Blanchflower and Bryson (2021) on Covid and Mental Health

David G. Blanchflower and Alex Bryson, “Biden, Covid and Mental Health in America.” NBER Working Paper 29040, July 2021.

• The onset of Covid brought on an economic cataclysm in the US [and elsewhere, of course]. Weekly claims for unemployment assistance in the US prior to mid-March 2020 were on the order of 250,000. One week later, they were 2.9 million, and the subsequent week, 6 million.

• Unemployment in February 2020 was 3.5%, and in April 2020, 14.7% (or five percentage points higher when absent (effectively laid-off) workers are included). By November 2021, the US returned to mid-2020 levels of unemployment claims, and the October 2021 unemployment rate was 4.6%.

• What did the pandemic, and its economic effects, do to mental health in the US? To answer this question, the authors employ Household Pulse Survey Data (an ongoing survey) from April 2020 to June 2021, covering some 2.3 million Americans.

• Happiness in the US had been declining for decades prior to Covid (using the very happy, pretty happy, not too happy scale); extreme distress (and deaths of despair) had been rising for decades, especially for people under 30.  

• Anxiety, depression, and worry all peaked in November 2020 (the presidential election month); but by April 2021, mental health was back at pre-Covid levels. The Covid-onset surge in mental health problems was largest for the young. 

• The mental health impacts of Covid on young people, combined with schooling disruptions and a bad macroeconomy for labor market entrants, could hold negative long-term economic effects for the "young during Covid" cohort.

Semple (2021) on Life‑Evaluation and Public Policy

Noel Semple, “Good Enough for Government Work? Life‑Evaluation and Public Policy.” Journal of Happiness Studies 22: 1119–1140, 2021.

• We collect happiness data via "life-evaluation" measures such as the Cantril ladder. But a leading strain of public policy thinking is "welfare-consequentialist," where individual utility or welfare is at the center of judging the desirability of different social states. 

• Happiness is not the same as welfare. But can we use life-satisfaction data anyway in evaluating welfare?

• The approach examined by Semple – life-evaluationist welfare-consequentialism (LEWC) – argues that the government should seek to maximize aggregate subjective well-being – and life satisfaction is sufficiently measurable to be implementable. In some circumstances. happiness data are informative of the success of public policy (even when there is no consensus on what actually constitutes welfare). That is, maximizing welfare can often be implemented by maximizing happiness, as measured by subjective wellbeing.

• Practicality is an important argument for the LEWC approach: we have broad, long-term data on subjective wellbeing. Further, where happiness is an imperfect proxy for welfare, it still tends to indicate the sorts of things that make people better off. 

• Happiness research has revealed that mental health problems detract markedly from subjective wellbeing; further, people do not adapt over time to some negative mental health conditions. [Look at the advantage of happiness over willingness-to-pay: "The average person who has not experienced clinical depression simply cannot say, in a reliable way, how much they would be willing to pay to avoid it. By contrast, notwithstanding the problems identified above, those who are clinically depressed, and those who are not, are able to give reasonably consistent evaluations of their own lives [p. 1133]."]

• Targeting mental health with policies that make treatment more available also helps to target those who are worse off, those whose subjective wellbeing is at the bottom of the distribution. And better mental health for parents holds positive second-order impacts for the happiness of their children.

• Approaches to human welfare are all over the map, including preference satisfaction and hedonism and...  But LEWC is grounded in data, it looks at the evidence on what produces happiness. We do not need to agree on what constitutes human welfare to implement LEWC. 

• The LEWC approach, then, offers a form of robustness; it can advance welfare without presuming what constitutes welfare.

• Much public policy is too small or abstract for its effects to be measured by happiness; further, people do adapt over time to many changes in their life circumstances. So, it is sensible to sometimes supplement SWB with preference fulfillment in serving as a proxy for welfare. Preferences for longevity can be used, for instance, to overcome some of the "moment in time" issues connected to happiness measures.

Berman, Ariely, Gosnell, et al. (2020), “Reframing the Loneliness Epidemic”

Kristen Berman, Dan Ariely, Evelyn Gosnell, et al., “Reframing the Loneliness Epidemic.” Pages 123-131 in The Behavioral Economics Guide 2020, edited by Alain Samson. 

