Wise Ancestors, Good Ancestors: Why Mindfulness Matters in the Promotion of Planetary Health

Abstract

The concept of planetary health blurs the artificial lines between health at scales of person, place, and planet. It emphasizes the interconnected grand challenges of our time, and underscores the need for integration of biological, psychological, social, and cultural aspects of health in the modern environment. Here, in our Viewpoint article, we revisit vaccine pioneer Jonas Salk’s contention that wisdom is central to the concept of planetary health. Our perspective is centered on the idea that practical wisdom is associated with decision-making that leads to flourishing—the vitality and fullest potential of individuals, communities, and life on the planet as a whole. The SARS-CoV-2 pandemic has illustrated the acute consequences of unwise and mindless leadership; yet, wisdom and mindfulness, or lack thereof, is no less consequential to grotesque biodiversity losses, climate change, environmental degradation, resource depletion, the global burden of non-communicable diseases (NCDs), health inequalities, and social injustices. Since mindfulness is a teachable asset linked to both wisdom and flourishing, we argue that mindfulness deserves much greater attention in the context of planetary health.

1. Introduction

“I want those who follow us to look back on us as having been wise ancestors, good ancestors.”

Jonas Salk, 1984 [1]

The term planetary health, popularized in the 1980–90s, underscores that human health cannot be uncoupled from the health of natural systems within the Earth’s biosphere. Coincident with the rise of environmentalism in the 1970s, the artificially drawn lines between personal, public, and planetary health began to diminish [2].

Planetary health has been defined as the interdependent vitality of all natural and anthropogenic ecosystems; this vitality includes the biologically defined ecosystems (at micro, meso and macro scales) that favor biodiversity; it includes the more broadly defined human-constructed social, political, and economic ecosystems that favor health equity and flourishing (otherwise known as high-level wellness); this definition also includes the business ecosystems that influence sustainable and health-promoting local and global commerce [3]. As stated in the 2018 Canmore Declaration, attitudes, values, and behaviors, as well as personal, community and multinational relationships, are central determinants of planetary health; that is, human vitality (flourishing) depends intimately on planetary vitality that in turn depends on the behaviors of humankind, on human kindness, empathy, mutualism, responsibility, and reciprocity at the individual, community, societal and global levels.

Although best known for his pioneering work in vaccine development, physician-scientist Jonas Salk was a strong advocate for planetary health; in 1980 he emphasized the interwoven relationship between individual human health, and the health of the planet, underscoring that planetary health itself will have profound “biological and sociocultural influences on health throughout the human life span” [4] (Figure 1). Acknowledging the grand challenges facing humans on an ailing planet with finite resources, Salk focused on wisdom as the primary human asset that can determine health and quality of life in the here-and-now; moreover, wise judgements determine the fate of subsequent generations of all species, and the health of the planet. In his words: “Wisdom, understood as a new kind of strength, is a paramount necessity for [humans]. Now, even more than ever before, it is required as a basis of fitness, to maintain life itself on the face of this planet, and as an alternative to paths toward alienation or despair”[5].

Here, we revisit Salk’s contention that wisdom is central to the concept of planetary health. In particular, we highlight the emerging scientific study of wisdom, a body of research that was largely non-existent when Salk was writing in the 1970–80s. Our perspective is centered on the idea that practical wisdom is associated with decision-making that leads to human flourishing, a continuum between the vitality of the individual linked to the vitality of close and distant others [6]. As such, we examine some of the salient science surrounding flourishing as it pertains to planetary health. In this context, we explore mindfulness, the moment-to-moment awareness that is characterized by open, non-reactive, non-judgmental attention [7]. Since mindfulness is a teachable asset linked to both wisdom and flourishing, we argue that mindfulness deserves much greater attention in the context of planetary health.

2. What Is Wisdom?

“Wisdom is like love, intelligence, decency and justice in that it is a good thing to have and the more a person has of it, the better.”

John Kekes, Ph.D. 1982 [8].

