International Journal of Wellbeing

Beyond asymmetry: An epidemiology of compassion for a more compassionate global health

2026-02-24T07:53:01+00:00

As the contributions to this special issue illustrate, compassion is a key motivator for individuals and, increasingly, health systems in global health. This commentary considers the power dynamics of compassion in global health, particularly challenging the notion that compassion is inherently asymmetrical. I illustrate that it is not the compassion itself that is unequal but rather the visibility of its actors, depending on their power and position. The challenges and opportunities for building equity through an epidemiology of compassion are considered.

Towards an Epidemiology of Compassion

2026-02-17T08:14:43+00:00

No abstract

Appreciation for peer reviewers: Towards an epidemiology of compassion

2026-03-03T19:32:04+00:00

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

2025-11-03T06:17:40+00:00

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.

Compassion in context: A contemplative neuroscience perspective on expanding compassion beyond the individual

2025-11-24T12:49:43+00:00

A central challenge in developing an epidemiology of compassion is establishing how to determine that compassion is “present” in an individual or population. To do so requires expanding beyond individualistic conceptions of compassion to consider how compassion might manifest in relationships, in communities, and within societies. This includes agreeing upon a definition that is flexible enough to span levels of analysis, and operationalizing how to identify and quantify compassion at each level. Some of these challenges are unique to the epidemiological framework, while others have been explored by researchers in contemplative studies, psychology, and neuroscience in the process of defining our own fields of compassion science. In this paper, I consider the insights from these related fields, and reflect on how they can be applied to an epidemiological framework. I give special consideration to the challenges of measuring a latent and emergent phenomenon, spanning levels of analysis, and defining compassionate action. I also consider how the related concepts of interdependence and common humanity might help identify key indicators of compassion at a population level. Finally, I propose a set of theoretical models that illustrate the levels at which compassion may emerge, and merge the epidemiological triad model with insights from compassion science to provide a framework for the study of compassion from an epidemiological perspective.

‘The voice of that boy is still trickling in my ears’: Ethnography and the epidemiology of compassion

2025-10-02T13:12:22+00:00

There is growing interest in understanding compassion not only as an individual feeling but as something that circulates through communities and institutions, shaping decisions, relationships, and commitments over time. Recent calls for an epidemiology of compassion suggest that compassion be treated as a population-level phenomenon, with its own patterns of emergence, transmission, and lasting effects (Addiss et al., 2022). Yet there is little empirical research showing how compassion actually works in practice, especially within global health policymaking.

This paper draws on an ethnographic study (2020–2025) of people within global health networks working on neglected tropical diseases (NTDs), to explore how compassion arises, spreads, and endures. Using in-depth interviews, participant observation, and creative anthropological methods, the study examines how compassion becomes ‘catching’ in certain moments. Vignettes include: a boardroom silenced by a woman’s tears recalling classmates with podoconiosis; a long-held memory of a suicidal teenager shaping advocacy decades later; and a foot washing involving Ethiopian patients and UK parliamentarians.

These emotionally charged moments are fleeting, but their effects are not. They act as exposure events, shaping motivating memories, disrupting hierarchies, and sustaining long-term motivation. The study suggests that compassion can, perhaps, be thought of as behaving epidemiologically: with triggers (first-hand or second-hand exposure), vectors (stories, touch, shared rituals), patterns of distribution, and protective effects (re-energising slow advocacy work).

This work supports calls for an epidemiology of compassion by showing how compassion is felt, transmitted, and remembered across people, places, and time. It also argues for integrating more qualitative, sensory, and story-based methods into global health research to help trace the emotional energies that may underpin collective change.

