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New evidence from a randomized trial. By Tyler J. VanderWeele Ph.D. Key points Forgiveness can be understood as replacing ill will towards an offender with goodwill. Forgiveness is different from excusing, reconciling, or foregoing justice. A randomized trial of a forgiveness workbook indicates beneficial effects on mental health and flourishing. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. We have all been hurt by others. Sometimes those wounds last for a long time. It can be difficult to know how to deal with such hurts, or with those who have inflicted them. One approach is to bury and suppress the wounds, but often they then remain with us and re-emerge. Another approach is to let the wounds fester, to ruminate upon them and upon anger, and possibly seek revenge. Sometimes that revenge may help pacify one’s outrage; at other times it may not. An alternative approach to dealing with the hurts we all experience is forgiveness. We might define “forgiveness” as the replacement of ill will towards an offender with goodwill. Conceived as such, forgiveness is distinct from excusing or condoning the action; it is distinct from reconciliation; and it does not require foregoing justice. Forgiveness does not entail ignoring issues of responsibility and accountability. One can forgive an offender and hope for his or her ultimate good, while also pursuing a just outcome. One can also forgive an offender without necessarily seeking a restored relationship. This point is especially important in cases, say, of repeated violence or abuse, wherein the ending of the relationship may be best for the victim and offender alike. Likewise, because forgiveness and reconciliation are not identical, one can also forgive even if the offender has passed away. In conflicts, often both parties are hurt, and forgiveness can be helpful in both directions. Prior research on forgiveness has included randomized trials of forgiveness interventions and longitudinal analyses of observational data. This research has indicated that forgiveness lowers depression and anxiety. Forgiveness can, over time, help free the victim from the hurt, rumination, and suppression, and from the offender. And again, one can pursue forgiveness and justice simultaneously. Most prior forgiveness interventions have required many sessions with a trained therapist. In our most recent randomized trial study, we have examined whether the past 30 years of work in clinical psychology on forgiveness could be distilled into a self-guided workbook that could be effective at promoting forgiveness and improving mental health. If so, given the ease of dissemination of such workbooks, the public health consequences could be profound. REACH Forgiveness Model The workbook we studied employed Everett Worthington’s REACH model of forgiveness where each letter of REACH stands for a different part of the process. R is for recall: recall the hurt and let the emotions associated with it surface; do not suppress them. E is for empathize: empathize with the offender, trying to understand their reasons for the action, without condoning the action or invaliding one’s feelings. A is for altruistic gift: realize that forgiveness is an altruistic gift that can be offered or withheld, and realize also that one has oneself sometimes done wrong and has been forgiven. C is for commit: commit to forgive, to try to replace ill will with goodwill. H is for hold on: hold on to the forgiveness, realizing that it takes time for emotions to heal and that sometimes the anger will return. The workbook was developed by selecting the most effective exercises from prior research that could be completed in two to three hours, to help people who want to forgive but were having trouble doing so. Our Forgiveness Randomized Trial We carried out a waitlist randomized trial to examine the effectiveness of this forgiveness workbook. The study had about 4,500 participants in five relatively high-conflict countries: Columbia, South Africa, Ukraine, Indonesia, and Hong Kong. In a waitlist randomized trial design, participants are randomized to receive the intervention either immediately, or after a delay (in this case, two weeks), and then outcomes are measured right before the second group gets the workbook. Given prior research on forgiveness, it seemed unethical to permanently withhold the workbooks from participants in the trial, so a waitlist design seemed best. Happily, the workbook was indeed effective at increasing forgiveness. Those who received the forgiveness workbook immediately reported experiencing higher levels of forgiveness after two weeks than those who were randomized to delayed receipt. Moreover, there was also evidence from the trial that the forgiveness workbook lowered depressive symptoms and anxiety symptoms, and that it increased hope. There was also evidence that it increased various aspects of flourishing—happiness, health, meaning, character, relationships, and even a sense of financial security—as assessed by our flourishing measure. The formal paper on our randomized trial is currently under journal peer review, but given the importance of this work, and our upcoming forgiveness conference (described below), we decided to release a pre-print on the study and more details are available here. Public Health Implications Given the important effects of forgiveness on mental health and well-being, and the existence of an effectively costless, easily disseminated self-guided forgiveness workbook, forgiveness should arguably be considered a public health issue. The public health impact of a particular exposure or phenomenon is sometimes assessed as a function of how prevalent or common it is and the size of its effects on the outcomes that we care about. Something that is both common and has large effects on health outcomes will shape population health. On these grounds, forgiveness is important. The experience of being wronged is very common; and forgiveness, which can be fostered by the use of the workbook, can itself improve mental health and well-being. If the workbooks were disseminated in clinical, school, and workplace settings, and if local, national, and international efforts were made to promote forgiveness and utilize such resources, we argue that more people could forgive and reap the benefits of improved mental health. (The forgiveness workbook can be downloaded here and freely distributed. I have personally used it myself and have found it very helpful.) Difficult Questions, and Our Conference There are of course difficult moral questions around forgiveness that are important in their own right, but also important in thinking about forgiveness in the context of public health. Are there limits to forgiveness? What are the moral conditions under which forgiveness might be considered appropriate? While there is certainly no universal consensus, arguments have been put forward that, provided the victim does not deny the wrong that was done or its implications or deny or suppress feelings about it, forgiveness—understood as replacing ill will towards the offender with goodwill—can always be morally appropriate. Again, forgiveness does not entail foregoing justice, and this distinction is critical especially if forgiveness is promoted in clinical or community settings, and in thinking about the morality of forgiveness. But what if the wrongdoer does not acknowledge the wrong or does not repent? Forgiveness—understood as replacing ill will towards the offender with goodwill—can still take place. And such forgiveness may still help free the victim from the offender. Conversely, if something you say or do deeply hurts or offends another person, even if you believe you did nothing wrong, it can still be helpful to express sorrow for the other’s pain. In some cases, this itself might facilitate healing and might help the other person to forgive. These are, however, difficult questions, and to help try to address these, the Human Flourishing Program, in collaboration with Harvard’s Memorial Church, the Making Caring Common Project at the Harvard Graduate School of Education, the Harvard Catholic Forum, the Religion Conflict and Peace Initiative at Harvard Divinity School, and the Templeton World Charity Foundation, are hosting an Interdisciplinary Conference on Forgiveness to bring together scholars and practitioners from psychology, law, peace studies, philosophy, theology, and public health to ponder these and others important and difficult issues surrounding forgiveness. The conference will be held at Harvard University April 21-22, 2023, and is free and open to the public. Enmity and Love Forgiveness perhaps also points us towards the need for love within community, and a restoration of love when things have gone wrong. It arguably even points towards a need for a love of one’s enemies, of those who have a settled ill will towards oneself, or those towards whom one is inclined to have settled ill will. Our society has become increasingly polarized. We will not agree on everything, and those disagreements can be important. And yet, it is important also to recognize the humanity of those we disagree with, to understand those differences, and to work towards finding those aspects of what is good that we can agree on and seek together. We can at the same time seek to correct the other, while seeking to be corrected ourselves. There is a paradoxical logic of love for one’s enemies, and forgiveness facilitates this logic and love. By replacing ill will towards another with goodwill, forgiveness may prompt prosocial action that may itself propagate, thereby potentially helping to heal division. Love—love for one's enemy—seeks both the good of the other (sometimes including correction), but also, when possible, a desire for reconciliation. Love extends beyond even forgiveness. Our society needs to foster a greater love of neighbor, and love of enemy. People in many parts of the world right now are observing “Holy Week,” a remembrance of what Christians believe to be the life, death, and resurrection of Jesus Christ. The account given in the Gospel of Luke is that Jesus, after having been nailed to a cross, cried out, “Father, forgive them, for they know not what they do.” I hope that we may embody that same spirit of forgiveness. However, may we do so also in full recognition that the other side may view us as offenders, as having nailed them to the cross. Amidst our difficulties and tensions, may we pursue a spirit of forgiveness that seeks understanding and love, peace and reconciliation. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Ho, M. Y., Worthington, E., Cowden, R., Bechara, A. O., Chen, Z. J., Gunatirin, E. Y., Joynt, S., Khalanskyi, V.V., Korzhov, H., Kurniati, N.M.T., Rodriguez, N., Salnykova, A., Shtanko, L., Tymchenko, S., Voytenko, V.L., Zulkaida, A., Mathur, M. and VanderWeele, T. (2023, March 3). International REACH Forgiveness Intervention: A multi-site randomized controlled trial. https://doi.org/10.31219/osf.io/8qzgw VanderWeele, T.J. (2018). Is forgiveness a public health issue? American Journal of Public Health, 108:189-190.