Across cultures and over millennia, wisdom has been celebrated as a revered human asset [9]. From the Western perspective, early dictionaries separated wisdom from mere accumulation of knowledge, and underscored “mental and moral excellence” in the process of applying knowledge; in particular, the wise individual was defined as one who has “the power of discerning and judging correctly, of discriminating between what is true and what is false, between what is fit and proper and what is improper” while “choosing laudable ends and the best means to accomplish them” [10,11]. Aristotle’s perspective on practical wisdom centered on decision-making that ultimately serves broad aspects of human flourishing, rather than merely the personal health, wealth and ‘good life’ of the individual; specifically, moral virtues such as gratitude, trust, generosity, and honesty are central to the reasoning, judgements and decision-making that in the end, consider the consequences of wise decisions not only to the self, but to the flourishing of others [6,12].

Contemporary scientists and scholars in the field of wisdom studies define wisdom in a way that stays close to the 19th century dictionaries—according to consensus, wisdom is described as “morally-grounded excellence in social-cognitive processing”. Specifically, moral grounding refers to a group of inter-related aspirational goals: balance of self, pursuit of truth (vs. dishonesty), and pro-social orientation toward shared humanity. Excellence in social-cognitive processing, according to consensus, refers to the use of meta-cognition directed at reasoning and problem-solving in situational domains that have the potential to affect other people. This application draws on intellectual humility (awareness of one’s limited knowledge), context-adaptability (pragmatic reasoning, open-mindedness to change), perspectivism (considering different perspectives and long-term thinking), dialectical/reflective thinking (balancing and integration of viewpoints, including opposing perspectives), and epistemic/intellectual humility (e.g., unbiased/accurate thinking, seeing through illusions, understanding one’s limitations) [13].

The empirical study of wisdom has advanced through the development of models of wisdom and wisdom frameworks that seek to provide understanding and clarity on the characteristics of the construct [14,15]. Along the way, a variety of validated instruments such as the Self-Assessed Wisdom Scale, the Three-Dimensional Wisdom Scale, the Brief Wisdom Screening Scale, and the San Diego Wisdom Scale have been developed [16,17,18]; these scales can capture many of the features now viewed as critical components of wisdom—prosocial attitudes and behaviors (empathy and compassion), emotional regulation, social decision-making/pragmatic knowledge of life, reflection/self-understanding, tolerance of diverse values, humor, and the ability to effectively deal with uncertainty and ambiguity in life (see Box 1). Combined, research related to these instruments show wisdom to be a measurable personality trait that can be linked to many aspects of health, well-being and quality of life [19,20]; [21,22,23,24,25]; moreover, wisdom as a measurable construct can be examined vis à vis biological markers known to be associated with health and disease [26,27].

Box 1. The Wisdom Mindset.

Dr. Judith Gluck and colleagues (2019) state that wisdom is “deep, personal, experience-based knowledge about life that is acquired through and goes along with a certain mindset”. The hallmark of that mindset is “the willingness and ability to take a broad, non-self-centered perspective on life with the goal of understanding it in all its complexity; [individuals with] this mindset are more likely than others to learn more about life and accumulate wisdom-related knowledge over time, and they are more often able to deal with difficult situations wisely”. Dr. Gluck and colleagues conclude by emphasizing that a greater understanding of how we can foster the wisdom mindset “may be one of the most crucial questions for humanity at this point” [14].

With a greater understanding of wisdom as a human asset, and the obvious need for greater emphasis on wisdom in relation to the grand challenges currently faced by humanity, experts have begun to examine wisdom interventions. Based on a meta-analysis of 57 studies (involving over 7000 subjects), there is certainly evidence supporting the ability of interventions to enhance the components of wisdom—emotional regulation, prosocial behaviors, and spirituality in particular [28]. We will discuss aspects of these interventions in more detail below. For now, we transition the discourse toward the aim of wisdom in the 21st century—that is, flourishing for individuals, communities, and life on planet Earth.

