Every year since 2012, the United Nations has released a World Happiness Index report. The recently released 2018 report ranks 156 countries by their happiness levels—and in those rankings, the U.S. came in at 18.
Here’s how the report works: Researchers gather data from at least 3,000 people in each participating country. Participants are asked to imagine that they are on an imaginary life ladder that has 10 rungs. The top rung (10) represents maximum happiness; the bottom rung (0) is where things are as bad as they possibly could be. Participants are asked to rate what rung they are on in six different categories: Income (GDP per capita), healthy life expectancy, social support, freedom, trust (absence of corruption), and generosity.
On the 2018 report, Americans’ average rung number was 6.886. In comparison, the top five countries scored over 7.4, and the bottom five countries scored under 3.3. The no. 1 happiest country was Finland, followed by Norway, Denmark, Iceland, and Switzerland.
In many of the categories studied, the U.S. is doing great. However, there are two major areas where the U.S. could improve: extending healthy life expectancy and building stronger social support.
Do Americans have a healthy life expectancy?
One potential reason people in America aren’t as happy as people in other countries is that Americans may be struggling with their health. Jeffrey Sachs, a co-editor of the World Happiness Report and a professor of Health Policy and Management at Columbia University, suggested in a press release that the ranking was “in part because of the ongoing epidemics of obesity, substance abuse, and untreated depression.”
Life expectancy for Americans is actually declining. The average American will live around 80 years, compared to 82.6 in Switzerland, 83.1 in Iceland, and 82.1 in Sweden. (The country with the highest life expectancy in the world is Monaco, with 89.4 years). So what’s behind that decline, anyway?
Widespread obesity is affecting Americans’ health.
According to the Centers for Disease Control, over a third of Americans are categorized as obese—36.5 percent, to be precise. Research from the Organization for Economic Co-operation and Development suggests that America has the highest obesity rates in the world. WHO data suggests that only 23 percent of adults in Finland are obese, 21.5 percent in Norway, and 18.2 percent in Denmark.
As the National Institutes of Health website explains, obesity is linked to a number of health problems including high blood pressure, heart disease and stroke, type 2 diabetes, sleep apnea, fatty liver disease, kidney disease, some types of cancer, and problems in pregnancy including an increased risk for a c-section delivery.
Childhood obesity is also widespread, and obese children are likely to become obese adults. The University of California San Diego Health website explains that “obese children and adolescents have a greater risk of social and psychological problems, such as discrimination and poor self-esteem, which can continue into adulthood.”
And the opioid epidemic is affecting individuals and families across the country.
Sadly, many Americans struggle with addiction and substance abuse. In recent years, addiction to opioids has surged—the National Institute on Drug Abuse estimates that over 115 people in the United States pass away every day due to opioid overdoses. In 2016 alone, 11.5 million people misused prescription opioids, and the Department of Health and Human Services (HHS) declared the epidemic a national crisis in 2017.
Mental health issues are also quite common.
The National Alliance on Mental Illness (NAMI) estimates that one in five Americans will experience mental illness in any given year. One in 25 adults will experience a serious mental illness that “substantially interferes with or limits one or more major life activities.”
Mental health conditions are particularly high among people living homeless and incarcerated individuals. What’s more? Serious mental illness costs the U.S. $193.2 billion in lost earnings every single year.
And many Americans struggle to access—and pay for—adequate healthcare.
Many people are unable to pay out-of-pocket to see a doctor, and at least 28.2 million people in the U.S. do not have health insurance. A substantial number of families struggle to pay medical bills, the National Health Interview Survey reports. And a study from 2009 found that among Americans declaring bankruptcy, medical debt played a huge role in their financial issues.
Ultimately, health problems can and do affect happiness.
“There are many underlying medical conditions that can affect happiness, and I have seen this with my own patients,” says family physician Jennifer Caudle, DO. “For example, chronic disease such as diabetes, arthritis, and COPD can affect someone’s outlook on life, and thus happiness.”
“Another example is that sudden changes in our lives—such as the [loss] of a family member, loss of a job, or stress in a relationship can affect happiness as well. I also believe that how we interact with others (online vs. in person, for example) can affect our happiness. Finally, it’s important to consider mental health diagnoses, such as depression and anxiety, as these may play a role as well.”
Another area where America could improve? Social support.
Back in 2015, the American Psychological Association (APA) surveyed people around the U.S. about their feelings on social support—meaning whether they believe they are cared for and have people they could turn to for assistance.
“Many Americans don’t feel they have access to this valuable resource,” the APA website states. “When asked if there is someone they can ask for emotional support, such as talking over problems or helping make difficult decisions, 70 percent said yes. However, more than half (55 percent) also said they could have used at least a little more emotional support.”
Many Americans have a strong, supportive community through their neighborhood, school, profession, religious institution, or hobbies, and feel that they are adequately supported and cared for. Others are not so fortunate. What’s more, the U.S. does not have the widespread structural support for families that other, higher-ranked countries in the World Happiness Index offer.
Compared to the countries in the top 5, America’s family leave policies leave a lot to be desired.
Parents who are welcoming a new addition to the family often have to work around limited or non-existent parental leave policies at their jobs. While many two-parent families would ideally like to have both parents at home during the transition period when a newborn or adopted child comes into their lives, that’s not always possible. That means that responsibilities might fall more on one parent, and parents may be required to go back to work far sooner than they would like to after a child’s arrival.
“Parental leave is horrible for moms and even worse for dads,” says Jenni Skyler, a licensed therapist from The Intimacy Institute.
Under the Family and Medical Leave Act, some companies are required to offer new parents up to 12 weeks of unpaid leave to care for a new child. But there is no legal requirement for companies to provide paid leave. In fact, according to the Organization for Economic Cooperation and Development, America is the only developed country in the world where employers aren’t required to offer paid leave to new moms.
This can put additional financial and emotional stress on families at times when they need extra support. For some people, it’s simply not feasible to take much unpaid time off work.
Skyler also says that limited vacation time can put stress on families (there’s no legal minimum paid vacation in the U.S., meaning employers decide how much paid and unpaid time off to grant their employees). “When you are able to spend quality time, certainly with your spouse and your family, that’s an investment in your relationship towards happiness,” Skyler notes.
Happiness is difficult to quantify, but it sounds like there are a few things we could learn from the countries ranked higher than the U.S. in the World Happiness Index.
This ranking is only one way of measuring quality of life, and many things are left out of it. And, of course, the results are an average—there are people in the U.S. who are much happier, and much unhappier, than that final ranking. That said, given how strong the American economy is, the fact that it ranks 18th in the listing does come as a surprise.
The number one happiest country, Finland, offers free education, generous parental leave and vacation policies, and publicly-funded universal healthcare. From Finland and other higher-ranked countries, perhaps there are some things America could learn.
How can we improve the health of America’s population and increase life expectancy? How can we ensure that families and individuals receive the support they need to adequately care for themselves and their loved ones? The solutions likely involve the government, social institutions, and the population working together to create a healthier, happier country.