The release of the first wave of a 200,000-person study on flourishing. By Tyler J. VanderWeele Ph.D. Key points The first wave of the Global Flourishing Study data was released February 2024. Flourishing varies by demographic group, but these relations themselves vary by country. Studying flourishing allows us to promote flourishing across the globe. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. Flourishing Around the Globe We seek to flourish as individuals, as communities, as nations, and as a global society. The opportunities to flourish are tremendous, but so are the obstacles. We must employ numerous strategies to understand and promote flourishing within our societies. One such strategy is making good use of flourishing data. We are thus delighted to announce the release of the first wave of the Global Flourishing Study data, and to provide some initial insights from it. The Global Flourishing Study The Global Flourishing Study (GFS) is a study of over 200,000 participants, from 22 geographically and culturally diverse countries, with nationally representative samples in each country, and with planned annual data collection on the same panel of individuals for five waves of data. The study includes participants from Argentina, Australia, Brazil, China (Hong Kong), Egypt, Germany, India, Indonesia, Israel, Japan, Kenya, Mexico, Nigeria, the Philippines, Poland, Turkey, South Africa, Spain, Sweden, Tanzania, the United Kingdom, and the United States; it includes a set of questions on well-being along with demographic, social, economic, political, religious, personality, childhood, community, health and character-based questions. The study itself is being carried out in collaboration between scholars at the Human Flourishing Program at Harvard and Baylor’s Institute for Studies of Religion, with data collection by Gallup, and with support from a consortium of funders including the John Templeton Foundation, the Templeton Religion Trust, the Templeton World Charity Foundation, the Fetzer Institute, the Paul Foster Family Foundation, the Wellbeing for Planet Earth Foundation, Well Being Trust, and the David & Carol Myers Foundation. The first wave of data was just recently released in February 2024 and is being hosted by the Center for Open Science. As an open-access data resource, any researcher can receive the data by submitting a pre-registration to the Center for Open Science. We now in fact have a team of over 50 researchers working away on the data and will be releasing a series of peer-reviewed research papers on the study towards the end of the year. However, we can already discuss some initial, intriguing insights. Some Initial Results While we will be looking at numerous aspects of well-being in our research analyses, we will restrict comment here to some initial results that pertain to our own flourishing assessment, spanning happiness, health, meaning, character, relationships, and financial stability (the measure is available in over 40 languages across the globe). Our future work will also look at these various aspects of flourishing separately, along with numerous other aspects not covered by our core assessment, such as peace, balance, mastery, and freedom, along with various more nuanced aspects of happiness, health, character, social connectedness, and financial well-being. As discussed further in a short Gallup.com article, in most of the 22 countries, on a scale from 0-10, the average flourishing score falls between 6.5 and 8, with the only exceptions being Indonesia where the average score was slightly above 8.0 and also Turkey and Japan, with average scores slightly below 6.5. In the United States, consistent with some of our prior work pre-pandemic, the mean score for this 2023 wave of data was just above seven (7.11). Aggregated over the 22 countries, men and women had roughly similar flourishing scores, with men scoring only very slightly higher than women. Interestingly, however, there was quite a bit of variation across countries. For example, in Japan, women report notably higher flourishing than men, whereas in Brazil men report notably higher flourishing than women. In a number of countries, with the 2023 data, we now find that flourishing increases with age, a pattern we had previously noted in the United States starting in 2022. Unfortunately, many young people are not doing particularly well today. But this increasing-with-age pattern was not the case in all countries, and some countries (e.g. India and Egypt) have more traditional U-shaped patterns relating age and well-being, with younger individuals and older individuals doing better than those in mid-life. A more thorough investigation of these results, and of trying to understand the variation across countries, will be a topic of our upcoming research. Many of the other demographic relationships are perhaps not particularly surprising: those who are employed report higher flourishing than those who are unemployed; those who are married report higher flourishing than those single or divorced; those with higher levels of education report higher flourishing than those with less education. And, as discussed in our Gallup.com article, and as we’ve discussed elsewhere, religion too is related to flourishing in important ways. All of these will likewise be important topics for future investigation. With only one wave of data, we can provide descriptive analyses as above, but these cross-sectional descriptive statistics should not be interpreted as implying causality. In contrast, some of the analyses we are currently working on are retrospectively examining childhood experiences and present flourishing, and future analyses will make use of multiple subsequent waves of data, and these will have more potential to provide causal insight. We look forward to all that we might potentially learn later this year, and in the years ahead. Promoting Global Flourishing We are excited about the months ahead and the research that the Global Flourishing Study will enable. We hope also that researchers all over the world will access the data and learn from it. And we hope that collectively the insights that emerge from the Global Flourishing Study will help us promote flourishing, and re-orient policy to enhance flourishing, in societies all around the world. We’ll certainly be sharing more in the months ahead. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Chen, Y., Johnson, B.R. Ritter, Z., VanderWeele, T.J. (2024). Global Study Aims to Uncover How Humans Flourish. Gallup.com

Seeking the transcendent. By Tyler J. VanderWeele Ph.D. Key points Over the last decade, research on religion and health has become increasingly rigorous Religious participation benefits longevity, social connection, well-being, and purpose Religious participation lessens depression, substance use, and suicide Religion is a powerful social determinant of health and well-being Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. We essentially all long for that which is of ultimate significance, that which can imbue meaning, and that which gives us a sense of connectedness. Many long for what is transcendent, or for a truth, beauty, and goodness that extends beyond everyday experience. In such longings, we effectively have an at least implicit spirituality as we seek what transcends beyond ordinary life. That longing for the transcendent has found various forms of communal expression as well, within the various world religions. Systems of beliefs and practices unite people together in a community with a shared vision for the experience of, or union with, the divine or transcendent. And that effectively is what constitutes religion. Decades of prior research has indicated that such religious participation is also associated with a wide range of temporal health and well-being outcomes. In building upon and contributing to that research, in collaboration with the Human Flourishing Program at Harvard, we are pleased to announce the release of Koenig et al.’s 3rd edition of the Handbook of Religion and Health. The Handbook constitutes the most comprehensive treatment of the role of religion in shaping health and well-being to date, and draws upon, synthesizes, summarizes, and weighs the evidence, of over 10,000 studies on this topic. Building Knowledge of Religion and Health Over Time Our understanding of the relationship between religion and health has gradually expanded year after year. While some of the earlier studies on the topic were less rigorous, and had often employed cross-sectional data, making causal inference almost impossible, over the past couple of decades the research has become increasingly rigorous. Large longitudinal studies with extensive confounding control and sensitivity analysis, have provided evidence for effects of religious service attendance on numerous health and well-being outcomes including, for example, all-cause mortality, depression, suicide, and many others. By 2009, a meta-analysis of numerous more rigorous longitudinal studies indicated a 27% reduction in all-cause mortality for those attending religious services regularly vs. not. By 2021, a similar meta-analysis, restricted to longitudinal studies, provided evidence for powerful effects on mental health, most notably depression. In 2022, researchers at the Human Flourishing Program and the Initiative on Health, Religion, and Spirituality at Harvard, under the leadership of our colleague Dr. Tracy Balboni published a systematic review of large longitudinal studies of religion and health indicating effects of religious participation on longevity, depression, suicide, smoking, drug use, alcohol abuse and various aspects of quality of life and well-being. The handbook supplements that prior work yet further by synthesizing the evidence not only from the largest and most rigorous studies, but also the weaker or smaller studies, summarizing the state of research even when evidence is more limited so as to help guide and direct future research efforts to learn more. While for some outcomes such as longevity, depression, substance use, and social support, the existing evidence is arguably now quite definitive, for others we still in fact know relatively little (e.g. schizophrenia) or the emerging picture is complex (e.g. pain). Beyond these other outcomes, we also have a lot to learn on aspects of religion and spirituality beyond service attendance, and also on the role of spirituality and religion in other non-Western contexts and countries, and how this varies across the world religions. We very much hope that our Global Flourishing Study, the first wave of which will be released early next year, will help in this endeavor. Beyond new studies, work also remains to be done on evidence synthesis. While numerous meta-analyses have been carried out, along with other books summarizing these, to the best of our knowledge, only the two meta-analyses mentioned above, on longevity and depression, have restricted attention to more rigorous longitudinal studies. We have recently received support from the Templeton Religion Trust to expand this more rigorous evidence synthesis further to carry out longitudinal meta-analyses for outcomes extending beyond mortality and depression, and including suicide, cardiovascular outcomes, alcohol, smoking, drug use and life satisfaction, and to examine the sensitivity or robustness of these meta-analyses to potential unmeasured confounding. Further evidence to be integrated includes quasi-experimental studies from economics suggesting effects of religious participation on depression and on death of despair, along with studies on mediators or mechanisms for the effects of religion on health. From Research to Population Health Considerable work also remains to be done on the translation of research into policy and practice to improve population health. The handbook covers this as well with numerous sections on clinical implications and case vignettes and chapters on public health, health policy, and human flourishing. These matters are not always adequately taken into account in clinical and public health discussion. Major reviews of determinants of mental health and suicide often completely neglect discussion of religion as a social determinant of health, despite evidence that declining participation may explain about 40% of the increased rates of suicide and 28% of increased rates of depression. As discussed elsewhere also, the implication of this research are in no way straightforward. But sensitive ethical evidence-based approaches of taking a brief 2-question or 4-question spiritual history in clinical settings, or encouraging religious community participation for those who positively self-identify with a religious tradition and other form of community participation for those who do not, has the potential to powerful enhance health and well-being. Much has thus been accomplished but much more needs to be done both with regard to research and with regard to moving from research to practice, and we encourage interested readers to examine the Handbook further. As the holidays approach, many turn away from the busyness of life to spend time with friends and family. Many seek to reflect on, remember, seek out, and celebrate, the transcendent. Many turn to, and draw upon, those communal celebrations offered by religious communities. Christians all over the world commemorate the birth of one whose life brings light, who is celebrated as the Prince of Peace, who has shaped human history, with, across the globe, two billion people seeking the transcendent in his presence. As we pursue that which gives us ultimate meaning, significance, and connection, let us work together in seeking that peace, that truth, that goodness which our inherent spiritual longings prompt us towards. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Koenig, H.K., VanderWeele, T.J., and Peteet, J.R. (2023). Handbook of Religion and Health. 3rd Edition. Oxford University Press.