The flows of compassion to help create a more connected world

2025-10-17T12:00:12+00:00

Compassion involves noticing suffering in self and others, and then trying to help alleviate and prevent it. At its core, therefore, compassion is relational, and it permeates through all interpersonal relationships, for example, those with partners, children, parents, colleagues, as well as with how individuals relate with strangers or people they dislike. As a result, there is a giver and a receiver of compassion, and how that is experienced in everyday life in these important relationships, can be the critical building blocks to how somebody starts to build their own self-relational style, which is also known as self-compassion. Each of these ‘flows’ of compassion, towards others, receiving, and towards self is shaped by context and impacts mental health. However, research has often focused on the individual, which is insufficient for a population-level understanding. This paper argues that this relational 'flow' framework is the necessary foundation for a new epidemiology of compassion—the study of its distribution and determinants in specified populations. Using this epidemiological lens, this paper: 1) examines the dyadic mechanics of compassionate 'transmission', 2) evaluates the methods to measure these flows, 3) reframes moral boundaries as a way to define 'at-risk' populations, and 4) proposes a systems-level, 'public health' approach to intervention, using healthcare as a key example. What is fundamental is the need for compassion; how to cultivate it at a systems level is a critical question if a safer and more connected world is to be realised.

Cultivating compassion across development: A multi-systemic framework for intervention and measurement

2025-10-17T11:58:21+00:00

Our humanity affords us abilities that can be harnessed to harm or to heal. One could argue that the survival of our humanity is strengthened when we harness healing. Compassion is a capacity we as humans can draw on for just this purpose. It is increasingly recognized as essential for individual and societal well-being. Yet most existing models and measures are derived from adult populations and overlook how compassion emerges, changes, and can be cultivated across childhood and adolescence. This paper aims to advance the developmental science of compassion by presenting two complementary models that together offer a comprehensive account of the contextual foundations and developmental processes of compassion development from early childhood through late adolescence (ages 3-18). The first model synthesizes four intersecting systems to provide a topographical understanding of the contextual architecture shaping how compassion is rooted in and progresses through early development. These include motivational, emotional, relational, and cultural contexts that interact with human development in ways that directly shape how we can know compassion through observable behaviors, relationship interactions, ways of communicating, and ways of thinking. The second model translates these contextual influences into a dynamic developmental sequence involving five interrelated psychological processes: awareness of suffering, appraisal of its meaning, motivation to respond, compassionate action, and the impact and meaning-making that follow. Although these processes unfold in a general progression, they interact recursively; for example, early helping behaviors can shape later emotional regulation, relational attunement, and ethical reasoning. To support empirical research and applied work, the paper aims to propose a Framework for Measurement that enables the operationalizing of these processes across four observable domains, behavioral, relational, communicative, and cognitive, providing developmentally sensitive lenses for assessing compassion across the 3–18 age span. Together, these models offer a cohesive developmental architecture for understanding how compassion is cultivated within real-world contexts and across diverse cultural settings. The paper concludes by outlining implications for research, educational practice, and public health, arguing that a developmental approach to compassion measurement and training provides critical tools for strengthening prosocial motivation, relational health, and societal resilience.

Applying the methods of chronic disease epidemiology to the study of compassion

2025-10-17T11:49:31+00:00

Now, more than ever, the world needs compassion—at the level of the individual, the community, the workplace, and society as a whole. As an abstract concept, the idea that increasing compassion will benefit society on many levels is simple. But as a target for public health intervention, our fundamental understanding of compassion is poor. How can we craft interventions to increase our willingness and capacity to help others through adversity and suffering when our understanding of the factors that increase compassion, the barriers to compassion, and their interplay, is limited? Work by a wide range of social and behavioral scientists has laid the foundations for compassion studies by establishing consensus definitions and identifying recurring themes in compassionate interactions. We believe that applying epidemiologic methods to study the determinants of compassion will provide a complementary, quantitative foundation for future initiatives, interventions, and benchmarking. In this paper, we explore how compassion has many of the same features as chronic diseases, including multiple dimensions, time scales, and degrees of modifiability, evolution over time, non-linear progression, and complex, interacting influences. We weigh the suitability of various epidemiologic study designs for studying compassion. We then propose a number of analytic approaches from chronic disease epidemiology that could be used to build quantitative, and potentially even causal, models of compassion. We examine the advantages that would be gained by using methods such as multi-level modeling, sequential conditional mean modeling, marginal structural modeling, and machine learning to study compassion and its influences, along with the potential limitations of each method. Finally, we round out the paper with a discussion of the challenges involved in using epidemiologic frameworks to study compassion.

