Most of us will experience suffering at some point in life. It can creep up slowly through daily struggles, or it can overwhelm us suddenly in a moment of tragedy. While suffering is a shared human experience, each person’s suffering is often deeply personal. This can make it difficult to describe our own suffering or fully understand the suffering that others experience. Yet despite its widespread nature, suffering has received far less attention in population health research than many other aspects of well-being.
A lot of what we know about the experience of suffering has come from research within clinical settings or populations, such as people with cancer or those receiving end-of-life care. The Global Flourishing Study provides a unique opportunity to broaden this picture by providing insight into how common suffering is in the general population, who might be at higher risk of experiencing suffering, and how suffering can affect well-being.
How common is suffering across the world
The Global Flourishing Study follows people over time in 23 countries and territories to better understand what a flourishing life looks like in different parts of the world. In previous work using the first wave of data collected from more than 200,000 people in 2023, roughly 44% of adults across the included countries reported ‘some’ or ‘a lot’ of suffering in response to the following question: “To what extent are you suffering?” There was variation across countries, ranging from 24% in Poland to 60% in Turkey.
These findings suggest that suffering is not confined to clinical populations but is instead a common feature of everyday life across diverse societies and cultures.
Examining how suffering influences future well-being
In a new study, we used the first two waves of annual data to ask a new question: is suffering associated with well-being approximately one year later in national samples from 23 countries?
When results were pooled across countries, suffering was associated with worse well-being on more than 40 of the 56 outcomes examined, including lower happiness, relationship satisfaction, hope, and financial security.
While these observational findings do not definitively prove that experiencing suffering causes lower subsequent well-being, similar results have been reported in prior longitudinal research with smaller samples. The consistency of these findings across multiple countries strengthens evidence that suffering is closely linked with numerous dimensions of human flourishing over time.
Why everyday suffering deserves greater public attention
These findings show that there are many people who experience “everyday” forms of suffering that can affect well-being. This reinforces the importance of working toward a world with less preventable suffering. Many sources of suffering, such as violence, poverty, and neglect, could and should be reduced.
At the same time, we must be realistic. Some sources of suffering, such as the loss of a loved one or living with the consequences of a life-altering personal mistake, may not be fully preventable. In some cases, the suffering that is experienced may be fitting in response to loss, disappointment, or wrongdoing.
If suffering is not something we can avoid entirely, then it seems important for us to ask: how can people be appropriately supported when they experience suffering?
We cannot fully understand human flourishing without giving greater attention to human suffering.
—Richard G. Cowden
Expanding support beyond clinical care
One approach is to strengthen the availability of resources that can help people prepare for, endure, and respond constructively to suffering. These ends are already a priority in fields like medicine, palliative care, psychology, and psychiatry. But not everyone who experiences suffering necessarily needs formal treatment, intends to seek it, or can readily access it, even if they are likely to benefit from additional help.
This is why it may be important to make beneficial resources and support more widely available for the broader population, such as self-directed workbooks, psychoeducational groups, or community workshops. Expanding these accessible interventions could help bridge the gap between informal coping strategies and specialised clinical care, particularly in communities where mental health services are more limited.
Scalable community resources could improve resilience
The freely available TRANSCEND Suffering workbook is a self-guided tool designed to support people experiencing suffering. Developed to help individuals better understand and respond to difficult life experiences, the workbook offers practical exercises and evidence-informed strategies that users can complete independently.
Resources such as this can be flexibly adapted and scaled through health systems, workplaces, schools and universities, religious communities, and civic organizations in ways that are sensitive to local needs and contexts. Although scalable resources should not replace professional care when it is needed, they may help to fill an important gap by reaching a broader range of people outside clinical settings.
A broader vision for human flourishing
We might be tempted to think that a fully flourishing humanity is one in which nobody ever experiences suffering, but eliminating all suffering might not be realistic or even an ideal vision for humanity. A more suitable vision may be one in which preventable suffering is reduced wherever possible, and those who experience suffering have increased access to beneficial resources and support. By attending to suffering as a public health issue, it may strengthen our ability to reduce its burden and expand possibilities for human flourishing around the world.
Reference
Cowden, R. G., Padgett, R. N., Felton, C., Wilkinson, R., Macchia, L., Chen, Z. J., Weziak-Bialowolska, D., Koning, S. M., Gundersen, C., Johnson, B. R., & VanderWeele, T. J. (2026). Longitudinal associations of suffering with subsequent multidimensional well-being in the Global Flourishing Study. Communications Medicine. Advance online publication. https://doi.org/10.1038/s43856-026-01693-5
