Online Wellness Course: Discussion Board Assignment - Four parts

South African Journal of Psychology 43(2) 147 –155 © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0081246313484238 sap.sagepub.com

Wellness without fairness: The missing link in psychology

Isaac Prilleltensky

Abstract To promote human welfare, psychologists must advance two important goals: wellness and fairness. Hitherto, research on wellness or well-being has discovered connections among overall satisfaction with life and important facets of life, such as relationships, income, and physical health, but the connections among various types of wellness and specific aspects of fairness remain obscure. Research on justice in psychology, in turn, has focused largely on the impact of distributive, procedural, and interactional justice on job performance and not so much on wellness outcomes. I argue that psychologists must explore in depth the association among various types of wellness, such as interpersonal, occupational, physical, and psychological, and diverse kinds of fairness, such as distributive, procedural, interpersonal, cultural, developmental, retributive, and intrapersonal. The pursuit of wellness without fairness will not yield the outcomes individuals and communities need. We must make more explicit the relationship between justice or injustice and flourishing in life.

Keywords Ethics, fairness, justice, well-being, wellness

Introduction

Wellness, or well-being, has been correlated in psychology with many factors, such as health, rela- tionships, income, housing, free time, religion, and transportation (Buettner, 2008, 2010; Chmiel, Brunner, Martin, & Schalke, 2012; Cohen, 1999; Nieboer, Lindenberg, Boomsma, & Van Bruggen, 2005; Rath & Harter, 2010), to name but a few; yet, the association between wellness and fairness has been largely neglected from our discipline (Prilleltensky, 2012). Other fields such as public health (De Vogli, Ferrie, Chandola, Kivimäki, & Marmot, 2007; Donohoe, 2013; Freidl, Fazekas, Raml, Pretis, & Feistritzer, 2007; Levy & Sidel, 2006), human resources (Bernhard-Oettel, De Cuyper, Schreurs, & De Witte, 2011), political science (Mutz & Mondak, 1997; Sun & Xiao,

University of Miami, USA

Corresponding author: Isaac Prilleltensky, School of Education and Human Development, University of Miami, P.O. Box 248065, Coral Gables, FL 33124, USA. Email: [email protected]

484238 SAP43210.1177/0081246313484238South African Journal of PsychologyPrilleltensky 2013

State of the Science Editorial

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2012), and philosophy (Segev, 2006; Sen, 2009) have surely dealt with the wellness–fairness nexus, but the psychological literature reveals few studies that directly address the connection between well-being and justice. Some researchers have analyzed the relationship between fairness and well-being in particular settings, such as the family (Grote, Clark, & Moore, 2004; Ullmann- Margalit, 2006), schools (Schmader, Major, & Gramzow, 2001), and the workplace (Fujishiro, 2005; Kivimäki et al., 2005), but we are hard pressed to find any studies that examine comprehen- sively the connection between the many facets of wellness with the many types of fairness (Miller, 2001). A notable exception, not yet available in English, is the compilation in Italian by Santinello and Vieno (2011), which contains chapters on the impact of injustice on well-being in schools, work, relationships, and groups.

To be sure, there is scholarship exploring connections among constructs associated with fairness and wellness, such as Fiske’s (2011) work on envy and scorn and their deleterious repercussions for the envious, the envied, the scornful, and the scorned; Miller’s (2001) work on injustice and disrespect and their negative impact on self-image; research on microaggressions and their impact on mental health (Blume, Lovato, Thyken, & Denny, 2012; Torres, Driscoll, & Burrow, 2010); and effects of discrimination on stress (Fuller-Rowell, Evans, & Ong, 2012; Lee & Ahn, 2012; Pascoe & Smart Richman, 2009); or child abuse, an obvious form of injustice with multiple negative psy- chological outcomes (Prilleltensky, Nelson, & Peirson, 2001a); but in my view, we need to estab- lish a more clear line of research and action dealing specifically with the complex relationship among various domains of wellness and diverse types of fairness. I want to make this case by defining wellness and its many facets, fairness, and its various types; by discussing the presumed connections among the two constructs; and by proposing next steps. To prevent confusion, I will use wellness and well-being interchangeably, and will do the same for fairness and justice.

What is wellness?

Well-being is both a positive and desirable state of affairs with life as a whole and with specific domains of life, such as health, economic situation, and relationships (Chmiel et al., 2012; Diener, Helliwell, & Kahneman, 2010; Huppert & Linley, 2011a, 2011b; Prilleltensky & Prilleltensky, 2006). Significant and consistent correlations have been found among perceptions of satisfaction with life as a whole and satisfaction with specific facets of life (Cohen, 1999; Cummins, Mellor, Stokes, & Lau, 2010; Nieboer et al., 2005; Pavot & Diener, 2008).