Flourishing is under fire. By Tyler J. VanderWeele Ph.D. Key points Research on flourishing has come under reasonable critique. There needs to be more qualitative and cross-cultural research on inequalities and flourishing assets. There is, however, considerable cross-cultural consensus on character and on flourishing. We can work together, amidst disagreement, to promote flourishing for all. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. Fourishing has been the topic of philosophical and theological reflection for millennia; its empirical study is relatively young. Much has been learned, but there is still much to uncover. Any developing discipline will be shaped by the particular emphases and interests of its investigators, by the availability of data, and by sheer happenstance. Any newly emerging field will have blind spots. Some important questions and salient information are sure to be overlooked or neglected, at least for a time, but these omissions can and should be corrected as they are brought to light. Recently, an anthropologist at the University of Connecticut carried out a service to the field of empirical flourishing research by providing a broad critique of the existing flourishing literature. Several of her criticisms are very reasonable and need to be addressed, but others do not, in our view, quite adequately characterize the state of research. Regardless, there is still a lot to learn, and many gaps that still need to be filled. Earlier this year, we at the Human Flourishing Program at Harvard also published a response to this critique, since some of the criticisms specifically concerned the work of the program. We in fact further invited the critique’s author to present at the program, and we very much benefitted from the exchange. In what follows, we’ll provide a brief overview of some of the content of the exchange, but we also encourage interested readers to look through the whole of the critique itself, along with our response. Reasonable Criticisms Several of the paper’s criticisms of the field of flourishing seem very reasonable and point towards issues that need to be addressed. First, the field needs more qualitative work, and more work on understanding the views and experiences of everyday people as to “what flourishing looks or feels like, what makes flourishing possible, or what might stand in the way and thwart their ability to flourish.” Much of our own work, and that of many others, has been quantitative, but more qualitative research is clearly also critical. The field would benefit if more of this were carried out. Second, more research needs to be done on how understandings of, and experiences of, flourishing vary across cultures. We hope that our own Global Flourishing Study will contribute in that regard. However, even with this study, although we solicited and received input from scholars from numerous continents, the study questions themselves were undoubtedly still shaped by Western perspectives, as is the field of well-being research more generally. We’ve been collaborating with the Japanese Wellbeing for Planet Earth Foundation and the Global Wellbeing Initiative to better understand non-Western perspectives on well-being. Balance and harmony have, for example, emerged as important aspects of well-being that are perhaps given more attention in the East than the West. But much more needs to be done on this important topic. Third, we agree with the critique that questions concerning inequities in power and resources, matters of justice and structural conditions, and documenting and responding to minority experiences have not to date received adequate attention in the flourishing literature. Part of this may be due to not having as much data on holistic flourishing as we do on health or financial resources, thus rendering it more difficult to carry out such work (which again we hope the Global Flourishing Study will help partially remedy), but some of it is simply a matter of a need for greater effort to address these concerns. We have carried out some work on flourishing inequalities, but much remains to be done. Of course, once we broaden the scope of the outcomes, and consider all aspects of flourishing, sometimes the results can be more surprising, or can be in the reverse direction of material inequalities. For example, some work reports higher levels of purpose in poorer developing countries than in richer developed countries, which is the reverse of what one finds with happiness; or reports higher levels of purpose and character strengths or social connectedness among black or Hispanic individuals than among white individuals. We should thus also seek to understand and appreciate the assets and strengths of communities that are more materially disadvantaged, while also attending to the material inequities themselves. In any case, the field as a whole needs to give greater attention to these issues. Character and Commonalities in Flourishing While we think each of the points above does indeed need to be better addressed in the flourishing literature, some of the other critiques or proposals we believe would push the field in the wrong direction. We believe that one of the strengths of the flourishing literature has been resisting the temptation to reduce well-being to happiness, and thus to include within flourishing, notions of character and virtue, following centuries of philosophical and religious wisdom throughout the world. Our own flourishing assessment includes this dimension as well. Aristotle in fact thought that flourishing effectively consisted principally in the development and exercise of virtue. In contrast, much of contemporary Western scholarship has been wary of addressing these topics. Some do not even want to even mention the terms “virtue” or “character.” Concerns are raised that such notions are paternalistic; that the very idea of character is culturally relative; and that any discussion of these matters is likely to result in blaming the victim. These are important concerns, but the appropriate response is arguably to more sensitively address these topics, rather than to abandon them altogether. While there will inevitably be differences in the character strengths that are valued across societies, cross-cultural research suggests that there is a lot that is held in common including valuing courage, justice, humanity, temperance, wisdom, and transcendence. As we’ve argued elsewhere, for the virtues of courage, wisdom, and justice, for instance, if one were to ask who wanted to be cowardly, foolish, and unjust, one would get very few takers. There is variation in precisely how these virtues are understood, but that virtue is important, and that these specific virtues are important, is shared across cultures. It really is only in pockets of the contemporary West that one finds any hesitation. Likewise, while blaming the victim for poor character is often inappropriate, that does not mean that character is irrelevant or that we cannot seek to develop character within ourselves and promote character strengths within society more generally. Again, as discussed elsewhere, there are now character interventions, which have been evaluated in randomized trials, demonstrating that it is possible to increase compassion, gratitude, patience, forgiveness, and perseverance/grit; and moreover the interventions can go on to also improve psychological well-being, sleep, anxiety, depression, self-rated health, and test scores. To not utilize such character interventions—in schools or workplaces, say—is to neglect an important and powerful tool to enhance flourishing throughout society. Character is important for our own lives, and it is especially critical for those who are in positions of power and influence, if we are to work towards a better society. Neglect of matters of character will impoverish us and our communities. Flourishing for All Related to these concerns about character is also the broader question of the extent to which we can come to any consensus around flourishing within society. Navigating the complexities of differing understandings of flourishing is in no way straightforward. Ideally, we would identify what is held in common (and, as we’ve previously commented, we believe this is a lot) and work together. Ideally also, we would be aware of where there is disagreement and why and work towards systems and policies that empower various particular communities to pursue the aspects of flourishing that are most important to them. Inevitably, there will be tensions and policy decisions that do satisfy everyone. Each society must navigate these complexities, and this is no trivial task. However, we have perhaps placed too much emphasis on the disagreements and points of tensions and not enough on what is held in common. While realizing that there certainly are limits, we believe we would be best off focusing on what is held in common so as to work together, amidst the tensions and disagreements, to attempt to promote flourishing for all. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References VanderWeele, T. J., Case, B. W., Chen, Y., Cowden, R. G., Johnson, B., Lee, M. T., Lomas, T., and Long, K. G. (2023). Flourishing in critical dialogue. SSM-Mental Health, 3, 100172.

The need to empower the study of love. By Tyler J. VanderWeele Ph.D. Key points Love of neighbor has the potential to overcome cycles of hatred and violence. Love has both a unitive and a contributory aspect. To promote love, we need a more adequate assessment and empirical study of love. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. These past weeks and years, we have seen escalating conflict, violence, death, and war in Israel and Palestine, in Russia and Ukraine, in innumerable other conflicts around the world, and in increasing division and polarization within our own country. None of these struggles are easy or straightforward to resolve. The histories lying behind such conflict and violence, and the motivations for the actions taken, are complex and not infrequently dark, manifesting not only hurt but also hatred, sometimes mutual. We can and should mourn the loss, mourn those who have died, and mourn the evil that has taken place. We can and should hope and pray for resolution, support those who are suffering, and assist communities and leaders in working toward peace. There are no easy steps to disentangle or prevent such conflict, and we will likely never be able to eradicate hatred from the human condition. But it is worthwhile nevertheless to ponder what is possible, what small steps we might take to counter and prevent hatred, and, whenever possible, to overcome hatred with love. While the form that love takes amidst conflict is complex, and while love itself may entail legitimate and just resistance and self-defense ultimately aimed at peace, an attitude of love and respect for the humanity of others has the potential to shape and limit and, perhaps also, help prevent violence. Even, and perhaps especially, in the midst of conflict and strife, it may be worthwhile to reflect upon how we can empower greater interpersonal love—a love to overcome hatred. The Study of Love Although love shapes much of our life, motivation, and decision-making, and although it forms the foundation of ethics in many world religions, it is nevertheless relatively neglected within academic research and scholarship. Pockets of psychology might consider romantic love or parent-child love; philosophers have pondered love’s definition; but, by and large, love does not occupy the same place in academic discourse that it does in our daily lives. We have perhaps partially missed the potential that a fuller study and understanding of love might hold to allow love to overcome hatred and enable the fostering of love to promote human flourishing. Part of the difficulty of studying love is the diversity of ways that the word “love” is used and the diverse array of things that are sometimes said to be loved: family, friends, food, pets, country, justice, beauty, God, etc. In every case, however, love arguably has either a unitive aspect (our wanting to be with or united to what we love) or a contributory aspect (our wanting to contribute to the good of what is loved). These often co-occur, though sometimes only one or the other aspect of love is present. These different aspects of love, and the diverse range of objects we might love, can make the study of love challenging. At the Human Flourishing Program at Harvard, we have recently released a paper arguing that whenever the verb “love” is used, one or both of these unitive or contributory aspects are in play. Or, more precisely, when the expression “He/she loves . . .” is employed, then “love” is used to indicate either “a disposition toward desiring a perceived good or desiring union with it, either as an end itself or with it being a source of delight in itself” (i.e., unitive love) or “a disposition towards desiring good for a particular object for its own sake” (i.e., contributory love). Love as a disposition is a relatively stable (even if not perfectly uniform) trait, which aims either at union with, or contributing to the good of, the beloved. Some of the complexity of studying love is that either unitive or contributory love may be present without the other. Often in human relationships, however, we expect, desire, and hope for both to be present. We are currently using this characterization of love to try to empower a fuller empirical study of love. Empirical Assessments of Love The study of love can and should draw upon the rich theological and philosophical traditions on this topic. However, our understanding of love and of how to promote love can also be advanced by empirical research, and, indeed, there can be a fruitful interchange between these various modes of conceptual and empirical inquiry. While there have been prior proposals to form an empirical epidemiology of love, at least some of the difficulty in implementing this vision has been a lack of coherent, conceptually grounded measures. Now, and in the years ahead, we are hoping to take on this challenge. We have in fact been recently awarded a grant from the John Templeton Foundation on the Construct and Assessment of Interpersonal Love to help carry out this work. We are, and