Work and Physical and Mental Health

Work and Physical and Mental Health
Dr. Claudewell S. Thomas Psychiatrist RANCHO PALOS VERDES, CA

Claudewell S. Thomas, MD, MPH, DLFAPA, is an established psychiatrist currently retired and living in Rancho Palos Verdes, California. He received his medical degree in 1956 at SUNY Downstate College of Medicine and specializes in social psychiatry, public health psychiatry, and forensic psychiatry. Dr. Thomas was board... more

Finland has been declared "The Happiest Country on Earth" by a U.N. commission with Scandinavian countries occupying the top four entries in the category. With recent immigrants to Finland also enjoying the depiction "happiest", the old homogeneity explanation is insufficient unto the "happy day". Since Finland is one of those midnight sun countries (Aurora Borealis) of varying long nights and endless days, and is insufferably cold much of the time, it's not their sunny beaches and blood warm waters that can account for it. The most recent issue of the American Journal of Public Health (March 2018) supplies an answer as to why.

This journal issue supplies a comprehensive analysis of the relationship of work (employment, voluntary, etc.) to a sense of worth and other social determinants of health. Let's take a look at what the Journal issue (Emily Quinn Ahonen et al has to say, "Leaving work out of public health inequities research creates a blind spot. Work primarily determines a person's income, comprises much of social prestige and provides social connection, all of which are related to power" I would conclude that the Finnish (and Scandinavian) happiness relate to more security in the population vis à vis employment, fairness, and redress of inequity, than in our country where Life, Liberty and the Pursuit of Happiness are our declared goals.

We have defined an arena of social issues where battle can take place around values with loose and inaccurate ties to economic and geopolitical realities. I say GEO because the apparent local politics can be separated from international issues by those clever enough and motivated. But epidemics and pandemics, the use of deadly transmissible agents, mechanically or by natural vectors are all issues that must concern an intelligent population secure enough to be able to rationally deal with threat. It is fairly obvious that a population riven by employment concern, but uncertain or non existent health care provision, is being prodded into seeing the "other" as an immediate threat that cannot do so.

It appears that those who suffer from illness cannot afford to be passive in the dialogue concerning resources since in "unhappy countries" their interests are unlikely to be served by those whose angry competitiveness and/or selfishness and greed motivate towards stigmatization and neglect. Recent research indicates employment inequity as being quite significant in the chain of health availability. A number of newspaper articles and a number of blog comments indicate a propensity for Americans toward defining happiness as obtainable through access to mood/mind altering drugs. Since altered states of this sort are transient and require more decreasingly effective drugs, this is a road to disaster and gives us fresh insight into the opioid epidemic while defining us as an unhappy country.

I suspect that the happiness of countries discussed has at its core a dyad of employment equity and availability, and in the event of unemployment, a negative income tax or some form of guaranteed income which under-girds access to appropriate health care often in the form of a single payer system. As in the case of the opioid epidemic (The death penalty is not an answer (for whom and where along the fruits of the poisonous tree do you stop?)) those who may be subject to the damage, need to be aided by those who seem to be above and beyond it, but who are affected by virtue of social connectedness, and are invariably involved. The pursuit of happiness is a joint venture!