• Loneliness involves a dearth of satisfying relationships 

• Some 20% of Americans report not having any close friends 

• Loneliness undermines subjective well-being and health – and there is no widely available, effective “treatment” 

• Nearly half of loneliness can be traced to one’s genes 

• People tend to get lonelier as they age 

• Women, on average, are lonelier than men 

• Unemployment and retirement both increase loneliness 

• Loneliness can be a sort of self-fulfilling trap 

• How to deal with the loneliness epidemic? Reframing!: instead of treating loneliness, perhaps we can prevent it. In particular, can we nudge friendship? 

• An old study found that a 45-minute meaningful conversation made people feel as close with their (previously unknown) conversation partner as they felt in their more established relationships. 

• But people are risk averse, and (perhaps) they shy away from conversations that could result in rejection. 

• One approach is to change the default, to make deep conversation the expected behavior.

• Experiment 1: A Conference Networking Study. At the beginning of a conference for finance sector workers, Conversation Cards were distributed that contained probing questions participants would answer in conversing with each other. Other conditions included a "just network as usual" command and an "avoid small talk" suggestion. 

• The subjects responded well to the Conversation Cards – but they still weren’t all that interested in following up to build friendships. (The "avoid small talk" folks were sort of frustrated, at a bit of a loss to break the ice.)

• Experiment 2: Nudging Deep Conversation in a Social Setting (Friday night happy hours)  

• The conditions were (1) conversation about the future v. (2) conversation about the past v. (3) an ice-breaker activity with no conversational guidance 

 • The conversational prompts both worked! More talking sessions, and more desire to build the connections... 

• Should we rethink social architecture to encourage deep conversations, without exposing people to large social risks? (And do the conversations really have to be deep?) 

• You can acquire the Conversation Cards at the cost of production and transfer (see p. 129).

Blanchflower (2020) on Unhappiness and Age

David G. Blanchflower, “Unhappiness and Age.” Journal of Economic Behavior and Organization 176: 461–488, 2020. 

 • We “know” that happiness tends to hit a nadir around the age of 50 – but do unhappiness and related conditions such as stress and loneliness and pain reach a peak at about that time, too? 

• This article looks at tons of data (total "N" almost 14 million) from many, many nations, for the most part drawn from the third millennium CE. 

• The conclusion is stark: unhappiness and related measures tend to peak for people in their late 40s or so, mirroring pretty closely the results for happiness measures. 

• There are a host of analytical issues involving, for instance, the precise measure of reported “unhappiness” and the selection of control variables for regression analysis. Nonetheless, the main finding of a peak of unhappiness in midlife is quite robust to how these issues are handled, even across countries. 

• The impact of some life events is symmetric with happiness and unhappiness: unemployment decreases happiness and raises unhappiness; higher incomes increase happiness and lower unhappiness. 

• Oddly(?), being of male gender seems to decrease unhappiness and to decrease happiness. 

• There’s a lot of variance in unhappiness between countries. Ireland in 2014 reported a 12.1% rate of adult depression, while in Poland, it was 4.2%. But in both countries, the rate of depression was highest for 55-64 year olds. 

• Americans are outliers with respect to the amount of pain reported; in 2018, one-quarter of Americans report having suffered pain on the previous day, and prescription painkiller use is common. 

• Suicide rates tend to show a peak in middle-age, but then they eventually begin to rise again at older ages. 

• In the US in 2018, almost 10% of people say that their mental health was not good for at least 20 of the past 30 days. 

• There’s even a midlife peak in the belief that the country as a whole is getting worse. 

• The increase in unhappiness associated with midlife is on a similar scale to what happens with bad events, such as becoming unemployed or losing a spouse.

Twenge and Cooper (2022) on the Happiness Class Divide

Jean M. Twenge and A. Bell Cooper, “The Expanding Class Divide in Happiness in the United States, 1972–2016.” Emotion 22(4): 701–713, 2022. 

• Signs of a growing class divide in the US include the data on income inequality, “deaths of despair,” and the rising mortality rate for non-college educated white Americans. 