will be, using the characterization of love above—as unitive and contributory love—to develop a series of interrelated measures of interpersonal love including parent-child love, romantic and spousal love, love within friendship, and also love of neighbor, love of stranger, love of enemy, and love of God. Many of our most important loving relationships occur within the context of family and friendship, and these have and will form an important part of our work. However, we also are seeking to develop assessments for less commonly discussed aspects of love, such as love of neighbor and love of enemy. While these notions are important in various religious traditions, they have received yet less academic and empirical study. However, we believe that these more general forms of love are critical to promoting a more flourishing society. We hope over time to study how to foster love of neighbor and love of enemy. Over the last couple of years, we have, in fact, completed initial drafts of our assessments for love of neighbor and love of enemy, and have carried out initial pilot data collection and cognitive testing. We are currently in the process of more extensive data collection to allow for fuller psychometric evaluation of these measures, and we would welcome feedback on the measures themselves. However, we are also looking for opportunities to embed these measures in various longitudinal cohort studies to better empower the empirical study of love. If you help manage a cohort study and this might be of interest, please do contact us! The long-term empirical study of human psychology and behavior takes a great deal of planning, and we would like to begin these efforts as soon as possible. The Promotion of Love While the empirical study of love may seem to some to be preposterous—an attempt to measure the unmeasurable—arguably more can be accomplished than might be immediately apparent. In fact, we have already been carrying out research in that regard. Our prior research, for example, has indicated that parent-child love powerfully shapes subsequent flourishing, and that parental love is effectively the most impactful among a variety of parenting practices. Our recent randomized trial of a forgiveness workbook intervention may be seen as a powerful approach to restoring love following some offense or hurt. And we currently have other randomized trials underway on promoting character skills for loving relationships within schools. We hope to continue to study how to promote various forms of interpersonal love, and how doing so might contribute to human flourishing. The fostering of love is important in our day-to-day life and relationships. But fostering love is important for our society as well. Families and friendships form the fabric of our social life together. But, additionally, it is also the case that more general forms of love are also needed—a desire to be with and contribute to the good of all people on account of their inherent dignity, value, and humanity. The Jewish Law, the Christian New Testament, and the Quran all allude to, or even command, “love of neighbor,” with the Jewish Law extending this to “stranger” (Deuteronomy 10:19), and the New Testament even to “enemy” (Matthew 5:44). It is not necessarily easy to have or to foster such universal forms of love, but it is worthwhile to consider how we might do so. The future of our society may in large part depend on the extent to which we are able to accomplish this. If we are to counter hatred, to work together across disagreement, and to try to prevent war and conflict, we need to understand and appreciate the inherent value and goodness of all people, including those with whom we are opposed. We need this love within our communities, within our leaders, and within ourselves. Even with such love, the path will not be easy, but understanding the value of each person and being disposed to contribute to their good has the potential to powerfully transform our own lives and our future. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References VanderWeele, T.J. (2023). On an analytic definition of love. Journal of Ethics and Social Philosophy, 25:105–135.

Examining the effects of the decision to marry. By Tyler J. VanderWeele Ph.D. Key points Marriage itself positively affects health, happiness, purpose, and relationships. These effects persist, even taking into account that marriage sometimes ends in divorce. Efforts should be made to better support marriage, parenting, and family life, as well as the flourishing of all people. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. Marriage is, and remains, one of the most enduring social institutions and a central foundation of family life. Numerous prior studies have suggested that marriage itself supports both the flourishing of spouses and children. Most studies indicate marriage has important effects on human well-being, from increased longevity to lower depression to greater happiness and greater thriving of children. Meta-analyses of more rigorous longitudinal studies have indicated fairly consistent evidence for effects, for example, on physical health and longevity, and on mental health. Nonetheless, a mini-subfield within academia has developed that attempts to critique or disprove the effects of marriage on human well-being. One relatively recent (and not entirely unreasonable) critique of the existing literature is that most studies and analyses do not properly account for the fact that becoming married also puts one at risk of divorce, and divorce itself is associated with worse well-being outcomes. Most analyses examining these questions effectively compare the currently married to the previously married (but now divorced). This can make marriage look more beneficial than it is because it pulls out marriages that did not work out well and ended in divorce, and thus only examines the more successful and happier marriages. Because of this, one critic went so far as to accuse prior analyses of employing what she called a “cheater technique.” The reality is more subtle: There are different types of questions that one can ask about marriage and human flourishing. One question is what the average effects are of getting married on human well-being (including risking the possibility of a subsequent divorce). A different question is what the effects seem to be of staying married. Most prior analyses and studies have studied the latter question, and so in some ways the “cheater technique” critique has largely gone unaddressed. Our most recent study of marriage and divorce has thus focused on the former question to attempt to examine this outstanding critique and to take into account the possibility that deciding to get married might for some eventually lead to divorce. Our Study on Marriage To address the question of the effects of deciding to get married on well-being (rather than just deciding to stay in a happy marriage) requires a large sample and a long follow-up time, because one cannot just look at existing marriages; one must look at a group that was initially unmarried and then compare those who subsequently decided to get married with those who did not and follow them up. There also needs to be sufficient time to assess the effects on health and well-being, along with the possibility of subsequent divorce. Fortunately, the data from Harvard’s Nurses’ Health Study II helps provide what is needed. We used data on 11,830 nurses who were unmarried in 1989 and then compared those who married over the next four years versus those who did not, and followed up these groups for 25 years to examine their health and well-being outcomes later in life. Some of those who got married in that four-year stretch did end up becoming divorced subsequently, and so their outcomes are included also amongst those who decided to get married. Our analyses looked at a number of different well-being outcomes after 25 years, including physical health and longevity, health behaviors, psychological well-being, depression, among others. Whenever possible, our analyses also controlled for these same outcomes in 1989 prior to their potential marriage, along with a host of other social, demographic, economic, and health-related variables to try to eliminate the possibility either of confounding, or determine that it was mostly those who were initially healthy and happy who went on to get married. All of these strategies help strengthen causal inference. In spite of this more rigorous design and control, and even after including the outcomes of those who subsequently got divorced amongst the group that became married, our analyses more or less still corroborated much of the prior literature on the topic. Namely, we found moderate effects of becoming married on increasing happiness, purpose in life, and hopefulness, and on reducing depressive symptoms and loneliness. We also found substantial effects—about 30 percent declines—on reducing smoking, coronary heart disease, and stroke, and on mortality from all causes during the 25-year follow-up. These are notable effects on important outcomes. Our study did not indicate effects on all outcomes; there was little evidence of any effect on subsequently being overweight/obese or on cancer, or on heavy drinking, or on diet quality. Yet there wasn’t much evidence for adverse effects on these outcomes either. The beneficial effects that the study did uncover helps address the existing critiques and indicates important effects of deciding to marry on health and well-being, even taking into account the possibility that marriage carries the risk of divorce. Supporting Marriage Our study did not directly assess the mechanisms by which marriage affects all of these health and well-being outcomes, but the effects on a fairly diverse range of outcomes is suggestive. Some of the effects likely result from companionship. Some may be related to health behaviors. Especially later in life, some may be related to the provision of care. Contrary to portrayals in the popular media, some studies indicate, on average, higher levels of sexual satisfaction within marriage. Some of the effects likely arise from the experience of being loved, and indeed from at least some sense of security and stability offered by one’s lifelong marriage vows. The research arguably has some important implications for supporting marriage within society. Marriage is an important pathway to human flourishing. It increases physical health, mental health, happiness, and purpose, and it both constitutes and contributes to close social relationships. Moreover, the effects of marriage on the well-being of children may be even more profound than on spouses. Having children itself might even be viewed as a form of flourishing. Marriage is, of course, not always easy and can cause strain, challenges, and even anguish, but perhaps in part by working through some of those difficulties, it helps develop a stronger character, a deeper commitment, and a greater sense of purpose in some cases. While numerous activities are available that evidence indicates boost health and happiness, there are fewer easy activities to improve meaning and purpose, or character, or relationships. For these things longer-term commitments and communities and institutions are perhaps especially important, and marriage is arguably one such institution. Given the important effects of marriage on health and wellbeing, societies should support marriage. Marriage penalties in the welfare system that disincentive marriage should be eliminated. Better parental leave and child support policies could be put into place. Societal expectations over having an expensive wedding or a costly ring, which can discourage those less advantaged from marrying, could be altered. And marriage itself could be supported by providing greater marital counseling resources: Evidence-based online marriage programs could be widely disseminated to help address marital problems before they get so bad that divorce seems like the only option. Inevitably, some marriages do not work out and causes of this can be diverse, but given the negative effects of divorce itself (which our study also documented), if some of these could be prevented by offering further support, this too could improve societal well-being. However, this very possibility also points to the need of supporting the flourishing not only of those in marriage, but for all. Supporting Flourishing for All The results of our study relating marriage and well-being should in no way be interpreted as somehow indicating the superiority of married persons, or as an excuse to neglect the well-being of those who are not married. Different people have different callings and we need to support the flourishing of people in all states of life. Various religious teachings in fact sometimes even suggest that a committed single life can be a higher calling, at least in part because of the capacity to love and care for and serve a wider array of people. Single people—religious or not—play critical roles in the life of our society. Moreover, although marriage is an important pathway to the flourishing of spouses and children, efforts should most certainly be made to support and assist single parents as well. The challenges of navigating life and of parents are magnified yet further without the help of a partner, and we should give serious thought to how we might best support the flourishing of such parents and children, potentially again through better parental leave policies, parenting resources, and child support services. We must work towards supporting all persons in flourishing. Marriage is a core pathway to human flourishing. It is not the only pathway, but it has been and will continue to be an important one for many people, for the raising of children, and for the continuation of society. Efforts should be made to support marriage; to help spouses, and children, and also all parents and all people to flourish. Doing so is part of what constitutes a flourishing society. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Chen, Y., Mathur, M.B., Case, B.W., and VanderWeele, T.J. (2023) Marital transitions during earlier adulthood and subsequent health and well-being in mid- to late-life among female nurses: an outcome-wide analysis. Global Epidemiology, 5:100099.