Toward an analytic framework for the spatial epidemiology of compassion

2025-11-21T13:15:39+00:00

The epidemiology of compassion seeks to better understand factors related to the experiences (giving, sharing, and receiving) of compassion. Here, we summarize existing analytic tools from different disciplines allowing analysts to explore local and neighborhood features as a context for better understanding a “geography” of compassion. We provide a brief review of the concepts defining compassion, how these concepts might be measured at local levels of geography, how epidemiology provides a framework for estimating associations between these measures and other local features, and how spatial statistical models adjust for spatial correlations and provide measures of uncertainty associated with estimated associations. We next outline how these tools, taken together, can enable empirical studies of local compassion. We discuss what sorts of epidemiologic questions can be answered, and what compromises analysts will make along the way based on choices of data and analytic methods. We seek to provide a broad framework for such analyses and outline examples illustrating the types of data available and what questions could be answered from each. This framework provides a setting for more detailed creation, description, estimation, and navigation of compassion “landscapes” from the perspectives of giving, sharing, and receiving compassion.

Statistical methods for developing index measures of compassion

2025-10-13T14:13:10+00:00

Compassion is a complex, multi-dimensional concept. As a result, measuring compassion is a complex task. The measurements can be subjective, varying by person and context. Often, the questions used to create measures of compassion are indirect or incomplete due to their multi-dimensional aspects. Quantifying compassion utilizes statistical tools not commonly used in the field of epidemiology.

This paper reviews two families of statistical methods (primarily Principal Components Analysis and Factor Analysis) that can be used to meet these challenges. The review will cover the central concepts of each method and reference sources with data, annotated output, and code using several popular products (R, SPSS, STATA, SAS). Several currently used compassion indices are discussed, using a simple conceptual framework designed to illustrate typical challenges in the process of index development. The framework is composed of three components: the caregiver, the environment, and the recipient, with the environment broadly defined to include management policies, the type of health care facility, and other factors external to the caregiver and patient.

Summary discussions include the challenges associated with these methods and those associated with integrating results from these analyses into the statistical and mathematical modeling processes.

Fostering compassionate public healthcare leadership towards sustainability: Evidence from Bihar, India

2025-11-04T11:55:09+00:00

Introduction. Compassionate leadership, a critical driver for healthcare development, performance, service quality and citizen satisfaction, remains less cultivated in Indian public healthcare. Embedded in Piramal Foundation’s philosophy of Sewa Bhaav (spirit of service), globally recognized models of compassion-based ethics were integrated in Compassionate Leadership & Personal Transformation Training (CL-PTT). Collaborating with Emory University, United States and the Government of Bihar State, India, this multi-pronged omnichannel approach facilitated leadership unlocking “Agency to Serve” among healthcare professionals.

Methods. The CL-PTT intervention was assessed in a cross-sectional study of 949 healthcare workers at 35 district hospitals, of which 18 received the intervention. Key objectives were: (1) to assess leadership competencies and correlate them with citizen experience; (2) to understand provider attitudes and behaviours; (3) to identify gaps and inform course correction. A co-designed, scenario-based, field-validated Leadership Assessment Tool measured 16 personal, social and people leadership competencies. The Citizen Experience Feedback Tool captured citizen-provider interactions from 702 citizens across both outpatient (OPD) and inpatient (IPD) departments. The development of both tools was guided by extensive literature review, established frameworks and tacit knowledge captured through iterative expert consultations.