Rath and Harter (2010) have recently summarized results from data collected by the Gallup Corporation around the world and concluded that five factors constitute the key elements of well- being: career, social relationships, community, health, and finances. In an effort to synthesize the central domains of well-being, my research team integrated the vast literature of facets of well- being and determined that there are six key domains summarized in the acronym I COPPE, which stands for Interpersonal, Community, Occupational, Psychological, Physical, and Economic well- being. Our team assessed the correlations among six specific domains and overall wellness and found meaningful, positive, and high correlations among each domain and satisfaction with life as a whole (Prilleltensky et al., 2013). This line of research explores subjective well-being or the perception of satisfaction with life by research participants.

In addition to subjective evaluations of well-being, there are obviously objective assessments of wellness, such as income, density of social networks, crime rates, or signs of physical health, including body temperature, blood pressure, and cholesterol levels. Both kinds of measures, objec- tive and subjective, are important and complementary, and the neglect of either can lead to incom- prehensible paradoxes, such as the ones experienced in Colombia and Mexico in recent times.

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In the last decade of the past and the first decade of the present century, Colombians and Mexicans reported, respectively, the highest level of satisfaction in the world. This was at the time when both countries reported extreme levels of random violence, kidnappings, and killings. Had we looked only at their subjective perceptions of well-being, we would have obtained a very incomplete pic- ture of happiness in their countries. Similarly, had we looked only at crime statistics, we would have predicted that their populations would be in a constant state of depression. The seeming para- dox that crime and random violence can co-exist is explained by the surge of democracy in these countries during the periods in question, and by the traditional emphasis these countries put on family, friendships, and overall close relationships (Graham, 2009; Inglehart, 2010; Inglehart, Foa, Peterson, & Welzel, 2008). These protective mechanisms account for the well-being of the popula- tion and compensate for the dismal lack of security people experience in these countries. A com- prehensive portrayal of well-being in individuals and communities requires objective and subjective appraisals. Focusing on the latter, at the expense of the former, has led psychologists like Seligman (2002) to erroneous conclusions, whereby he claimed that income and education do not matter for well-being, whereas there is ample evidence that people with both higher education and income experience fewer psychosocial problems and higher levels of self-esteem and self-efficacy (Donohoe, 2013; Freidl et al., 2007; Fuller-Rowell et al., 2012; Levy & Sidel, 2006; Pascoe & Smart Richman, 2009; Prilleltensky, 2012; Prilleltensky & Prilleltensky, 2006; Rath & Harter, 2010; Wilkinson & Pickett, 2009).

A preoccupation with intra-psychic dynamics and a misplaced emphasis on resilience have led researchers such as Seligman (2002) to ignore contextual factors in well-being, such as income, education, and opportunities in life (Ehrenreich, 2009). While the human mind has great capacity for adaptation, and the human spirit has great endurance, it is a mistake to presume that most indi- viduals can overcome adversity unscathed, or that external factors can be overcome by internal pirouettes of the mind. There is no question that some people, endowed with intelligence and empathy can, with appropriate supports, overcome adversity, but they remain a minority (Prilleltensky, Nelson, & Peirson, 2001b). For the vast majority who face oppression and injustice, life becomes a constant struggle (Nelson & Prilleltensky, 2010), which is why it is so surprising that psychologists have not explored in depth yet the connection between fairness and wellness. It is encouraging to see that some psychologists have begun to make the empirical connection between wellness and fairness more explicit (Grote et al., 2004; Miller, 2001; Santinello & Vieno, 2011; Schmader et al., 2001), but much remains to be done to understand the reciprocal nature of types of wellness and types of fairness.

Why is wellness important?

Well-being has not only intrinsic but extrinsic value as well. People who report high levels of well- being experience fewer psychological and physical problems, better relationships, live longer, are more productive at work, miss fewer days of work, and have reduced risk of suicide (Keyes, 2005, 2007; Keyes, Dhingra, & Simoes, 2010; Keyes et al., 2012; Keyes & Grzywacz, 2005; Keyes & Simoes, 2012).