A new U.N. World Day for prevention and healing. By Tyler J. VanderWeele Ph.D. Key points To fully promote flourishing, we also need to be attentive to suffering. Suffering is distinct from depression, and both require attention. We also need to address the causes of suffering, including childhood sexual abuse. The U.N. has announced a new World Day for Childhood Sexual Abuse Prevention and Healing. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. The promotion of flourishing requires not only active efforts to improve happiness, meaning, character, and other aspects of well-being but also healing from past hurts. Suffering We have all had experiences that resulted in physical or emotional pain, and many of these left lasting scars, whether physical, mental, or spiritual. Some of these experiences result in severe trauma and intense suffering. We need to take such suffering seriously. We need to try to prevent it and foster healing, and if possible even growth, amidst it. Some of our research at the Human Flourishing Program at Harvard has focused on the topic of suffering. We have published a review concerning the concept of suffering, how we might measure it, and what the future directions in empirical research on suffering might be. We have considered how depression is empirically distinct from suffering. While depression always constitutes some form of suffering, many who suffer, and suffer intensely, are not clinically depressed. There are forms of suffering, such as physical suffering or existential suffering, or social suffering, that can be quite different from depression. Conversely, some who are depressed, while they say there are suffering to some degree, do not say they are suffering severely. Their challenges with depression are real, but the degree of suffering varies. Of course, suffering may cause depression or give rise to anxiety and vice versa, but depression and suffering are nevertheless conceptually and empirically distinct. Mental health care has become better and better at treating depression, but we arguably need to also attend to suffering both within health care and within society more broadly. Child Sexual Abuse and Prevention We also need to attend to the causes of suffering. One particular cause of suffering to which the Human Flourishing Program has devoted considerable effort is addressing prevention and healing from childhood sexual abuse. Last year we organized a symposium on “Faith and Flourishing: Strategies for Preventing and Healing Child Sexual Abuse.” The symposium had over 1,900 registrants, Nobel Peace Laureate Denis Mukwege as keynote speaker, a blessing from Pope Francis, speakers from countries all over the globe and across numerous religious traditions, and testimony from abuse survivors. The event also served as a catalyst for an initiative to establish a World Day for the Prevention of and Healing from Child Sexual Exploitation, Abuse, and Violence. We are very happy to announce that on November 7, 2022, the United Nations General Assembly approved a resolution establishing November 18 as a World Day to raise awareness of the sexual exploitation and abuse of children. The resolution was due in no small part to the efforts of our Human Flourishing Program Research Associate, Dr. Jennifer Wortham, who chaired our symposium and worked tirelessly to build the coalition needed to establish the World Day. We very much hope that each year, World Day will draw attention to this important issue so that more effort from all parts of society—schools, families, workplaces, governments, and religious communities—will go toward prevention and toward bringing perpetrators to justice and creating pathways to healing. Moral Injury and Healing In the years ahead, we plan to continue these efforts at the prevention and healing of sexual abuse and also of other forms of suffering. The reality of abuse can have profound physical, psychological, spiritual, and social effects on victims. Each of these needs to be addressed. Such abuse and other forms of harm and wrongdoing can moreover also be disruptive to a person’s sense of right and wrong, good and evil, or their own or others’ value and worth. When such threats to one’s moral outlook are sufficiently severe as to cause persistent distress, it arguably becomes proper to speak of “moral injury.” This kind of injury can occur to the victims of abuse and wrongdoing but also to its perpetrators or witnesses. We do not at present seem to pay enough attention to these moral dimensions of injury and distress. The notion of moral injury in the contemporary research literature arose first in the context of military veterans experiencing distress over having committed acts or having witnessed acts that they considered wrong and that disrupted their understanding of good and evil or their sense of their own goodness or perhaps that of once-trusted leaders. The experience of such veterans manifested itself in ways distinct from post-traumatic stress disorder. It had a powerful moral dimension—feelings of guilt, shame, anger, or betrayal—which, if left unaddressed, could haunt veterans for years. This experience of moral injury, however, is not confined to witnesses or perpetrators but is relevant to victims as well. It is part of what must be addressed in thinking about healing from abuse or other harm. We have recently launched a new initiative at the Human Flourishing Program to try to contribute to the existing work on the measurement and study of, and treatment approaches for, such moral injury. It is important we try to address suffering on all levels: prevention, awareness, treatment, and healing—not only in its physical, mental, and social dimensions but in its spiritual and moral dimensions as well. Only then will we be able to more adequately promote fuller human flourishing. While some people inevitably suffer more than others, we are ultimately all in this life together. There is a communal dimension to suffering: Because we are social beings, we often feel heartfelt sorrow over the suffering of those around us and over the suffering that seems embedded in our fallen world as it is. We must work together to address suffering and its causes. We must work together to help one another through suffering and to ponder the meaning of our suffering and how we might grow, and what actions and responses our suffering might point us toward. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References VanderWeele, T.J. (2019). Suffering and response: directions in empirical research. Social Science and Medicine, 224:58-66. Cowden, R.G., Węziak-Białowolska, D., McNeely, E., and VanderWeele, T.J. (2022). Are depression and suffering distinct? An empirical analysis. Frontiers in Psychology, 13:970466. Cowden, R.G., Rueger, S.Y., Davis, E.B., Counted, V., Kent, B.V., Chen, Y., VanderWeele, T.J., Rim, M., Lemke, A.W., Glowiak, K.J., and Worthington, E.L. (2021). Suffering, mental health, and psychological well-being during the COVID-19 pandemic: a longitudinal study of U.S. adults with chronic health conditions. Wellbeing, Space and Society, 2:100048.

... and a possible way forward. By Tyler J. VanderWeele Ph.D. Key points Recent flourishing data indicate lower levels of well-being among young people. Life satisfaction in the United States is now strictly increasing with age. This is true for happiness, health, meaning, character, relationships, and financial stability. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. At the Human Flourishing Program at Harvard, we have been advocating more systematic measurement of well-being to better assess what is going well and what isn’t, how things are changing over time, who needs help, and in what ways. For the last couple of years, we have been reporting on nationally representative data within the United States on our flourishing assessment, covering numerous aspects of well-being, including happiness, health, meaning, character, social relationships, and financial stability. In a report we recently published in JAMA Psychiatry, we presented such flourishing assessment data for January 2022. Some signs are encouraging, and for some age groups, the self-reported scores are roughly similar to the national averages we'd reported before the pandemic. However, one particularly striking feature of this most recent data is that young adults (especially those aged 18-25 years) are not doing especially well, and they are not doing well across multiple aspects of well-being. Age and Well-Being The traditionally reported patterns of well-being and age have focused mostly on happiness and life satisfaction. These had suggested that the relationship between well-being and age was U-shaped, with younger people and older people generally doing better than those who are middle-aged. Many of those who were middle-aged were perhaps struggling both with young children and aging parents. However, over the past decade or so, the shape of this pattern of well-being with age changed in dramatic ways. In January 2022, the data indicate that, across the various dimensions of well-being, self-reported well-being scores strictly increase with age (see the figure below). This is true for happiness, but also for health, meaning, character, social relationships, and financial stability. The left part of the “U” has essentially completely flattened. Relatively speaking, young people are not doing as well as they once were. They report being less happy and less healthy; having less meaning, greater struggles with character, and poorer relationships; and less financially stable compared to their older counterparts. The differences in well-being with age were, in fact, much larger than they were for gender or race. There has been discussion of a national mental health crisis among youth. The present disconcerting data indicate that the crisis is much broader, embracing numerous aspects of flourishing, and with potentially dire implications for the future of our nation. Speculations Concerning Causes Data of the type we collected cannot tell us what is causing this well-being crisis. To try to tease apart causes, we generally need longitudinal data on the same group of individuals over time (as in our Global Flourishing Study). However, other data and studies might help give clues as to some of what might be occurring. Some of the difficulty may well be economic: With housing costs ever increasing, inflation high, and substantial education debt, it may seem difficult for young adults to have hope for a more stable future. Some of the issue may also pertain to a crisis in meaning. While universities have supplied increasing knowledge, it is not clear that they have done as good a job at providing comprehensive systems of meaning and understanding. Religions and philosophies have traditionally often supplied these, but participation in religious communities has declined substantially, especially among youth, which may also alter numerous other aspects of well-being. More prevalent crises in identity probably also do not help. In some places (at least according to my own experiences exploring educational options for my children), students are encouraged to wrestle with their own gender identity as early as kindergarten, which to me seems to be too early to address such questions. Geopolitical events and concerns ranging from the COVID-19 pandemic itself, to global warming, to threats of and realities of war, all also threaten well-being but may do so especially for those who have not lived much of life in more stable times. These issues are, of course, a concern in and of themselves, but a loss of frameworks of meaning may also exacerbate things. Some of the well-being troubles may also arise from technology and social media use. The effects of social media use on