Journal of Integrative and Complementary MedicineVol. 29, No. 5 EditorialFree AccessFeeling Good, Living Well: The Importance of Happiness for HealthHolger CramerHolger CramerAddress correspondence to: Holger Cramer, PhD, Institute of General Practice and Interprofessional Care, University Hospital Tu¨bingen, Osianderstraße 5, Tu¨bingen 72076, Germany E-mail Address: holger.cramer@med.uni-tuebingen.dehttps://orcid.org/0000-0002-3640-8046Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.Bosch Health Campus, Stuttgart, Germany.Search for more papers by this authorPublished Online:15 May 2023https://doi.org/10.1089/jicm.2023.0176AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail No medicine cures what happiness cannot.Gabriel García Márquez (1927–2014)Happiness is healthful. Meta-analyses show that happiness is associated with lower mortality.1 Yet, just as health is not simply the absence of disease, happiness is not simply the absence of unhappiness. Although negative emotions and depression are associated with a higher burden of disease, the positive association between happiness and health is probably independent of this.1Accordingly, the investigation and promotion of happiness should be an important goal of public health.A few weeks ago, on March 20, 2023, this year's World Happiness Report (WHR) was published—exactly 10 years after March 20 was declared the International Day of Happiness. Based on the idea of the then, and first democratically elected, Bhutanese Prime Minister Lyonpo Jigme Yoser Thinley that the success of a nation should be measured by Gross Domestic Happiness instead of Gross Domestic Product, the WHR measures the happiness of the inhabitants of the world's nations.2 What a grandiose, and above all almost trivially obvious idea: to define the success of a nation as the happiness of its inhabitants.At the core of the WHR is the Gallup World Poll's life evaluation question. Here, respondents are asked to compare their current life with the best possible life and the worst possible life. About 1000 such assessments are collected per country and year and weighted to be representative of the country's population. The WHR then bases its happiness rankings on a 3-year average of these life assessments.2This year, for the sixth year in a row, Finland won first place as the happiest nation in the world. The United States came 15th, still one place better than us notoriously unhappy Germans. The unhappiest nation was Afghanistan, a constant even before the Taliban regained power, interestingly enough. On the life evaluation question's 0–10 scale, the Finns scored a mean of 7.8, the United States and Germany both 6.9, China 5.8, and Afghanistan 1.9.2 The latter is shockingly low but not really a surprise given decades of wars, terror, poverty, and suppression. It seems easy to imagine a better life when living in Afghanistan.But why are Finns the happiest people in the world? Finland's high ranking in the WHR may be attributed to a range of factors, including a strong sense of community, a focus on work-life balance, an excellent education system, and a love of nature. These factors can contribute to a society that values well-being, equality, and social support, and in turn lead to a high level of happiness and life satisfaction. Originally, I wanted to write about the Finnish sauna tradition, which is certainly not only beneficial for health but also for the mind, especially in a rather cold northern country such as Finland. However, while researching for this editorial, I came across a much more fascinating topic: the Finnish psyche. Here one almost automatically comes across the concept of “sisu”.3Sisu is a Finnish word with no real equivalent in English that refers to an extraordinary quality of persistence and resilience, especially in the face of adversity or challenge. It is often translated into English as “grit,” “determination,” or “resilience,” but it encompasses a broader sense of courage, bravery, and perseverance.In Finnish culture, sisu is highly valued and considered to be a defining characteristic of the Finnish people. It is often cited as a key factor in Finland's success as a nation, both historically and in modern times. This is because sisu encourages people to persevere through difficult times and to find meaning and purpose in their lives, even in the face of adversity.The Finnish people have a long history of resilience and determination, dating back to their struggles against harsh winters, difficult living conditions, and invasions from neighboring countries. Sisu is said as having helped them to persevere through these challenges and to build a strong independent nation, and to create a society that values community, equality, and well-being for all.In many ways, sisu is seen as a key factor in the Finnish approach to life. It encourages people to embrace challenges and to find meaning and purpose in their struggles. This, in turn, leads to a greater sense of fulfillment, happiness, and well-being: it is not (only) the conditions under which we live that determine our happiness, but rather how we deal with them. And resilience might be crucial here.An astonishing result of the WHR: the average global happiness in 2020–2023 was largely the same as in 2017–2019,2 meaning that 3 years of the pandemic were not enough to take away humanity's happiness. A powerful message that underlines how resilient humanity as a whole is. It seems that sisu is not a purely Finnish trait after all. In fact, despite its social distancing imperative, the pandemic does not seem to have encouraged antisocial behavior at all: WHR records a global “surge of benevolence”2 that peaked in 2021 but still manifested itself in a quarter more prosocial acts in 2022 than in prepandemic times. And altruism, according to one core finding, makes people happy, especially the altruists themselves.4 And not only this, altruism also boosts our health.5Perhaps this should be revealed to the egoists, who could then be altruistic without hindrance—for purely egoistic motives.