Analysing the link between noncommunicable diseases and happiness: evidence, policy and lessons from Bhutan

Abstract

Health and happiness are interdependent. Bhutan has been pursuing Gross National Happiness (GNH) as a state policy since 1972. Nevertheless, the growing epidemic of noncommunicable diseases (NCD) threatens to undermine the achievement of GNH. NCDs are now accountable for 69% of all deaths. The objective of my thesis is to generate evidence to support NCDs as a policy priority and to provide action oriented recommendations to strengthen prevention and control of NCDs through strategic engagement with GNH. Quantitative analysis reveal that one third of the adult Bhutanese population are overweight, hypertensive and have symptoms of common mental disorders while 6.4% are diabetic. Also the prevalence of modifiable NCD risk factors was high. This analysis confirms that NCDs are major public health problem and require political commitment and policy priority. NCD and GNH policies both prioritise reduction of premature deaths and increasing population well-being. This provides the premise for health sector and GNH to identify shared agenda. The shared agendas are common policy objectives that the health sector can draw on to show how strengthening action on NCDs will also contribute to achieving GNH. Through in-depth analysis of GNH domains and determinants in conjunction with NCD objectives, five shared agendas were identified. These shared agendas can be integrated into policies across relevant sectors during the implementation of the GNH policy screening tool. This thesis contributes to measuring NCDs as a major public health problem in Bhutan; highlights that the NCDs can be addressed as a whole-of-government approach by identifying shared agendas. Although we based our analysis on the specific processes implemented in Bhutan, growing interest in measuring happiness mean our analysis will be relevant to other countries.