well-being do, perhaps, vary somewhat by mode of engagement. However, some of the best studies suggest that, at least on average, and especially for high rates of use, the effect of social media engagement on well-being is negative, and social media use is considerably higher among young people. A large part of the pattern we see with lower well-being among younger people might also have to do with the disproportionate social effects of the pandemic on relationships across age groups. Those who are older, who have had established relationships and longer-term community, have perhaps been able to better weather the pandemic conditions over the past couple of years. Those with existing relationships and communities can draw upon those resources and have been able to more easily re-engage as pandemic conditions have lightened. However, younger people often do not have these pre-existing relationships and communities—indeed it is this stage in life in which relationships and communities are formed, and opportunities for such formation have been very severely impeded these past two years. Political polarization may well be another cause. Such polarization has created hate and animosity, likely exacerbated by social media use, even to the point that political adversaries substantially misconceive the actual views of the other side. There seems less of an orientation to the common good. Weakening communities may also yet further be weakening a sense of the common good. A hateful, dysfunctional politics does not give rise to hope. Moreover, a proper orientation toward the common good should concern not only present circumstances, across both sides of the aisle, but also a common good oriented toward the future, toward economic and social policies that enable young people to advance, that help young people flourish, and that will sustain society for generations to come. It is not clear at present that we have this. The Way Forward Our data, unfortunately, do not provide solutions, but the data do make clear that there is a problem that needs to be addressed. Data of the type we have presented also do not tell us whether the patterns of age and well-being have altered so that, under the current societal structures, young people will eventually improve with age (what would be called an “age effect”) or, alternatively, if, given what has occurred and the experiences that have taken place, the current generation of young people will continue to struggle (what would be called a “cohort effect”). Some of this may depend on the actions that are taken in the years ahead. However, regardless of which of these two explanations, or some combination of the two, is correct, the crisis at present seems clear. We need to work on helping young people, of this generation and subsequent generations, to thrive. We need to foster systems of meaning and deeper engagement with the most fundamental questions of life. We need greater discipline in our social media use, from individuals to communities to corporations. Parents and schools could appropriately restrict use and also help teenagers and others to develop healthier patterns of use; corporations need to take well-being studies seriously, and design platforms that do not impede well-being. We need to focus on rebuilding relationships and communities post-pandemic. Finally, we need a politics more oriented toward the common good—both oriented toward the common good of the present but also toward the common good of the future, and of future generations. The well-being of our youth, and the future of our society, depend upon it. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Chen, Y., Cowden, R.G., Fulks, J., Plake, J.K., and VanderWeele, T.J. National data on age gradients in wellbeing among U.S. adults. JAMA Psychiatry, in press. Published online August 24, 2022. doi:10.1001/jamapsychiatry.2022.2473

Spirituality plays a role in both health and illness for many. By Tyler J. VanderWeele Ph.D. Key points Spiritual or religious community is an important health resource for many people. Many patients want their spirituality to be taken into account when they receive medical care. Many clinicians, however, lack training in spiritual care. To determine a patient's spiritual needs, or lack thereof, clinicians can take a brief spiritual history of patients. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. Spirituality and medicine have a long, intertwined, history. The very emergence of hospitals in the West arose in part out of the hospitality and care provided by monasteries. Many hospitals have since been founded by religious institutions, and much of medical care throughout the world is still provided by religious hospitals and medical mission efforts. Religious and spiritual life and community provide an important health resource for many people throughout the world. And many people’s medical decisions are shaped by their spiritual and religious beliefs. And yet, over the past century, we have also seen an increasing division between medicine and spirituality. Certain aspects of medical care have focused more on technology and on disease, than on the person. In many clinical settings, spiritual care is provided very infrequently, even in end-of-life contexts. Most clinicians report having received no training in providing spiritual care. The situation today in the West is very different than it has been throughout much of the past. During the past three years, several of us at the Human Flourishing Program at Harvard along with colleagues at the Initiative on Health, Religion, and Spirituality, and elsewhere, have been carrying out an extensive systematic review of the literature on spirituality in health and illness. That work was recently published in the Journal of the American Medical Association and we hope that it might help to re-integrate spirituality and medicine. Our Systematic Review Our systematic review attempted to survey all literature on spirituality and serious illness, and on spirituality and health outcomes, from January 2000 through April 2022. In total, 8,946 abstracts were reviewed for serious illness, and 6,485 for health outcomes. Strict criteria were used for study inclusion so as to focus on the most rigorous evidence including large sample sizes, validated measures and, for health outcomes, a longitudinal design. The literature was summarized and synthesized into a number of different potential evidence statements. We then formed a diverse panel of 27 experts to review the individual studies and summaries, to evaluate the strength of the evidence for the various summaries and statements, and to propose, and then quantitatively assess the support for, various possible implications of the research and evidence. Results and Evidence Based on the extensive review of the literature, and on evaluation of the evidence, the expert consensus panel concluded that, for serious illness, there was strong empirical support for several findings: spirituality is important for most patients; spiritual needs are common; spiritual care is frequently desired by patients; spiritual needs are infrequently addressed in medical care; spirituality can play a role in medical decision-making; spiritual care is infrequent in medical care; unaddressed spiritual needs are associated with poorer patient quality of life; and provision of spiritual care is associated with better patient end-of-life outcomes. The panel furthermore concluded that, for health outcomes, there was strong evidence that religious service attendance was associated with lower mortality risk; less smoking, alcohol, and drug use; better mental health; better quality of life; fewer subsequent depressive symptoms; and less frequent suicidal behaviors. For the associations between religious service attendance and health, meta-analyses of longitudinal studies indicated that those frequently attending religious services had a 27 percent lower risk of dying in follow-up and 33 percent lower odds of subsequently becoming depressed. Spirituality or spiritual community thus appeared to be important both in illness and in health. Practical Implications The expert consensus panel also proposed, and evaluated the empirical support for, various potential implications of the research. The three top-ranked recommendations for serious illness were to incorporate spiritual care into medical care of patients; include spiritual care training for medical students, clinicians, and others on medical teams; and ensure access to chaplains for those faced with serious illness. The three top-ranked recommendations for health outcomes were to have clinicians recognize and consider the beneficial associations between religious/spiritual community and health in providing person-centered care; increase awareness of public health professionals of the evidence on the protective health associations with religious/spiritual community participation; and recognize spirituality as a social factor associated with health. At a practical level, clinicians could take a brief spiritual history with questions like, “Is spirituality or faith important to you in thinking about your health and illness?” and “Do you have, or would you like to have, someone to talk to about spiritual or faith matters?” Such questions can be asked even if patients and clinicians do not share the same set of religious beliefs, and referrals can be made as appropriate. More frequently including chaplains on medical care teams would facilitate such referrals, and would help meet patient needs and patient desires to see these matters addressed. While the current paper focused on the implications for clinical care, we have discussed elsewhere the possible population health implications of such research as well. Encouragement to participate in community, religious or otherwise, could prove to be a powerful way to improve population health. Such encouragement might also help rebuild community in the wake of the pandemic. Even in clinical contexts, religious/spiritual community participation could be encouraged for those who already positively self-identify with a particular religious tradition, and participation in other forms of community could be encouraged for those without religious affiliations and beliefs. For those who have had past negative experiences in religious communities, referrals could be made to appropriate specialists who can provide care and support. Taking a spiritual history may help uncover these experiences. These simple practical steps may help re-integrate spirituality and medicine. Re-Integrating Spirituality and Medicine Many if not most patients want spiritual care when faced with serious illness. Spiritual community can itself be an important pathway for promoting health. Medicine and spirituality need not be kept separate. The practical steps of taking spiritual histories, providing training in spiritual care, and increasing awareness of community as a health asset could help bring about a re-integration of spirituality and medicine. Given that spiritual care both is desired and is an important resource, true person-centered care requires attention to these matters. True person-centered care requires the re-integration of spirituality and medicine. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Balboni, T.A., VanderWeele, T.J., Doan-Soares, S.D., Long, K.N.G., Ferrell, B., Fitchett, G., Koenig, H.G., Bain, P., Puchalski, C., Steinhauser, K.E., Sulmasy, D.P., and Koh, H.K. (2022). Spirituality in Serious Illness and Health. Journal of the American Medical Association (JAMA), 328:184-197. VanderWeele, T.J., Balboni, T.A., Koh, H.K. (2022). Religious service attendance and implications for clinical care, community participation and public health. American Journal of Epidemiology, 191:31-35.

