It would be difficult to be interested in human flourishing without
having some interest in understanding the differences in incidence of “suffering”,
negative emotion, and depression in different parts of the world.
I have written a few posts about negative emotion recently,
but it is now a few years since I looked explicitly for a relationship between
“suffering” and depression at an international level. The last time I looked, I
couldn’t see any relationship. I concluded that “the data … suggest
there is no simple relationship”.
There is now some new data available, so I have taken
another look. But I don’t want you to get too excited, because you
might end up feeling disappointed.
A data set on depressive disorders in 2010 has been compiled
by Alize Ferrari and others as part of the Global Burden of Disease Study.
The researchers collected data on the depressive disorders from published
articles and pooled the data using a statistical technique (Bayesian
meta-regression). The data used below relates to major depressive disorder (MDD)
which is also known as clinical depression. It involves at least one major
depressive episode in which the affected individual experiences a depressed
mood almost all day, every day for at least 2 weeks.
The negative emotion data is sourced from the Gallup World Poll. Respondents were asked if they experienced worry, anger, sadness or depression yesterday. The data used is based on country averages of yes/no
answers (yes = 1).
The data on suffering is from the new Gallup-Healthways Global Well-being index. The index covers 5 dimensions of well-being: purpose (liking
what you do and learning or doing something interesting); social (having
supportive relationships); financial (having enough money to do what you want
and not being worried about money); community (liking where you live and having
pride in your community) and physical (feeling active and productive, and in
good health). People are classed as suffering in a particular element if their
well-being in that element is low and inconsistent.
For the purpose of this
exercise I have estimated the percentage suffering in each country as the
average of the percentages suffering in each dimension.
After the three data sets were combined I had data for 114
countries. At the country level, there is a modest degree of correlation between
the three variables:
Struggling and MDD: 0.24
Struggling and negative emotion: 0.20
Negative emotion and MDD: 0.06
.
The graph presented below provides a basis to compare
averages for the relevant variables in 10 regions of the world.
All three indicators tell an unambiguous story of misery in
the Middle East and North Africa. Suffering seems somewhat higher in Sub-Saharan
Africa, but the incidence of negative emotion is apparently lower in that part
of the world than in the Middle East and North Africa.
Central and Eastern Europe seems to have a fairly high
incidence of all three indicators of misery. The incidence of depression and
suffering is similarly high in the former Soviet countries, but the incidence
of negative emotion is similarly lower.
East Asia stands out as having a relatively low incidence of
negative emotion and depression, but a higher incidence of suffering than Latin
America. According to the Gallup-Healthways data, the incidence of suffering in
Latin America is not much greater than in Europe.
It is possible to speculate on reasons why the three
indicators tell different stories in several regions of the world. Cultural
factors probably explain the relatively low incidence of negative emotion in
East Asia and Sub-Saharan Africa. Cultural factors might also explain why the incidence
of suffering has been assessed to be relatively low in Latin America. (As discussed
in an earlier post, cultural factors might also explain why the Gallup-Healthways
index shows a high percentage of the population in Latin America to be thriving).
There may also be potential for the estimates of depression to be biased by such
factors as differences in availability of trained mental health professionals.
That leaves me concluding that caution is required in
comparing suffering, negative emotion and depression in different parts of the
world. I know that is a fairly lame conclusion, but I did warn you not to get
too excited.