Results. Significantly higher odds of ‘good’ (uppermost tertile) leadership competencies were found among healthcare professionals in the intervention facilities compared to non-intervention (adjusted odds ratios (aORs) for personal=3.7, social=6.0, people=6.5, and overall=5.4 categories), and measures of self-awareness, emotion management, non-violent communication, team development, and providing feedback were significantly higher. Compared to control facilities, citizen experiences in the OPD were better in intervention facilities for active listening (93.5% vs. 85.2%), adequate consultation time (90.6% vs. 76.5%), and encouragement for questioning (81.2% vs. 68.2%). Overall, CL-PTT was associated with better leadership competencies and improved citizen-provider interactions.

Conclusion. Findings validate the transformative potential of integrating compassion-based ethics into leadership development programs for healthcare delivery and citizen-centered care.

Echoes of compassion in the Global Flourishing Study: Cross-national distributions and predictors of prosociality and loving care

2025-09-30T13:31:05+00:00

Background. This article explores compassion as a manifestation of ‘love in action’ (sometimes termed compassionate love) that can be expressed in many ways. As a first step, we focus on four key outcomes: three compassionate acts (helping strangers, volunteering, and charitable giving) and a broader measure of love that encompasses compassion (showing love and care to others). We view compassion as an outcome that is associated with identifiable enabling conditions (e.g., good health), as well as a cause of valued well-being outcomes, but little is known about cross-national variation in such associations.

Methods. We synthesized a series of studies that used data from the Global Flourishing Study (GFS), a diverse and international sample of 202,898 individuals across 22 countries. These studies examined the distributions of three compassionate acts and showing love/care across (1) countries, (2) demographic categories, and (3) examined candidate childhood predictors of the compassionate acts and showing love/care in adulthood, and cross-national variation in these associations.

Results. First, across all measures, there was meaningful variation across countries (e.g., helping strangers ranged from 11% [0.11, 0.12] in Japan to 83% [0.81, 0.84] in Nigeria) and within countries across measures. Second, there was meaningful demographic variation between measures across countries (e.g., love/care and charitable giving increased with age, helping strangers decreased with age, and volunteering was more uniform [until 80+]). Finally, when evaluating childhood predictors, the three compassionate acts and showing love/care had some similarities, and some differences (e.g., experiencing childhood abuse was associated with a higher likelihood of compassionate acts in adulthood, but lower love/care).

Discussion. These cross-national findings provide insights into the key sociodemographic variables and childhood predictors that may help guide the development of the epidemiology of compassion, including the emergence of a case definition for compassion itself. Cross-national variations in patterns across these measures suggest that future research must attend to important contextual differences.

Compassionate love: Theory, measurement, and application

2025-10-17T12:14:08+00:00

We review research on the conceptualization and measurement of compassionate love, generally defined as giving of oneself for the good of another. We begin by summarizing an existing model of compassionate love (Underwood, 2002, 2009) that outlines the antecedents, components, and consequences of this kind of love. Next, we discuss measurement, focusing on the most widely used scale, the Compassionate Love Scale (Sprecher & Fehr, 2005) and its derivatives. This scale can be used to assess compassionate love for strangers/humanity, close others, or a specific close other. We then present research on the antecedents or precursors of compassionate love, followed by a review of research on correlates of compassionate love (e.g., empathy, compassion) that could be either causes, outcomes, or reciprocally causal. The focus then shifts to the link between compassionate love and well-being. Finally, we discuss compassionate interventions and end with a call for further research on the epidemiology of compassionate love.

Compassion in health emergency management in Sri Lanka

2025-12-22T13:18:41+00:00

Compassion, defined as awareness of suffering, empathic attunement, and action to alleviate it, has been widely recognized in health care yet seldom examined systemically within Health Emergency Management (HEM). In Sri Lanka, recurrent crises provide a unique context for understanding how compassion is experienced, enacted, constrained, and sustained across the emergency management system.