3. Flourishing—People, Places, and Planet

The word flourishing is drawn from its Latin root floreo—to bloom. In the aforementioned 19th century dictionaries, the word bloom was defined as a “state of health and growth, promising perfection, a flourishing condition; a state full of life and vigor; a period of high success” [29]. Flourish was defined as “[growth] in honor, comfort and happiness, or whatever is desirable; to be increased with good things or qualities; to grow and augment; to thrive” [30]. In recent decades, researchers within health sciences have focused on flourishing as a measurable construct with relevance to individual and community health; available research links flourishing with healthier lifestyle decisions, including greater physical activity and fruit and vegetable intake, and lower consumption of sugary drinks, junk food and sweets [31]. Flourishing in early life predicts later life health and well-being [32], and lower levels of flourishing are associated with an elevated risk of all-cause mortality [33].

Although historical measures of flourishing tended to focus exclusively on psychological well-being (e.g., happiness or life satisfaction), the development of more sophisticated conceptional frameworks include domains of physical health, virtue strengths [34,35], meaning and purpose, and financial and material resources that are undeniably linked to sustained flourishing over time (see Box 2) [36]. In Western nations, those who score high on wellbeing scales perceive their family background as wealthy, rate their general health status as excellent, and report higher perceived social resource [37]; for example, optimism, a psychological asset oft-associated with flourishing and healthy lifestyle habits [38], does not sit on an equitable playing field—it is highly associated with socioeconomic advantage [39,40,41,42]. With consideration of financial and material resources within flourishing assessments, researchers can begin to connect personal and public health—the flourishing of individuals with that of communities, and humanity writ large [43].

Box 2. The WBA—An expansive flourishing assessment.

The Well-Being Assessment (WBA) developed by VanderWeele and colleagues is used to assess flourishing according to the framework described above. Specifically, the WBA evaluates six domains: (1) emotional health (e.g., “How satisfied are you with life as a whole these days?”); (2) physical health (e.g., “How would you rate your physical health?”); (3) meaning and purpose (e.g., “I have values and beliefs that help me understand who I am”); (4) character strengths (e.g., “I always act to promote good in all circumstances, even in difficult and challenging situations”); (5) social connectedness (e.g., “My relationships are as satisfying as I would want them to be”); (6) financial security (e.g., “I am able to meet my normal monthly living expenses without any difficulty”) [44].

The purpose and meaning component of the flourishing scale is also connected to wisdom [45,46]. For example, at least one longitudinal study has shown that wisdom predicts purpose in life, mastery, and subjective well-being rather than vice versa [47]. Since a sense of purpose predicts daily positive events and appears to promote affect stability [48], the upstream connection to wisdom is worthy of consideration (Figure 2). Purpose in life is connected to lower mortality and non-communicable disease risk [49,50,51] and the consideration of longer-term consequences of behavior [52]. Not surprisingly, prospective research shows that higher levels of purpose in life predicts greater use of preventive healthcare measures [53].

Questions related to flourishing, how it is obtained, and its relationship to health of persons, places (communities) and the planet (via pro-environmental behavior, considerate of next generations, and all species) abound. Is flourishing an upstream determinant of health, an outcome of health, or both? Black Americans have lower levels of flourishing than Whites, and Blacks with high levels of flourishing have the same mortality rate as Whites [54]. This underscores that flourishing is an asset that is not equally distributed through society and forces many urgent research questions. Consider that life expectancy (between 2008 and 2020) in the US has decreased disproportionally among Blacks, and previous gains in life expectancy have been erased. This stark reality reflects systemic racism and systems of power that unfairly disadvantage Blacks and other systematically marginalized groups [55,56]. It seems reasonable to assume that the determinants of flourishing are similar to those that determine overall health; thus, policy interventions that prevent the monopolization of valued resources by one group (to the exclusion of another group) will be central to closing the gaps in flourishing [54].

Since flourishing has drawn its research findings largely from Westernized nations, major gaps remain in the understanding of flourishing along culturally diverse populations, and in the Global South in particular [57]. Aside from flourishing specifically, even the analysis and reporting of Indigenous health (in general) has been approached from a Western medical view, with its descriptive and deficit-oriented approach—ignoring the holistic nature of Indigenous health [58]. The history of colonialism underscores that the flourishing of one community (e.g., settlers) has been at the expense of Indigenous peoples and others outside the structures of power [59].