The development of the two-factor model of mental health has generated great interest in well- being among clinicians and researchers. They see well-being as a viable route to complete mental health. The two-factor model demonstrates that complete mental health depends on the reduction of mental illness and the enhancement of well-being (Keyes, 2005, 2007). Much effort has been invested in the former but definitely not enough in the latter. Keyes (2007) has made a strong case for balancing the two paradigms. It is no longer acceptable to promote complete mental health by

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reducing mental illness alone. We must, concurrently, promote well-being. Complete mental health requires that we focus more attention on understanding and promoting well-being. Keyes (2005, 2007) has empirically shown that fostering well-being can reduce the length, severity, and preva- lence of mental illness.

Hitherto, we have established that wellness has many facets, that it can be evaluated through objective and subjective means, that it can promote complete mental health, and that it is very likely affected by different types of fairness. There is emerging evidence that fairness, or lack thereof, affect levels of wellness (De la Sablonnière, Auger, Sadykova, & Taylor, 2010; Fiske, 2011; Grote et al., 2004; Miller, 2001; Santinello & Vieno, 2011; Schmader et al., 2001). To under- stand this connection better, and to offer a research and action agenda, we need to explore more in depth the various types of fairness that can affect wellness.

What is fairness?

Following Rawls (2001), I will use fairness as synonymous with justice. There are two main types of fairness: distributive and procedural (Colquitt, LePine, Piccolo, Zapata, & Rich, 2012; Tornblom & Vermunt, 2007). The former refers to outcomes. The latter refers to process. Distributive justice pertains to the fair and equitable distribution of resources, gains and pains, benefits, and obligations in society. When people talk about social justice, they talk mostly about distributive justice. How to allocate goods such as health care, and burdens such as taxes, are central concerns of distributive justice. People and systems engage in distributive dealings all the time. It is not just structures like government that care about distribution, but groups, families, and dyads as well (Elster, 1992, 1995). From who does the dishes, to who pays the bills, distributive justice questions are ubiquitous (Miller, 2001). Getting your fair share, carrying your load, and getting what you deserve are all questions of distributive justice. How to apportion to each his or her due has concerned moral philosophers and social scientists for ages (Corning, 2011; Elster, 1992, 1995; Sandel, 2009). Whereas some favor need, and others merit, several thinkers favor a contextual approach whereby the criterion chosen corresponds to the circumstances of the case. In cases of inequality, the contextualists argue, need should be preferred to level the playing field. In cases of equality, where all start life with similar endowments and opportunities, merit should be chosen to reward effort (Corning, 2011; Deutsch, 1975; Facione, Scherer, & Attig, 1978). Psychologists have noted that people are sensitive to distributional fairness, but they have studied mainly their cognitive and decision-making processes (Miller, 2001), or job performance (Colquitt et al., 2012) associated with fairness. The connections among various types of fairness and vari- ous types of wellness remain a fertile territory to explore.

The second main type of fairness is procedural justice. As opposed to distributive justice, which is concerned with the what, procedural is concerned with the how. Human beings have a strong need to participate in processes and decisions affecting their lives. In the literature, this is called voice. Lack of voice renders individuals angry and frustrated, with a great sense of injustice. In the organi- zational development literature, procedural justice figures prominently as a correlate of work satis- faction and productivity (Colquitt et al., 2012; Miller, 2001; Tornblom & Vermunt, 2007).

Recent work by the Whitehall study team in England discovered strong associations between feeling respected at work and physical and mental health outcomes (De Vogli et al., 2007; Elovainio, Kivimäki, & Vahtera, 2002; Kivimäki et al., 2005). The higher the level of respect experienced at work, the better the levels of worker well-being. Their investigations represent the most explicit empirical statement yet about the connections among one type of justice—procedural—and spe- cific types of well-being—physical and emotional.

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In addition to the two main types of fairness—distributive and procedural—there are a number of subtypes that are more contextually based. In organizations, researchers have identified infor- mational justice (Colquitt, 2001; Greenberg & Colquitt, 2005), which refers to access to knowl- edge and transparency. In relationships, there is interpersonal justice, which is a combination of distributive and procedural justice: getting your fair share and having a voice in the relationship (Grote et al., 2004; Hatfield, Rapson, & Aumer-Ryan, 2008; Rayner, 1999; Ullmann-Margalit, 2006). In cultural relations, there is cultural justice, or the fair treatment of minorities or ethnic groups. In the legal system, there is retributive justice. Across generations, there is developmental justice or injustice. This is evident in cases of child or elder abuse (Prilleltensky, 2012). While these types of fairness are played out in relationships between two or more individuals, I claim that people can also be fair or unfair to themselves, leading me to think that there must be intrapersonal justice or injustice. This is obvious in cases of self-injurious behavior at one extreme (eating disor- ders, self-mutilation, or suicide) or self-deprecating talk at the other. We can be unfair to ourselves. This type of injustice leads me to think that we can probably invoke psychological injustice. When we disrespect ourselves or others, we engage in some kind of psychological lack of fairness.