• Has it become more true in the US that money and prestige buy happiness? Twenge and Cooper attempt to answer this question. 

• The data: the General Social Survey (GSS), 1972-2016, adults age 30 and above, n≈44,000. 

• “Class” here is of the socio-economic variety (SES), and is measured by income, education, and “occupational prestige” 

• The GSS happiness question: ‘Taken all together, how would you say things are these days—would you say that you are very happy, pretty happy, or not too happy?’ 

• Income, education, and occupational prestige all contribute considerably to happiness – and for income, the effect does not taper off as income rises. 

• The connection between SES and happiness has increased markedly between 1972 and 2016 – though some of this increase can be traced to increasing marital differences between SES classes. 

• The larger happiness gap between SES groups is, for white people, caused by diminishing happiness for those in the lower classes, while the upper-class folks almost held their own in terms of happiness. 

• For Black people, lower-SES people showed a small decline in happiness between 1972-2016, but high-SES people saw a significant increase in happiness. 

• Has class become more salient as income inequality increases?

Graham and MacLennan (2020) on Well-Being

Carol Graham and Sara MacLennan, “Policy Insights from the New Science of Well-Being.” Behavioral Science & Policy 6(1): 1–20, 2020; available for download here. 

• Advice for job-seekers! Inquire about autonomy, meaningful work, and a respectful atmosphere -- these will affect your well-being at work. 

• Economic growth can be accompanied by declining happiness (or declining subjective well-being (SWB)). 

• Three types of happiness measures: (1) Hedonic (or affective, or experienced); (2) Evaluative (life satisfaction); (3) Eudaimonic (meaning and purpose). These measures are far from perfectly correlated; people seem to think that evaluative measures (overall life satisfaction) are most important. 

• Four common findings: (1) Relative position matters; (2) Reference points matter; (3) Adaptation occurs, for both favorable and unfavorable events; and, (4) People can mispredict how their choices will affect their happiness, and actual choices might not reveal preferences (as measured by SWB). 

• Some additional common findings include: (4) Income is positively connected with happiness; (5) Income increases are subject to hedonic adaptation; and (6) With respect to age, happiness appears to be u-shaped. 

• SWB provides indirect evidence on the value of activities or possessions. 

• For instance, we don’t need to ask, how happy does smoking make you; nor do we just infer from your heavy smoking that it greatly contributes to your well-being. Rather, we can ask you in general how happy you are, and then learn about your activities, and see (across large numbers of people) if smoking is associated with increased happiness. 

• Maybe policy should aim to help the least happy people? 

• People in objectively poor circumstances might still have a lot of hedonic happiness – have they adapted, or lowered their expectations? 

• Beware of making happiness an official policy goal!? -- people will distrust the government's motives as well as the reliability of the data. 

• Much of your happiness is inherited. 

• Noise and commuting are hard to adapt to. 

• In health studies, SWB can be a supplement to QALYs. 

• Mental health becomes a priority when SWB is emphasized.

Sachs (2018) on “America’s Health Crisis and the Easterlin Paradox”

Jeffrey D. Sachs, “America’s Health Crisis and the Easterlin Paradox.” Chapter 7 in World Happiness Report 2018, available at https://worldhappiness.report/ed/2018/.

• In the US, “income per capita has more than doubled since 1972 while happiness… has remained roughly unchanged or has even declined.” (The Easterlin Paradox lives on in the US of A...)

• Some culprits: obesity, substance abuse (particularly with opioids), and depression

• Aggregate factors that influence cross-country SWB include: health; social support networks; personal freedom; social trust; and generosity

• The US displays declining life expectancy! Drug overdose deaths are a part of the story

• Some 38% of US adults are obese: added sugar and snacks are among the suspects. Corn subsidies promote the consumption of high-fructose corn syrup

• The obesity/depression circle: "Studies have found that obesity is a significant predictive factor for subsequent depression, while depression is a predictive factor for subsequent obesity [p. 151]." 

• There's also a screen time/depression circle, while video games and social media provide new sources of addiction

• Mental illness and depression remain the major determinants of well-being. In the US, "There is significant evidence of a major, long-term, and continuing epidemic of clinical depression...[p. 153]." 