What does Plato have to teach us today concerning work? By Tyler J. VanderWeele Ph.D. Key points To Plato, what people today call a "job" is the mastery of one part of reality that repairs a genuine need and contributes to the good. The Platonic tradition largely sees work as not changing the external environment but laboring on oneself. Work shapes one's character. Plato's "Republic" defines justice as each person doing his own job. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. One of the major research themes of the Human Flourishing Program at Harvard is work and well-being. We spend a great deal of our lives working, and what happens in the workplace affects the rest of our lives. Work has tremendous potential to enhance our well-being or inhibit it; to contribute to society or create challenges in people’s lives. When companies and individuals carry out work well, it can be one of the central pathways to flourishing. It can lead to greater engagement, help form character, be a forum for social relationships, and contribute to the good of society. Trying to understand how to best promote well-being in the workplace has been an important part of our empirical work. However, the role of work in human flourishing has received considerable attention in philosophical and theological writings as well, and reflection on these matters has likewise been an important part of the work of the Human Flourishing Program. In that regard, we are very pleased to announce the recent publication of a book by our Senior Philosopher, Jeffrey Hanson, on Philosophies of Work in the Platonic Tradition: A History of Labor and Human Flourishing. The remainder of this post provides a brief overview of some of the important ideas and themes that have emerged concerning work and well-being from this historic survey and its relevance for today; we’ll also be providing further coverage of the ideas and material in this book at a book launch webinar event on June 9th at 11:00 AM EST to which all are invited. To register click on this link: book launch. Plato on Work As noted above, the history of philosophy and theology offers rich resources for thinking about work and human flourishing, notably in the Platonic tradition. For this tradition, making is always moral. What kind of work we do and the conditions under which we do it are matters of ethical importance. For Plato, what the Greeks called techne is a kind of knowledge; techne is craft, which is the sort of activity that most people of Plato’s time occupied themselves with. That Plato has an interest in—and respect for—a variety of arts and crafts has long been acknowledged, but the reason for his interest has been much debated. Knowledge and Engagement Plato prized philosophical knowledge most of all, and he is rightfully acknowledged as the first major Western thinker to give his readers a comprehensive theory of what comprises philosophical wisdom. Part of that wisdom though includes techne, which explains why Plato himself thought the highest kind of philosophical wisdom would necessarily include a practical aspect: For him, wisdom is primarily theory but not exclusively. For the Platonic tradition, theory is always higher than practice. Nevertheless, Plato will frame the skills and crafts practiced by the ordinary people of his day as opportunities to glimpse in a limited way the highest realities that the philosopher contemplates in full. What most people did as what we would call a job is for Plato a kind of knowing. It is not the whole of knowledge and cannot be, but it is a mastery of some part of reality and a constructive response to it that repairs a genuine need and secures a worthwhile good. The carpenter, for example, knows wood, what it can bear, and how it can be shaped and cut and joined in order to produce a worthwhile object that in its small but inimitable way partakes of form and beauty. Philosophy and Work A philosopher will also be a maker of sorts. At the very least, the Platonic philosopher uses wisdom to make his or her own life morally excellent and aesthetically beautiful. In this way, all thinkers should also be doers. This maxim holds for all of Plato’s intellectual successors, from Socrates, the founder of Western philosophy and the hero of Plato’s writings, through the medieval Desert Fathers and Mothers, giants of church history like Augustine and Luther, to modern critics of the industrial age like John Ruskin and Simone Weil. For all these fascinating scholars of work, theory remains supreme, but action is a vital part of the theoretical life, so there is no final and sharp separation between them. We all need a constant interweaving of work and reflection, philosophizing and action, theory and practice. Work, Morality, and Character While contemporary social sciences tend to think of work as primarily concerned with making external changes to the world, for the Platonic tradition, work is always also laboring on oneself. Work thus is never merely an external phenomenon but also an inner dynamic. The Platonic tradition sees work as needed for any good at all and therefore not primarily about altering the environment. While work is done in response to a contemplated reality, it is also always done on oneself. The early monks, for example, understood this and did manual labor that was precisely not intended to make a profound change in the world but to change the self. They knew that what we do repeatedly, day in and day out, makes us who we are. Work shapes our character. In the Platonic tradition, work and morality are linked. All making is moral, and this is true in the first instance because work shapes the worker as above. But it is also true because the goods of work are also set in a social order, the justice of which is partly measured by the work done in it. What we work on, what we produce, what we do matters. Work and Justice Plato in fact sees a relationship between the individual soul and the city-state, which itself exists ultimately to allow for a just social order so that each individual can pursue her appointed task. The celebrated definition of justice in the Republic as each person doing his own job at first seems like a practical postulate, but in the end, rises to the level of a philosophical principle. This is because work is a way of participating in justice. That justice arises in a community in which everyone is not looking merely at their outward tasks but also looking after the quality of their own soul. Many of Plato’s followers thought the same, and we ourselves and our society would do well to likewise follow. Contemporary Situation The history of the philosophy of work in the Platonic tradition has a great deal of wisdom to offer us in our contemporary context. What we work on matters. It is a moral decision. Work shapes us, and what we produce in work shapes society. It can either contribute to or detract from justice. When carried out well, it can give rise to a sense of engagement, of knowing the material or craft in which we are involved, and of the interplay between reflection and practice. For those who are fortunate enough to have some degree of choice over their work, the choice both concerning what to work on and how to go about that work has an ethical dimension that we should take seriously, both as individuals and as a society. We should try to create workplaces and choose types of work that can contribute to the good and positively shape our own souls and those of others in society. Work is not the ultimate end. We work to provide goods and services to meet the needs of humanity; we work in part to shape our own character and soul; but the good of the soul—full human flourishing—is the end we are ultimately to be striving for. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Hanson, J. (2022). Philosophies of Work in the Platonic Tradition: A History of Labor and Human Flourishing. Bloomsbury.

We use techniques to deepen and broaden the social sciences. By Tyler J. VanderWeele Ph.D. Key points Discerning truth about flourishing requires good data and the most rigorous methodologies. Principles of causal inference, theoretically grounded measurement, and evidence synthesis are all important in discerning truth. Integrating further insights from philosophy, theology, and history enriches our understanding of what truly contributes to well-being. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. This post from the Human Flourishing Program at Harvard on methodology for flourishing is a bit more technical than others. Nonetheless, it seemed worthwhile to share a concise, synthetic account of our thinking to date about the best practices for investigating the constituents and causes of human flourishing. Employing the most rigorous methods not only enriches our understanding of flourishing, but is also crucial in ensuring the success of efforts to promote flourishing. Methodology for Flourishing To promote flourishing we must understand it. We must understand how it is distributed—who is flourishing and who is not and in what ways. We must also understand the factors that give rise to flourishing. Achieving such understanding is not necessarily an easy task. We need good data. We also need rigorous methodologies to help uncover the various determinants of flourishing. We thus seek to employ some of the most rigorous approaches to quantitative empirical analysis while also integrating this work with scholarship from the humanities. The program’s work has, in fact, helped pioneer new methodological approaches and some of these have arisen precisely from engagement with trying to study flourishing more comprehensively or from engagement with humanistic scholarship. The various approaches we have employed, and in some cases even developed, range from challenges in causal inference, to comprehensive analyses using outcome-wide studies or meta-analyses, to more integrative approaches to measurement and interfacing with the humanities. Causal Inference In our empirical work on the determinants of well-being, we try to employ, whenever possible, the most rigorous principles of causal inference, including employing longitudinal designs, rich confounder adjustment, controlling for baseline outcome and prior levels of exposure. We have published papers on study design considerations and confounding control principles summarizing the importance of these ideas. We also routinely use sensitivity analysis to assess how robust or sensitive our conclusions are to potential unmeasured confounding factors so as to better assess the strength of evidence. Some of our also work employs more sophisticated causal models such as marginal structural models and causal mediation analysis models to examine the effects of time-varying exposures or mechanisms. We have employed these approaches, for example, in our work on the effects of religious service attendance on mortality risk and depression and the potential mechanisms governing these relationships. Outcome-Wide Studies Most quantitative empirical studies attempting to assess causality examine only a single exposure and a single outcome. However, this does not allow one to easily see how the exposure or phenomenon under study may affect other outcomes, or what the relative effect magnitudes are, or whether there may be harmful effects on certain outcomes and beneficial effects on others. A more comprehensive study of flourishing requires examining multiple outcomes simultaneously. The outcome-wide longitudinal design developed at the program extends classical approaches for causal inference to examine multiple outcomes simultaneously. We have published both brief and more comprehensive introductions to this analytic approach and have used this approach to examine the effects on a wide range of outcomes of numerous psychosocial phenomena and exposures including parental warmth, parenting practices, religious service attendance, religious upbringing, forgiveness, social cohesion, volunteering, hope, purpose in life, life satisfaction, character strengths, and financial conditions. Meta-Analysis The strongest evidence often comes from meta-analyses that combine evidence over multiple studies. We have developed new metrics for meta-analyses that better characterize evidence when effects may be heterogeneous across settings and may manifest potentially beneficial effects in some contexts and detrimental effects in others. We have also developed methods to help assess whether meta-analyses are robust to potential unmeasured confounding and to publication bias (wherein some studies end up not being published in the research literature and are thereby excluded from such meta-analyses). We have used these approaches to help try to resolve controversies in meta-analysis around the effects of violent video games and media exposure on suicide, smoking, and sexual behaviors, as well as to gain additional insight into supportive employment interventions and job-crafting practices at work. Measurement The assessment of psychosocial constructs is a perennial challenge in attempts to study well-being. A large psychometric literature has developed along with a host of empirical methodological tools. Unfortunately, most of the empirical approaches are based purely on correlations and ignore potential causal relations between the potential factors under study. Most of the literature on psychometric assessment also tends to ignore the rich insights and important distinctions that have arisen within philosophy and theology concerning the relevant constructs. We attempt to develop a more integrated theory of measurement, taking into account causal relationships and incorporating insights and analytic frameworks and definitions from the philosophical and theological literatures. Although this more integrated approach is still under development, a number of important critiques of existing practices have already emerged, including issues concerning causal relationships between factors under study, differential causal relationships between different indicators of the same construct, and causal interpretation of composite measures using scales or indices. We have also been working towards incorporating insights from the philosophical and theological literature to produce more conceptually satisfactory measures of meaning, suffering, and spiritual well-being, and to likewise inform current projects on hope, optimism, and love. Humanistic Scholarship The study of flourishing is inherently interdisciplinary, with various disciplines providing important and distinct insights. Although much of our research is empirical, we also contribute humanities scholarship on well-being, including work in philosophy, theology, and history. Moreover, we are working towards trying to better integrate or synthesize knowledge across disciplines so as to allow insights from one discipline to contribute to the pursuits of another. Such work has included developing empirical hypotheses based on philosophical and theological traditions; allowing claims in the humanities to potentially be challenged and informed by empirical research; incorporating philosophical and theological insights and distinctions into measure development; using philosophy and theology to enrich the interpretation of empirical results; employing empirical social science research methodologies to evaluate interventions based on philosophical or theological insights; and bringing insights together from different disciplines and synthesizing them. We have written a short working paper on some of these approaches. While much work remains to be done in developing more systematic approaches to the integration of knowledge across disciplines, we remain committed to an interdisciplinary approach to the study of human flourishing and to continuing to explore how various academic disciplines might better engage with one another. We very much hope that the use of these various rigorous methodologies, and the integrating of insights from the humanities and social sciences, will help us better understand, and thereby also better promote, human flourishing. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Case, B.W. and VanderWeele, T.J. Integrating the humanities and the social sciences: six approaches and case studies. Harvard University Technical Report. VanderWeele, T.J. (2021). Can sophisticated study designs with regression analyses of observational data provide causal inferences? JAMA Psychiatry, 78:244-246. VanderWeele, T.J. (2019). Principles of confounder selection. European Journal of Epidemiology, 34:211-219. VanderWeele, T.J., Mathur, M.B., and Chen, Y. (2020). Outcome-wide longitudinal designs for causal inference: a new template for empirical studies. Statistical Science, 35:437-466. VanderWeele, T.J. (2017). Outcome-wide epidemiology. Epidemiology, 28:399-402. VanderWeele, T.J. and Ding, P. (2017). Sensitivity analysis in observational research: introducing the E-value. Annals of Internal Medicine, 167:268-274. VanderWeele, T.J., Jackson, J.W., and Li, S. (2016). Causal inference and longitudinal data: a case study of religion and mental health. Social Psychiatry and Psychiatric Epidemiology, 51:1457-1466. VanderWeele, T.J. (2015). Explanation in Causal Inference: Methods for Mediation and Interaction. New York: Oxford University Press. Mathur, M. and VanderWeele, T.J. (2020). Sensitivity analysis for unmeasured confounding in meta-analyses. Journal of the American Statistical Association, 115:163-172. Mathur, M. and VanderWeele, T.J. (2019). New metrics for meta-analyses of heterogeneous effects. Statistics in Medicine, 3:1336-1342. Mathur, M. and VanderWeele, T.J. (2020). Sensitivity analyses for publication bias in meta-analyses. Journal of the Royal Statistical Society, Series C, 69:1091-1119. VanderWeele, T.J. (2022). Constructed measures and causal inference: towards a new model of measurement for psychosocial constructs. Epidemiology, 33:141-151. VanderWeele, T.J. and Vansteelandt, S. (2022). A statistical test to reject the structural interpretation of a latent factor model. Harvard University Technical Report. VanderWeele, T.J. and Batty, C.J.K. (2022). On the dimensional indeterminacy of one-wave factor analysis under causal effects. Harvard University Technical Report.