So far, we have seen that there are two main types and a few subtypes of fairness. In the next section, I will propose that we study the various kinds of fairness across contexts, for each situation can involve more than one type of justice.

Why is fairness important?

Justice impacts our lives in multiple planes: From the relationship we have with ourselves, to the relationship we have with family, colleagues, citizens, and our government (Elster, 1992, 1995; Miller, 2001). In my view, we can think of each level of interaction—from the intrapersonal to the interpersonal to the systemic—as arenas of fairness. At each level of interaction, there can be one or multiple types of fairness at play.

Consider interpersonal relationships. In this arena, there are distributive, procedural, informa- tional, and psychological types of justice at play. Do I get my fair share of resources? Is my voice taken into account when we make decisions? Does my partner share with me essential information about finances? Am I respected in the relationship? Similar questions arise in work settings: Am I compensated fairly for my work? Does the boss care about what I have to say? Do I feel respected by my colleagues? and Do they share with me important and timely information? Even in conver- sations we have with ourselves there can be more than one type of justice involved: Do I claim my legitimate due in the world? Do I treat myself with respect or do I put myself down? The explora- tion of types of justice across levels of human experience is sure to deliver interesting and useful insights about the connection between fairness and wellness.

What is more, this approach can shed light on the complementary nature of various types of fairness. Take the case of educational underachievement by ethnic minorities. If we tackle this issue from a distributive justice perspective, we would want to know the impact of lack of resources and opportunities on the poor educational attainment of the group in question. However, if we stay within distributive justice and concentrate only on the problems and deficits of a group due to lack of resources, we run the risk of stigmatizing it. This is why we need to invoke cultural justice, which is about the fair treatment of diverse groups. Within minority groups, there are certain to be role models who succeed against many odds. It is a matter of cultural justice to recognize the strengths of minorities and celebrate them. Individuals within the minority group who succeed despite challenges can feel justifiably stigmatized if their assets are not acknowledged. There is literature in psychology dealing with the negative effects of being ignored while succeeding

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(Gable, Gonzaga, & Strachman, 2006), just as there is literature on the tyranny of poor expecta- tions of minorities, conceptualized as a form of microaggression (Torres et al., 2010). Failing to celebrate somebody’s success can amount to an injustice of strengths. People need to be recognized for their achievements.

If we were to focus only on the distributive injustices and the underachievement of an ethnic group, without acknowledging that some individuals within said group overcome adversity and succeed, we would have engaged also in cultural injustice, because we would have stereotyped an entire group. Moreover, we would have failed to acknowledge their effort, which is a form of dis- respect. We can see, through this example, interactions among diverse types of justice, and various forms of well-being. Complete well-being demands that we pay complementary attention to what is lacking in people’s lives—resources and access to good schools—with what is present—talent and success. Focusing on the former without the latter can stigmatize cultural subgroups. This analysis also reveals that people can experience one type of justice (e.g., distributive), but not oth- ers (psychological or procedural), leading to incomplete states of fairness and wellness.

Future steps

Psychologists have explored various facets of well-being (Pavot & Diener, 2008), but have largely neglected the role of fairness on wellness. Analogously, psychologists have studied various aspects of fairness, such as reactions to distributive and procedural justice and injustice (Miller, 2001; Tornblom & Vermunt, 2007), but have yet to explore the impact of these dynamics on wellness. With distinct exceptions, such as the work of Santinello and Vieno (2011), much conceptual and empirical work needs to be done to distill the connections among wellness and fairness.

Based on the preceding discussion, I would suggest that we (1) create a conceptual map to link various types of fairness with diverse aspects of wellness; (2) consider the impact of various types of fairness on various domains of wellness; (3) expand our studies of justice beyond distributive and procedural to include developmental, cultural, intrapersonal, and psychological; (4) study the presence of various types of fairness across diverse contexts: intrapersonal, interpersonal, organi- zational, and systemic; and (5) examine the complementary nature of various types of fairness, such as cultural with distributive, to achieve full wellness, or flourishing. Research along these lines can do much to propel specific action on fairness to improve and enhance wellness, for indi- viduals and communities alike. This is the promise of psychology to the world, and this is what we need to do.

Declaration of conflicting interests

The author declares that he does not have any conflict of interest.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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London, UK: Penguin Books.