A constructivist grounded theory study was undertaken through 23 semi-structured interviews with professionals across national, district, and divisional levels, including health staff, administrators, pre-hospital services, security forces, disaster managers, civil society, disability activists, and community representatives. Online interviews were conducted in Sinhala and English, recorded with consent, and analyzed using open, axial, and selective coding with constant comparison and iterative memoing.

Findings indicated broad recognition of compassion as essential in health emergencies, yet fragile in the face of stress, rigid rules, poor leadership, and resource shortages. Compassion emerged through interconnected layers: individual roots of upbringing, education, faith, and prior adversity; organizational stems shaped by resources, adaptive policies, and leadership culture; systemic flows of reciprocity between leadership, staff, patients, and communities; and cultural-philosophical traditions such as the Brahma Vihāras and Sangraha Vasthu that infused humanitarian practice with deeper ethical grounding. While some respondents perceived tension between compassion and humanitarian principles, narratives demonstrated that compassion reinforced and animated these principles when supported by organizational flexibility and cultural ethics. Instances of compassionate problem-solving contrasted sharply with harms caused by rigid application of insensitive rules.

The Lotus of Compassion in Health Emergencies Model synthesizes these findings, depicting compassion as seeds of innate potential, roots of individual formation, stems of organizational support, leaves of everyday practice, and flowers of visible expression in crises, nourished by leadership as sun and sustained by beneficiary reciprocity as bees and air. Compassion in Sri Lanka’s HEM is thus not an intangible or abstract value but a systemic quality that strengthens resilience and operationalizes humanitarian principles in practice.

Decoding Sewa Bhaav: Framework unpacking the spirit of service rooted in Indian traditions

2025-11-04T11:26:51+00:00

Introduction. Sewa Bhaav brings together Sewa (selfless service) and Bhaav (emotional and ethical intent behind action). While Sewa shows itself in outward acts of helping, Bhaav reflects the inner motivation and feeling guiding these acts. Despite being rooted in Indian traditions, Sewa Bhaav had little attention in contemporary research. This study decodes and defines Sewa Bhaav by combining insights from people actively engaged in service with literature from moral psychology, leadership studies, and Indic philosophies.

Methods. The study used a multi-phase, qualitative sense-making approach, to conceptualize and validate Sewa Bhaav, its drivers, confounders and modifiers. Phase 1 involved a focus group discussion with individuals engaged in selfless service, analyzed using Braun and Clarke’s thematic analysis framework approach. Phase 2 used narrative analyses of group discussions to embed constructs in real-life narratives. Phase 3 involved structured review of the literature to align emergent constructs with existing psycho-behavioral models. Phase 4 finalized the framework through expert consultation workshops, applying the Mutually Exclusive, Collectively Exhaustive (MECE) principle and modelling interrelationships via Directed Acyclic Graphs (DAG).

Results. Analysis thematically established eight core components of Sewa Bhaav: Egolessness, Compassion, Empathy, Resilience, Respect, Non-Violent Communication, Active Listening, and Influence Without Authority. Seven drivers identified were: Clarity of Purpose, Agency, Vision, Behavioral Integrity, Openness, Equality and Competence. Propositions were developed to articulate the role of each. Age, gender, education, caste, religion, and socio-economic hierarchies also shaped the expression and recognition of Sewa Bhaav.

Conclusion. This study advances Sewa Bhaav as a culturally grounded framework for selfless service, extending on moral psychology and leadership. Its application in public institutions highlights the potential of service-oriented ethics to strengthen human capital, foster resilience, and transform organizational practices. By positioning Sewa Bhaav as both a moral philosophy and actionable ethic, the framework offers valuable insights for cultivating compassion-driven governance, ethical leadership, and community well-being.