Peace is a neglected aspect of well-being in the West. By Tyler J. VanderWeele Ph.D. Key points Concepts of harmony and peace have perhaps received greater attention in Eastern than in Western cultures. Gallup World Poll data suggests that peace and harmony are associated with, but also distinct from, happiness. Most of the world would prefer a calmer life to an exciting life. If we truly desire a lasting peace we must promote love for one another. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. The current crisis in Ukraine has made clear the fragility of our peace. As the war grinds on, many of us are hard-pressed to turn our thoughts from the images of desperate refugees fleeing the rubble of their once-beautiful cities. Of course, the toll is unimaginably greater for Ukrainians themselves, whether living at home or abroad, and for their friends or colleagues. Peace is threatened—peace in Ukraine, and peace throughout the world. We must hope and pray for a restoration or peace, for an end of warfare, and must aid those in need. The crisis in Ukraine has perhaps also made clear how often we take peace for granted. Peace has not featured prominently in contemporary Western discussions of psychological wellbeing. While matters of happiness, purpose, relationships, and sometimes mastery, autonomy, or character are given attention, peace, balance, and harmony seem to be more often neglected. We have suggested that when assessing wellbeing, a good place to begin is on those ends which are nearly universally desired. Matters of peace, balance, and harmony arguably fulfill these criteria, but perhaps are given more emphasis in Eastern cultures and traditions, although the return of war to the West has doubtless made many more conscious of the goods of peace and harmony as well. Empirical Study of Peace, Balance, and Harmony The present field of wellbeing studies would certainly benefit from further attention to both the conceptual and empirical aspects of peace, harmony, and balance, and we hope to contribute to this work. We will be including questions on peace and harmony/balance in our Global Flourishing Study. These will, however, be only single-item assessments, so their conceptual depth and coverage will be limited, but the study may, with time, give clues as to what factors tend to give rise to peace at individual and communal levels. We have also carried out some preliminary work on fuller assessments of peace. However, as part of our collaboration with the Global Wellbeing Initiative and Gallup’s World Poll, we have also recently obtained some preliminary cross-sectional data on peace and balance from 113 countries throughout the world. We have reported simple descriptive statistics, comparisons with life satisfaction, and associations with a handful of other variables in a chapter in the recently released 2022 World Happiness Report. The assessment for peace was as follows: “In general, do you feel at peace with your life, or not?” and also “Did you experience… feeling [calmness] during a lot of the day yesterday?” The assessment for harmony or balance was “In general, do you feel the various aspects of your life are in balance, or not?” While the word “balance” is often understood as equilibrium between two poles, “harmony” more generally connotes right relations among multiple aspects of life, so the item used in the Gallup World Poll arguably contains aspects of both. In contrast with happiness (concerning which European countries tend to dominate the rankings), the countries which reported the highest proportions of feeling at peace were somewhat more diverse. Leading the list were Netherlands (97.6 percent), followed by Iceland (97.3 percent), Taiwan (95.6 percent), Finland (95.1 percent), Norway (94.9 percent), Lithuania (94.6 percent), Saudi Arabia (94.6 percent), and Malta (94.4 percent). For calmness, by contrast, Vietnam (94.7 percent) topped the rankings, followed by Jamaica (93.8 percent), the Philippines (92.7 percent), Kyrgyzstan (91.8 percent), Finland (89.7 percent), Romania (88.8 percent), Estonia (88.8 percent), Portugal (88.2 percent), and Ghana (88.0 percent). The countries topping the list for balance/harmony were somewhat more similar, though not identical, to happiness rankings, and all were European. The peace and calmness assessments were also notably more weakly correlated with GDP than were the balance/harmony or happiness assessments. Several other interesting patterns emerged. First, when asked about preferences for a calm life versus an exciting life, 74.3 percent of respondents across the globe preferred a calm life, and only 17.3 percent an exciting life (8 percent said both, 0.4 percent said neither). Perhaps unsurprisingly, calmness and peace do clearly seem to be widely desired. Second, rankings of peace, calmness, and balance were, somewhat contrary to our expectations, not notably higher in East Asian countries than elsewhere. This does not necessarily mean that they are not given greater emphasis in the cultural, philosophical, and religious traditions there —and moreover, all of these assessments must be taken with a grain of salt, as standards for peace and harmony may differ—but in any case, the rankings above were not entirely what we had anticipated. Third, there was only a modest correlation of happiness/life evaluation with balance (0.25), calmness (0.11), and peace (0.25). These do seem like distinct aspects of well-being. Love and Peace How might we bring about a more peaceful harmonious world? Our chapter did also look at various social, demographic, national, and behavioral correlates of peace and harmony, but, since the data was cross-sectional, it is difficult to draw any firm causal conclusions. Nevertheless, one of the strongest correlates with peace was freedom; another was friendship support. Much work, however, remains in studying these relationships and the determinants of peace and harmony. Thomas Aquinas proposed that peace is an effect of charity, the love of God and neighbor. If our principal desires are aimed at both enjoying the good we find in others, and also in seeking the good for others, we will be more likely to attain peace. Well-ordered love helps us to be at peace with ourselves and also, in turn, to bring peace to others, even—or perhaps especially—in the face of grave injustice and danger. It is indeed arguably the lack of love, including a lack of proper respect for our neighbor, that is at the root of the war in Ukraine. It is a violation of love for neighbor that has brought about the war. The justification of war, if any, is, of course, a disputed topic, but classical just war theory specifies, among the conditions for a morally justified war, (i) just cause, (ii) just intent, and (iii) just conduct. All three seem to be violated in Russia’s aggression against Ukraine. Strikingly, Aquinas discusses war within his broader discussion of love (among the vices opposed to love). Aggression without just cause such as self-defense; without just intent to advance the good, restore peace and avoid evil; and without just conduct (e.g., the non-targeting of civilians) violates love of neighbor. It is wrong. The war in Ukraine creates a host of political, economic, and humanitarian complexities—complexities and dilemmas that must be faced without easy answers. However, looking forward, we should additionally think about prevention, about preserving peace, about how to avoid such crises in the years to come. These are arguably not only political or strategic questions, but also questions of character, of leadership, of what might be required to promote love of neighbor amongst leaders, and within society. If Aquinas is right that peace is itself the effect of love, then this topic needs greater attention both in our academic research and in our public discourse. We need to better understand how to preserve and promote peace and harmony, and if we are to promote peace, we also need to better understand how to promote love. Receive Tyler's monthly insight and research updates from the Human Flourishing Program team. References Lomas, T., Lai, A.Y., Shiba, K., Diego-Rosell, P., Uchida, Y., and VanderWeele, T.J., Insights from the first global survey of balance and harmony. World Happiness Report 2022, Chapter 6. Xi. J. and Lee, M.T. (2021). Inner peace as a contribution to human flourishing: A new scale developed from ancient wisdom. In: Lee, M.T., Kubzansky, L.D., and VanderWeele, T.J. Measuring Well-Being: Interdisciplinary Perspectives from the Social Sciences and the Humanities. Oxford University Press. VanderWeele, T.J. (2017). On the promotion of human flourishing. Proceedings of the National Academy of Sciences of the United States of America, 31:8148-8156.