation.
|International||Creating additional measures of societal progress in addition to existing economic measures (e.g. gross domestic product or GDP) but without changing priorities.||Introducing wealth taxes and debt jubilees (where debts are periodically cleared) within and between countries
Boycotts, insurance denial, or disinvestments which create economic transition.
Recognising a wellbeing economy may be easier in hindsight than in advance. It is difficult to determine whether current strategies, plans, policies and implementation approaches are sufficient for (or even consistent with) attaining these outcomes within a reasonable timeframe. This is important, as the term ‘wellbeing economy’ is increasingly in use and arguably is at high risk of misappropriation and capture by organisations and governments who either do not sufficiently understand the implications of making the change to a wellbeing economy, or who wish to present themselves as being in favour of more radical change than is intended.
There are many relevant examples. The Finnish Government have described a wellbeing economy as one in which the population is increasingly healthy, thereby reducing a key perceived barrier to faster economic growth.24 The Scottish Government’s ‘National Strategy for Economic Transformation’ has a wellbeing economy as the overall aim, but without the necessary prioritisation or policy changes that would achieve this.25 The Australian Government’s “Measuring What Matters” initiative thus far seems limited to firstly a consultation largely focused on indicators (which closed at the end of January 2023) and, at the time of writing, inviting community responses to the proposed domains (closing at the end of May 2023), but without resource for a widespread and inclusive consultation and no sign of how these will subsequently shape policy making.19 In some statements, the World Health Organization has redefined wellbeing economy as “putting people’s quality of life and their wellbeing at the heart of economic recovery”.26
In these instances, the way the wellbeing of people (which these examples emphasise) is framed is as a contributor to economic goals. In other words, the economy is still seen as a goal in its own right – and people are positioned as a means to serve economic purposes. This implicit hierarchy is fundamentally at odds with the more robust and transformational wellbeing economy agenda espoused by WEAll and others. This agenda, instead, takes inspiration from First Nations communities, feminist economists, and ecological economists to view the economy as nested within social and environmental spheres – not parallel and certainly not superior to them. The implication of this perspective for policymakers is that the economy becomes a means rather than an end. The task that follows is to shape economies as being in service of social and environmental wellbeing, rather than position the wellbeing of people (let alone the planet) as necessary for economic outcomes.
There is great scope to achieve genuine wellbeing economies in a range of diverse ways – and also much scope for obfuscation. Holding the powerful to account using the the criteria we have set out above might be a useful first step towards the actually achieving this goal.
GM declares receiving funding from the World Health Organisation to support the 10th Global Conference on Health Promotion. KT works with the Centre for Policy Development on their wellbeing into government project.
Externally peer reviewed, invited.
© 2023 McCartney et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.