What’s next for compassion science? A multi-scalar framework for measurement and public health action

Abstract

Current approaches in compassion science, focused on individual traits and self-report, are insufficient for a public health agenda. This article proposes a multi-scalar epidemiology of compassion, expanding it from an internal state to an enacted, transpersonal skill shaped by systems. It argues that compassion is not only a trainable skill but also an innate capacity that can be unfettered by supportive structures. Our framework outlines measurement and action across three levels. At the micro-level, we call for moving beyond self-report to performance-based and physiological measures of dyadic interaction. At the meso-level, we propose ethnographic and network-based methods to assess "ecologies of compassion" in workplaces and schools. At the macro-level, we conceptualize "structural compassion"—the institutionalization of care through policy and economic systems—and propose developing indices for its measurement. This model emphasizes compassion’s cognitive dimension, aligning it with public health strategies that address deficits in understanding, not just emotion. By integrating contemplative science for testable interventions, this framework provides a robust research agenda to inform policies that build more resilient and caring societies by removing systemic barriers and creating enabling structures for care to flourish.