Discussions of flourishing and wisdom will be enhanced by consideration (not appropriation) of Indigenous wisdom. As stated by scholars Edwina Pio and Sandra Waddock, Indigenous wisdom “encompasses the weave of Indigenous knowledge, values and worldviews which are part of the sacred ecology and relationship with the ecosystem, values, cultural beliefs and relationships that exist within Indigenous communities…this sacred ecology embraces a network of cosmologies, cultures, beliefs, and epistemologies, which underscore relational connections with all of nature, flora and fauna, and people in the web of life” [60]. Indigenous wisdom emphasizes a world view wherein global flourishing (at local and larger scales) is rooted in reciprocity, working with Nature respectfully in ways that are sustainable, and valuing human life as inseparable from all life—that is, valuing human life means caring and attending to the interdependent bio-community [61]. Indigenous wisdom, and the many examples of successful, long-lived societies and economies based on Indigenous knowledge, present a challenge to the neoliberal orthodoxy (with its emphasis on possessive individualism, acquisition, competition and ‘ownership’) that otherwise maintains an unhealthy status quo at scales of person, place and planet [60,62].

Refined assessments of flourishing open doors for valuable inquiry. Can we identify the specific ways in which human flourishing differentially impacts physical and mental health and vitality via moderating influences, such as social, psychological, or financial resources? Much has been written on allostatic load—the collective toll of physiological wear and tear via stress [63]—but what are the physiological or psychophysiological correlates of human flourishing that mediate its impact on health? Purpose in life predicts lower allostatic load [64] but what role does wisdom play? Can interventions—at the level of the individual and large scale societal—be designed to foster or increase human flourishing? [65,66]. We will address the latter question in the next section.

4. Can We Boost Wisdom, Flourishing?

“The faculty of voluntarily bringing back a wandering attention, over and over again, is the very root of judgement, character, and will…an education which should improve this faculty would be the education par excellence.”

William James, 1890 [67].

Wisdom and flourishing are complex multidimensional constructs, build upon several decades of theory and research that has emerged largely from the fields of psychology and philosophy. As we have described above, although they can be viewed as distinct, there are multiple points of convergence between wisdom and flourishing, and there is little doubt that both are important assets of high value to the domain of planetary health. While experts refine wisdom and flourishing scales, and the frameworks that underpin them, it is an urgent priority to assess the potential of interventions that might increase wisdom and increase the odds of flourishing.

There are several reasons why mindfulness—attentional focus on the present, momentary, experience, and regulation of emotions in the present moment via a nonjudgmental attitude [68]—emerges as salient in discourse related to wisdom and flourishing. First, correlations between high levels of wisdom and mindfulness [69] have been noted, and mindfulness has been identified as a predictor of wisdom [70,71]; second, mindfulness has also been correlated with human flourishing [72,73,74] and lower allostatic load [75]. Thirdly, in an era where the need for wise leaders is an urgent priority, it is worth noting the emerging research demonstrating that mindfulness among leaders in various workplaces has a positive influence on employee wellbeing [76,77,78,79]. Indeed, because mindfulness training directed at policy makers seems to provoke enthusiasm for policy that tackles society’s problems at the level of the human heart and mind, mindfulness has been identified as a potential upstream driver of flourishing in society more broadly [80], particularly when introduced early in life during periods of developmental plasticity (Figure 3).

Before exploring some of the pertinent mindfulness research in detail, we underscore that it is not our intention to infer that mindfulness is the sole or even a primary pathway to dismantling the structural poverty, racism, settler colonialism and neoliberal orthodoxy that underpins ill-health and even the opportunities to flourish. Indeed, the term “McMindfulness” underscores the “business of mindfulness” and the mass-market techniques (similar to those of the McDonald’s fast-food chain) that end up “decontextualizing mindfulness from its original liberative and transformative purpose” [81]. It has been suggested that mass-market mindfulness masks (or even incorporates into the person’s worldview) the neoliberal systems (maintained through dynamics of power associated with affluence, militarism, and coercive relations [82]) that otherwise maintain ill-health at all scales [83]. Thus, it is our contention that the research discussed below can be viewed through a lens that might serve to challenge the unhealthy status quo, while at the same time promoting health of persons, places and the planet as a whole [84].