• Behavioral Economics Outlines also has outlined a contribution by Professor Sachs to the 2019 World Happiness Report on addiction and unhappiness  in the US. Incidentally, the 2021 World Happiness Report, co-edited and with other contributions by Professor Sachs, is available here. (All nine of the reports that have been released to date can be found here.)

Sachs (2019) on Addiction and Happiness

Jeffrey D. Sachs, “Addiction and Unhappiness in America.” Chapter 7 in World Happiness Report 2019.

• In the US, the Easterlin paradox continues to appear: "the average life evaluation in the United States, as measured by the Cantril ladder, has declined during the past dozen years, from 7.2 in 2006 to 6.9 in  2018, despite ongoing U.S. economic growth [p. 124]."

• Sachs hypothesizes that the US is in the midst of an addiction epidemic – with rising unhappiness and depression as consequences. 

• The addiction epidemic includes alcohol, tobacco, and other drugs, of course, but also the internet, food, sex, exercise, work...  

• Co-morbidities are common 

• Causes of the increase in addictions are hard to identify precisely, but there are many candidates: current life conditions, inequality, marketing (and designing more addictive goods, such as slot machines and cigarettes), failure to sufficiently regulate industries such as opioids and sweetened foods and social media...

• "The U.S. has had, by now, two startling wake-up calls: back to back years of falling life expectancy and declining measured subjective well-being [p. 130]." Better public policy is desperately needed, and directions to go are outlined in the Global Happiness and Well-Being Policy Report, 2019.

Bell and Blanchflower (2018) on Underemployment and Happiness

David N. F. Bell and David G. Blanchflower, “The Well-Being of the Overemployed and the Underemployed and the Rise in Depression in the UK.” NBER Working Paper No. 24840, July 2018. [A later version appears in the May, 2019 issue of the Journal of Economic Behavior and Organization.]

• Unemployment is very detrimental to subjective well-being (SWB); but what about underemployment? 

• It turns out that in the UK, working fewer hours than you would like to work (at the same rate of pay) also undermines SWB – though not by as much as does poor health or unemployment.

• Overemployment also lowers well-being!

• Though unemployment in the UK has recovered from the 2008 crisis, underemployment has not recovered; earlier this year [2018], it stood at about 3% of the labor force. 

• Incomes and real wages also have not recovered, perhaps because underemployment is a sign of slack in the labor market. 

• Men are more likely than women to be underemployed, and lower wage workers are more likely to desire more hours.  

• Data are drawn from four subjective well-being questions that focus on different conceptions of life assessment: (1) satisfaction; (2) worthiness; (3) happiness; and (4) anxiety. The first three measures show improvements in well-being over the 2011-2017 period; not so for anxiety.

• The usual age effects show up, with well-being minimized at ages 50-54; things again head south after age 75 (but from global highs at 70-74). Retired people display high well-being. 

• Depression is fairly common (and much more so now than ten years ago), with 2.3% of workers being depressed and almost 10% of the unemployed being similarly situated.

Blanchflower and Oswald (2017) Review Graham’s _Happiness for All?_

David G. Blanchflower and Andrew Oswald, “Unhappiness and Pain in Modern America: A Review Essay, and Further Evidence, on Carol Graham’s Happiness for All?” NBER Working Paper No. 24087, November 2017.

• The authors summarize and respond to a 2017 book by Carol Graham, Happiness for All? 

• Graham’s work centers on subjective well-being (SWB) measures, especially the Cantril ladder question, which, according to the World Happiness Report, "asks respondents to think of a ladder, with the best possible life for them being a 10, and the worst possible life being a 0. They are then asked to rate their own current lives on that 0 to 10 scale." 

• Some of Graham’s claims about happiness in the US: (1) SWB is getting more unequal, and income inequality lowers SWB; (2) people are increasingly unhopeful, especially white Americans and poorer Americans; and, (3) Americans, particularly poorer ones, suffer from high levels of pain and stress. 

• The age-adjusted suicide rate for black American men is one-third the rate for white American men.

