At first glance happiness from a biological perspective is easy to understand. Its hormones, stupid, that regulates it all. Only problem, there are many of them that interact and, apparently, a lot depends on the right dosis and duration of exposure or deficiency. Oxytocin deficiency seems to be a corollary of anxiety and lack of pro-social behavior, potentially making people less happy – to put it bluntly. There are other complex interactions between hormones not only in the circadian circle of humans like for cortisol, but also related to differential reactions to stress. Genetics and epigenetics are involved as well stress regulation and early exposition to stress during the life course has longer lasting consequences later on. How much stress is good for you? Climbing Mountains induces physical stress, but most people report lasting happiness referring back to such singular events. Hormones seem to play tricks with us as well.
Some time after the novel “Klara and the Sun“, endocrinologists have documented the positive effect of a robot on oxytocin levels in humans. Improvements to mental health and well-being are apparently easy considering that oxytocin is a driver of feeling happy as well. Maybe we should take our depressors and drivers of oxytocin more seriously to be “biologically” happy.
(Image: Extrait Frans Hals 1660, Catharina Hooft and her nurse. Exhibition Gemäldegalerie Berlin 2024) 
Happy Employee
The research on happiness, subjective well-being or overall satisfaction with your life is also an empirical question. Analyses of being happy donot only focus of overall happiness, but look much more into the details of happiness. Beyond the tricky longitudinal observations of happiness it is common scientific practice to deal with subdomains of happiness like satisfaction of employees with their job, satisfaction with one’s job beyond the honeymoon and hangover effect, best known from family studies.
Each of those subdomains has a significant effect on overall happiness. The novel “Happy Life” by David Foenkinos is an interesting example which focuses mainly on the subdomains of job satisfaction, satisfaction with private and romantic partners as the major domains of a happy life. As developed in the novel, people make job changes to re-orientate professional careers or reset their private life. A low point on the happiness scale in one domain might be compensated by higher levels in another domain. These impact from one domaine to another might have substantial time lags involved as well. More drastic resets (à la Foenkinos) can be avoided through focus on other subdomains of overall happiness as well.
How happy are you with your housing situation, neighborhood, your pet, your physical health? There a multiple +/-spill-over effects to overall happiness. Reading a novel might be one as well, just take time reserved to yourself.(Image BnF expo “women in sport”, 20024)

Own Insulin
People who suffer from type 1 diabetes do not produce enough insulin themselves. The World Health organization estimated that „in 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries“ (WHO 2023). The report on successful reprogramming of stem cells of a person to produce insulin again and subsequently transplanting these cells into the same person allowed to produce own insulin again for that same person (Mallapaty, 2024). The hope for millions of people with type 1 diabetes is high that eventually there will be a cure to the disease. Scientists caution that there are no data yet for how long the transplanted own stem cells will produce insulin. Hence, the hope is driving research forward on a promising way forward. The case of type 2 diabetes is very different as additionally the absorption of insulin in the body causes problems. We keep walking and building muscles to facilitate the insulin absorption in the body to guard against the onset of type 2 diabetes. Interaction of diabetes and aging is another topic that needs our attention as rapidly aging societies are at higher risks to face many more people with various forms of diabetes.

Walking Danger
Autumn brings color into nature. This is for some the bright side of life. However, the sun sets much earlier every day and many people begin to walk to school or work and back during the dark time of the day. Unfortunately, this entails an additional danger to those walking the cities as bad light conditions cause many accidents of pedestrians. The statistics provided by Destatis (2024) for Germany show a marked increase of walking accidents from September onwards and lasting throughout winter. Equip yourself with bright colors and reflectors to avoid being a walker in danger or a walking danger. On Sunday it is pretty safe to go for a stroll. City life is less stressful and professionals in a hurry usually take a rest on that day. The conclusion is to choose your track wisely in order to feel safe on weekdays.

Waiting time
A new report by Darzi, a former cancer surgeon and past minister of health in the UK, paints a dismal picture of the British health service (NHS) over the last 15 years under conservative rule. The public service has seen no increase in its budget accounting for population growth and the aging of the population. The service is no longer able “to give patients the timely care they need” (The Guardian 2024-9-12 title page). Increased waiting times lead to an estimated 14.000 premature deaths per year. Darzi presents data that show 300.000 persons had to wait longer than one year for a treatment that should have been performed within 18 weeks.
The staff seems desperate for changes as well as they have to spend more time on management of waiting times, time which is lost for real treatment. The quality of care is another issue which awaits urgent attention. Health cannot wait for most patients, but the neglect of investment in hospitals and people is expensive in the longer run. Even the reform efforts should not wait any longer. Time is a precious good and each life matters. (Image back cover of exhibition catalogue Käthe Kollwitz at MOMA 2024).