Mindfulness interventions have been the subject of volumes of international research, especially in the last two decades; these include but are not limited to, acceptance-based therapy, mindfulness-based stress reduction, mindfulness-based cognitive therapy, and dialectical behavior therapy [85]. Although the focus has typically been on outcomes such as stress, anxiety, depressive symptoms and individual happiness [86], the application of mindfulness as a means to raise awareness of, and action toward (transforming), poverty, racism and structural injustices, has been explored [87]. Mindfulness provides insulation against misinformation and may diminish the credibility of fake news and curb the spread of misinformation on social media [88,89,90]. Research shows that mindfulness develops “mental capital”, encouraging a curious, responsive, and creative engagement to experience that, at least in some settings, leads to wise decision-making among leaders [91]; on the other hand, as demonstrated during the ongoing SARS-CoV-2 pandemic, the consequences of mindless and unwise decision-making by leaders can be fatal [92].

The mechanisms by which mindfulness mediates flourishing (and spills over to the wellbeing of others) has been explored by various international researchers. Mindfulness predicts moral responsibility [93] and is associated with cognitive empathy [94], prosocial behavior [95], and ethical decision-making [96]; mindfulness appears to foster solution-focused thinking; such thinking involves focusing on goals, looking into unnoticed resources, and finding ways to achieve; in particular, attention-awareness to the present moment enhances goal orientation and resource activation [97]. Mindfulness can lead to awareness of otherwise unrecognized vitality in a person; this is at least one way in which mindfulness can promote posttraumatic growth as a result of the struggle with highly challenging life circumstances [98]. The lessons of mindfulness in the context of posttraumatic growth might apply at larger scales of organizations, communities, or societies [99].

In the workplace, the link between higher mindfulness among leaders and larger groups appears to be mediated, at least in part, by procedural justice enactment [77,78]. This construct is a measure of the extent to which a leader is viewed as upholding fair procedural rules such as voice, accuracy, and timeliness in the decision-making process; procedural justice enactment is viewed as a moral imperative that considers employees to be part of a respected collective in which personal goals beyond that of the leader are considered [100]. The personal mindfulness levels of those in the sphere of mindful leaders also matters to positive well-being outcomes [79]—much like the discourse on wise leaders in local and global communities, everyone’s attitudes, judgements and behaviors have impact on outcomes [92].

In the study of mindfulness-enhancing techniques in professional settings, loving-kindness meditation (LKM) has emerged as a viable candidate. Research shows that LKM can be used to facilitate kindness and compassion for oneself, distant others, the natural environment, and the world-at-large [101]; LKM increases awareness in an open and non-judgmental way; studies have shown that the practice improves mental health and well-being [102,103,104]. LKM procedures vary, yet it is generally a process of goodwill. For example, one might call to mind a particular person (e.g., a neighbor, a distant other) and silently repeat phrases that invoke goodwill, such as “may you be safe,” “may you be happy,” and “may you be healthy” [105,106]. Generally, the practice is intended to work in a stepwise fashion, initially directed at the self and loved ones, and outward toward acquaintances, strangers, and finally, all forms of life. In the context of planetary health and unprecedented biodiversity losses, the latter would seem to be an important consideration. In a brief LKM-like intervention (referred to as befriending meditation), the practice has been shown to reduce affective polarization between Democrats and Republicans by increasing positive feelings relatively more for the political outgroup than the political ingroup [107]. Preliminary research shows that among its potential benefits, LKM increases mindfulness [108].

Emerging research shows that organizational mindfulness is positively related to the ethical behavior of organizations; companies that rate high in mindfulness (measured via an 8-question Organizational Mindfulness scale) appear to be more aware of their environment and more conscious of ethical considerations [109]. Thus, it is now possible to imagine the large-scale implications of mindfulness, and the need to incorporate mindfulness within the planetary health paradigm.

Returning now to Salk’s notion that we must be “wise ancestors” in the here-and-now, it seems obvious that many of the ways in which mindfulness is connected to the flourishing of individuals and larger groups is in line with the features that define wisdom (Figure 4). Recall, wisdom is morally grounded excellence in meta-cognition that considers the balancing of diverse and often-conflicting interests. There is little question that wise policymakers engage in such balancing, as do leaders in all manner of capacities. The question for those interested in current and future health at scales of person, places, and planet, is whether or not wisdom can be “boosted”.