• Blanchflower and Oswald point out that almost surely, SWB is not nearly as unequally distributed as is income. 

• It does appear that Americans are becoming less happy, and that reported pain is very high (34% in past 4 weeks) in the US; the international average is 20%. 

• Middle-age Americans are particularly troubled. SWB tends to fall almost monotonically from the late teens until somewhere around age 40-50, and then tends to increase (slowly) for some 40 years.

• Education is associated with higher SWB. 

• There has been significant convergence in SWB among racial groups in the US in the past 45 years.

• Though there is some evidence that women in the US have become less happy in the last 30 years relative to men, reported SWB is quite similar across genders.

Moschion and Powdthavee (2018) on Drug Use and Happiness

Julie Moschion and Nattavudh Powdthavee, “The Welfare Implications of Addictive Substances: A Longitudinal Study of Life Satisfaction of Drug Users.” Journal of Economic Behavior & Organization 146: 206-221, February 2018. [This outline is based on the pre-publication version, pdf available here.]

• People in general seem to have difficulty in predicting what will make them happy.

• It may be that drug users mispredict the utility that they will get from drugs, in contrast to the rational addiction approach. So, the authors look to see if people who start to use drugs sometime in the previous six months are happier or less happy. If they are less happy, then this suggests (but by no means proves) that drug use is not rational, but results from mispredictions of the hedonic payoff from drug use.

• Mispredictions of future utilities might stem from focusing illusions or projection biases. If you are feeling blue today, focusing illusions and projection biases might tilt you, excessively, in the direction of drug use.

• A higher future price of the addictive good lowers current utility for rational addicts, but increases it for mispredicting addicts, even though both “types” of addicts respond to the future price increase by decreasing current consumption.

• Some (but not all) previous work has found that higher cigarette taxes or public smoking bans have been associated with increased subjective well-being for (predicted) smokers. [Even sure-fire evidence that ex-smokers are happier than they were when they were smoking does not undermine rational addiction theory: rational addicts know that they will be happier if they give up smoking, they just find the costs of quitting to be too high to justify the transition.]

• The longitudinal, bi-annual data comes from a housing insecure Australian population, 2011-2014, with n exceeding 1,100. The life-satisfaction question is of the 0-to-10-scale, “all things considered” variety. This is the dependent variable, while the main independent variables concern past, current, and future substance use. This sample is more than four times as likely to smoke as the average Australian – but is less likely to engage in heavy drinking.

• The data reveal that daily smoking is quite persistent over six-month periods, and relatively easy to initiate. Weekly illegal drug use is not very persistent, though cannabis consumption is quite persistent.

• Lower life satisfaction seems to precede daily smoking, daily pot use, and weekly illegal drug use, with the illegal drug use result being most robust. Current (high) consumption of any of the substances, including alcohol, seems to lower current happiness. Weekly street drug use is similar to getting a divorce, in terms of life satisfaction. The negative effects of illegal drugs tend to be worse for women and for the less educated.

Flèche and Layard (2017) on Misery

Sarah Flèche and Richard Layard, “Do More of Those in Misery Suffer from Poverty, Unemployment or Mental Illness?” KYKLOS 70(1): 27-41, February 2017 [prior version here].

• The authors define the miserable to be those whose self-report of life satisfaction is among the lowest in their nation -- (slightly) more specifically, in about the lowest ten percent (it varies by country).

• Their main measure of mental illness is an objective one: the person is in treatment or has received a mental health diagnosis.

• The data are drawn from the US, Australia, Britain, and Germany.

• There are many “causes” of misery, but poor mental health is a leading one, more important than poverty or unemployment or poor physical health. In the US, for instance, 27% of the miserable are poor, but 61% have been diagnosed with depression or anxiety.

• Mental illness might be harder to adapt to than physical illness. 

• Therapy appears to be able to help people alleviate their misery: perhaps 1 in 3 people who receive cognitive behavioral therapy for their depression/anxiety recover (who without treatment would not recover). In terms of life-satisfaction, there seems to be a huge payoff (many multiples of the cost) to making cognitive behavioral therapy more available. 

• Nonetheless, the vast majority of health care spending is aimed at physical health, not mental health.