Health GDP
A report by the WHO and the World Bank (2023) on universal health coverage and financial hardship has emphasized the difficulties to reach the goals defined by the strategic development goals (SDGs) by 2030 in this policy field. Moreover, the paper by Mazzucato and Ghebreyesus (2024) invites us to reconsider the importance of health in the overall assessment of development and progress. The authors ask us to “rethink the narrow focus on growth in gross domestic product (GDP) that typically dominates economic decision making”. There is of course a long debate on the status of health, GDP or wellbeing as major policy issues or even foundations of the a state’s major objective. For economists the question has been answered for decades to favor GDP growth and more or less the other objectives can be achieved with a time delay. Recently social scientists have highlighted the overall importance of wellbeing or happiness rather than GDP as stated in some constitutions. Health as an overall objective is another challenge to the existing economic framing of societies. In a traditional economic perspective the health sector is part of the GDP increasing public and private sector of the economy with insurers, equipment and persons contributing to it. On the other hand, health enters into the distribution or consumption part of the economy. Each country strikes its own balance between production and consumption. Put simply, in form of an equation where production equals consumption, health enters on both sides of the equation in each country. On the global, scale the distribution between costs and benefits of health have not narrowed over the past. The challenge for the world population remains steep. Considering unequal population growth across continents, the situation might get worse before it hopefully gets better. We still have to continue huge efforts to increase overall health on earth for example through large scale vaccination programs. (Image The tombstone of Molière in Paris 2024)

Desertification
Since 2018 we have evidence of the progression of desertification into some Member States of the European Union. The mediterranean countries are concerned as well as regions of Bulgaria and Romania near the Black Sea. There are multiple sources of desertification. The 3 main reasons of desertification are soil erosion, loss of soil fertility and loss of natural and desirable vegetation besides wind or water erosion and salinization. We also know that man-made climate change is at the root of the past and recent problems. The statistical indicators of land degradation are collected by the European Joint Research Centre and these data show a dismal picture of land degradation in general and desertification as part of this process. A study by Ilea et al. published in Nature 2024 projects an intensification of extreme weather in the coming years. Higher temperatures will most likely enhance desertification and more frequent flooding will contribute to more soil erosion as well. It is a rather strange process that we know we are creating severe problems for some regions which endanger the roots of their existence and yet we do not act upon those undeniable facts (United Nations SDGs list). The amount and dynamics of land deterioration put the global South under severe pressure, but also the wealthy parts of the Mediterranean basin will be affected. It about time to acknowledge that we are all part of the global changes and challenges. (Image palm tree in Paris, Jardin du Luxembourg, 2024)

Heat Stress
Heat causes cardiovascular and pulmonary stress. This has been well-known for a long time. A newly published epidemiological study for Germany reiterates this finding and adds more details to the picture of who is affected most by heat stress and heat-related mortality. Old age and being female increase the heat-related deaths in Germany according to the study by Zhang et al. (2024) published in the Lancet Regional Health. Our body’s thermoregular responses to heat stress like vasodilation or hyperventilation cause additional stress to our cardiovascular and pulmonary system. Excessive sweating and dehydration, possibly increased through medication, amplify heat-related risks. The study corrects the estimates by using fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) data on the district level in the analysis. High concentrations of PM2.5 and NO2 increase heat stress and related deaths as well. Inner cities are, therefore, not the best place to be during the hot season. Most southern European inhabitants of big cities are aware of these health hazards and act accordingly. In Germany it is much less a habit to quit inner cities during the hot days in summer, but climate change will make this a major concern. Greening inner cities is an urgent necessity, which is not just nice to have, but saves lives. (Image Berlin Bears, Berlin City Center 2023)

Paralympic Happiness
It is with great pleasure that we watch the paralympic athletes in Paris compete for Olympic medals. For many the emotions of participation and being applauded by so many people in a sport arena are great experiences. Happiness derives from such great games and audiences. The accomplishments of the athletes and their supporting teams are truly outstanding. The progress towards such high skill levels is remarkable for each of them. The adaptation to what appears to be a handicap with adequate support and technique allows to surpass limitations. Well exercised skills like swimming are possible to be performed with great skill to achieve incredible performances. The Paralympic Games in Paris 2024 are a great reminder that besides the athletes some artists had to struggle with handicaps, but achieved some of the finest pieces of art. Matisse, for example, is called frequently “le peintre-du-bonheur”, the painter of happiness. In his last few years he faced a severe handicap to paint, however the pursuit of abstraction helped him to continue to create masterpieces. The rather radical pursuit of abstraction and maybe simplification are uncovered in the exhibition “Matisse: The red studio” at the “Fondation Louis Vuitton”. This marks an important step in the artistic life course of Matisse and enabled him to continue his work in later life when his health made it very difficult to pursue his artistic work. (Image at Fondation Louis Vuitton 2024-9-1 exhibition Matisse).

Olympics for All
The Paris 2024 Olympic Games and the Paralympic Games have demonstrated the extraordinary competence, professionalism and competitiveness of all athletes. The television spectators and live participants in the events have been involved to a great deal.
After all this hype around sports let us consider the probability of getting involved in physical activities and sports. Additionally, it is of interest, whether people are encouraged to continue sports, maybe at higher ages as well through these sports events like Olympia.
High level athletes are most likely to continue their sports activities. In many countries the extraordinary athletes of the Paralympics faced tough challenges to pursue their sport interests and passion.
However, the public health challenge is the big unresolved issue of how to best raise an awareness for the pleasures and benefits of sport for the masses. (bibliography by BNF “Santé et activité physique). It is not only a matter of suitable infrastructure, but also the question of sports in your neighbourhood. This issue has implications for urban and rural communities and how they organize the practice of sports in an inclusive way. Each step may be a stepping stone into sports for all ages and pathologies.
The pleasure and benefit to walk or something simple as walking to or walking after work, are part of the solution to many public health issues.
The visitors of the Paris Olympics walked a lot.
This fun experience in an enthusiastic city will encourage many to continue the simple exercise without thinking about exercise. This will do the trick. Just do it, without thinking to much about it.