It is perhaps unsurprising that among the various wisdom-enhancing techniques used by educators, mindfulness is an important component [110,111]. In particular, “self-distancing”—adopting a “detached” or ego-decentered viewpoint, a central component of mindfulness—is emerging as one of the most effective strategies; this involves adopting a “detached” or ego-decentered viewpoint while reflecting on past (or imagined future) experiences of adversity. This process is often described as a “fly on the wall” perspective, with the reflection using third person language (as opposed to first person, self-immersed reflection). Self-distancing leads to lower levels of negative affect and physiological reactivity after reflecting on past events, and reduces emotional reactivity about future stressors [112,113]. Several experimental studies indicate that self-distancing can promote wise reasoning [14,114,115,116]. For example, experiments demonstrate that cueing people to reason about personally meaningful issues (e.g., career prospects for the unemployed during an economic recession; anticipated societal changes associated with one’s chosen candidate losing the 2008 U.S. Presidential election) from a distanced perspective enhances wise reasoning (dialecticism; intellectual humility), attitudes (cooperation-related attitude assimilation), and behavior (willingness to join a bipartisan group) [115].

Finally, it is worth noting that mindfulness is a key component of the skills development that characterizes acceptance and commitment therapy (ACT). Over the last quarter-century, ACT has strengthened its evidence base, and has been shown to help individuals productively adapt to challenges that are part of the human experience [117,118]. Through the development of greater psychological flexibility, individuals purposefully remain in the present moment by being mindful of thoughts, feelings, and bodily sensations; in addition, ACT clarifies fundamental hopes, values, and goals and cultivates a commitment to behaviors that are in accordance with these core values [119,120]. It would be interesting to determine if ACT interventions lead to specific changes in wisdom and flourishing at the individual, and perhaps larger community scales.

5. Conclusions

“Will we have the wisdom to perceive the long as well as the short-term advantages in the choices we make, so as to enhance the quality of our own lives and of the lives of the generations to follow? Will future generations speak of the wisdom of their ancestors, as we are inclined to speak of ours? It is relevant, and even part of wisdom to ask not only are we being good citizens of the world today, but are we being good ancestors.”

Jonas Salk, 1977 [121].

Planetary health is defined as the interdependent sustainable vitality (flourishing) of all natural and anthropogenic ecosystems. In this context, the many signs and symptoms of planetary ill-health and “dis-ease” can be captured under the umbrella of “Anthropocene Syndrome”. These include, but are not limited to, unfathomable biodiversity losses, climate change, social injustices, environmental degradation, resource depletion, the global burden of non-communicable diseases (NCDs), health and income inequalities, the spread of ultra-processed foods, consumerism, polarization, and incivility in tandem with a diminished emphasis on the unity of all humankind [122]. The consequences of unwise and mindless actions by leaders (and followers) in the face of any aspect of Anthropocene Syndrome can be catastrophic for health in the here-and-now, and for that of future generations.

Despite the obvious importance of mindfulness and wisdom as a path toward transforming values, strengths and actions that might promote health equity along the person, place and planet continuum, these overlapping constructs have received little attention in the planetary health discourse. In the acute phase, the lesson of SARS-CoV-2 is that we ignore the collective body of research on mindfulness and wisdom at our peril.

Of course, it is not our contention that mindfulness is a panacea for the problems faced by humanity [123], or that the wisest individuals and groups cannot commit reckless acts; rather, our argument is that the available evidence indicates that the study of wisdom (and one of its related components, mindfulness) should be at the core of the planetary health paradigm. The extent to which individuals and groups apply different types of intelligence and creativity toward a morally grounded common good—by balancing their own interests, the interests of others, and the interests of organizations/supra-individual entities (over the long and short terms, through the infusion of values) [124]—is at the heart of wisdom studies. It is also at the heart of understanding how we can shape healthy, equitable, sustainable, and flourishing environments.