Longitudinal Associations of Suffering with Subsequent Multidimensional Well-Being in the Global Flourishing Study

Background: Suffering is an undesired experiential state that can degrade well-being, but few studies have explored its potential impact on well-being at the population level. Methods: Using nationally representative samples from 23 countries and territories in the Global Flourishing Study (N = 207,919), this preregistered longitudinal study examined associations between suffering and multidimensional well-being outcomes assessed approximately one year later. Following the analytic template for outcome-wide designs, we conducted a series of country-specific weighted regression analyses where each Wave 2 outcome was regressed on Wave 1 suffering (controlling for Wave 1 demographic and childhood variables). Random effects meta-analyses were used to pool country-specific effect estimates for the 56 main outcomes encompassing psychological, social, physical, volitional, and material dimensions of well-being. Results: The cross-national meta-analyses provided some evidence of associations between suffering and worse well-being for both composite well-being indicators and most specific well-being indicators across different domains of functioning. Somewhat stronger and more consistent associations with worse well-being were observed for some domains (e.g., psychological well-being) compared to others (e.g., social participation). Effect estimates generally attenuated after applying a more conservative analytic approach that included additional adjustment for principal components extracted from the Wave 1 outcomes. Country-specific estimates showed some cross-national variation. Conclusions: Our findings provide novel population-level evidence on the implications of suffering for various aspects of well-being in a diverse set of contexts. We discuss some potential implications for implementing scalable interventions and informing public policy aimed at reducing the burden of human suffering.