Two people sitting at a table
“Research demonstrates how mental health positively affects physical health – through happiness, mindfulness, gratitude, optimism and social support, for example,” says Joel Milam, UCI professor of epidemiology and biostatistics, who introduced the Happiness, Well-Being and Health course this spring. Steve Zylius / UCI

Our mental well-being is not a concept typically associated with the responsibilities of public health professionals. But what “health” means has evolved over the past 74 years. Rather than simply a lack of physical ailments, “health” has been defined by the World Health Organization since 1948 as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” However, Western medicine/healthcare has been slow to adopt WHO’s approach.

Joel Milam, professor of epidemiology and biostatistics in UCI’s Program in Public Health, introduced the Happiness, Well-Being and Health course this spring so students could explore and understand the “positive and protective psychological, social and behavioral factors that influence physical, mental/emotional and social well-being,” according to the syllabus. This reflects a shift from the traditional Western view of health centered on symptomology and disease risks to a perspective focused on preventive elements, such as a strong support network to help individuals cope with stress, and other promoters of wellness.

“Research demonstrates how mental health positively affects physical health – through happiness, mindfulness, gratitude, optimism and social support, for example,” Milam says. “This research does not discount or deny bad days and traumatic events. They happen, and their impact is real, but throughout society, corporations, universities and even municipal governments have figured out that the goal is to create a more positive and supportive culture where well-being encompasses more than just the physical.”

This expanded whole-person approach not only recognizes the importance of the mind-body connection, he notes, but requires participation. Health doesn’t happen simply because you don’t get sick or injured; it’s achieved by taking action to promote wellness, Milam says. Optimum health results from incorporating mental and physical health habits, he says – practicing optimism, cultivating gratitude and leveraging social support networks, for example, as well as eating a balanced diet, getting regular exercise and maintaining a consistent sleep schedule. 

Mental health wellness toolkit

Some people have a naturally optimistic outlook on life and what Milam calls a “very high set point” for happiness and can remain quite upbeat even when circumstances are dire. This predisposition has helped them cope with the social isolation, disruption of daily life and inconvenience of lockdowns during the COVID-19 pandemic, he says. However, a large segment of the U.S. population has suffered negative mental health outcomes, triggering a dramatic increase in requests for help and bringing well-being to the forefront as a national public health issue.

Despite different predispositions, mindsets can be learned through unique interventions, Milam says. Just as meditation reduces stress by focusing attention on breathing, which activates your parasympathetic nervous system and calms your body down, there are other tools that can be used to help improve mental health.

Optimism exercises, for example, involve looking to the future to identify goals. Write them down, review what you can do to move toward accomplishing those goals on a weekly basis, and then assess your progress. Gratitude can be strengthened daily by writing down three good things that happened to you that day and why they happened, which causes you to have empathy for the people who benefited you.

Reacting enthusiastically to people in your network when they share good news with you – called active constructive responding – can improve social relationships. On a societal level, studies have found that democracies have higher levels of population well-being than do totalitarian structures. The ability of individuals to make their own choices is a strong predictor of well-being.

“It’s important for future public health practitioners to take this class, because it matters,” Milam says. “We’re using the scientific method to uncover the elements of what makes life worth living. It’s not denying or ignoring what’s going wrong, but it is a shift in focus to what’s going right in life.”

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