Compassionate epidemiology: A catalyst for reawakening ecological and relational awareness in global health

2025-12-22T09:30:12+00:00

The field of global health has articulated a commitment to alleviate preventable suffering and advance health equity worldwide. Compassion is frequently invoked as a core ethical value for global health action. Recent attempts to quantify compassion—an epidemiology of compassion—reflect its perceived value in shaping effective action. However, compassion resists full measurement, because it is socially embedded, historically situated, and relationally enacted. Efforts to measure compassion in isolation from these contexts risk producing incomplete or misleading representations, ultimately constraining equity and community well-being.

In response, we propose compassionate epidemiology as a conceptual and methodological framework that reorients global health toward relational accountability, lived experience, and ethical responsiveness to preventable suffering. Compassionate epidemiology does not reject quantitative methods; rather, it challenges its epistemic dominance by centering participatory processes, narrative evidence, and culturally grounded knowledge as core components of epidemiological inquiry. This paper makes two contributions: it conceptualizes compassion as a social and epistemic phenomenon beyond metrics, and it proposes compassionate epidemiology as a paradigm for transforming evidence generation, interpretation, and policy translation.

Organizational features associated with compassion in two primary healthcare centres in Kenya and Uganda

2025-11-24T12:24:09+00:00

To alleviate and prevent suffering, healthcare systems require collective action through organizational design and management. Therefore, healthcare organizations are appropriate contexts for studying the epidemiology of compassion – an emerging science that seeks to understand individual and systemic factors that foster compassion. Most research on compassion in healthcare settings has been conducted in high-income countries, focused on individual attributes that facilitate the giving of compassion. Less attention has focused on compassion in low- and middle-income country settings, or on organization- and system-level conditions that often determine whether compassion flourishes or falters. Epidemiology is a quantitative science, yet qualitative research can identify characteristics that warrant further testing and quantitative assessment. We conducted qualitative case studies of two primary healthcare organizations in Uganda and Kenya to examine how compassion is cultivated and sustained at the organizational level. Using the five components of the social architecture framework (network structures, organizational culture, roles, routines, and leaders) we discuss characteristics of these organizations that may enable compassionate responses to suffering among staff. Qualitative research in healthcare settings, framed by principles of organizational science, offers a pathway to sustaining healthcare workers and improving patient care. Increased attention to organizational and system-level compassion is needed, particularly in low- and middle-income countries where suffering is profound and complex.

The epidemiology of compassion in healthcare: An integrative review of organizational learning strategies

2025-12-08T10:55:40+00:00

Compassion is a fundamental healthcare principle of effective, ethical healthcare, yet it is increasingly challenged by pressures in modern healthcare systems. The emerging concept of “epidemiology of compassion” aims to understand the distribution and determinants of compassion across health care populations. This review examines organizational learning mechanisms as system-wide instruments to establish and maintain compassionate care in healthcare organizations. The research used an integrative review method to analyze studies from PubMed, DOAJ, and ProQuest databases, which focused on organizational learning and compassion. The research included studies about system-level interventions that developed leadership skills and changed organizational culture and implemented team-based learning and excluded studies that focused on individual training. The thematic synthesis used a six-domain epidemiologic framework to analyze the data while performing a secondary analysis across person, time, and place dimensions. The review found four fundamental organizational learning mechanisms, which included reflective practice, psychological safety, knowledge management, and leadership development spread across six epidemiologic domains: demographic features, personal characteristics, personal history, behavioral routines, contextual factors, and structural systems. Interventions that included shared reflection and co-design practices demonstrated improved structural and cultural integration of compassion practices. The person–time–place analytical framework provided understanding on how these mechanisms function during individual competency development (person) and institutional embedding and sustainability (time) and adaptation to diverse clinical settings (place). The implementation of organizational learning provides a scalable, evidence-based method to embed compassion throughout health systems. The alignment of these mechanisms with public health infrastructure allows compassion to become a system parameter that can be evaluated and designed through policy interventions. Future research should employ pragmatic, real-world, multiple methods and comparative designs appropriate for clinical settings.

Epidemiology of resilience and epidemiology of compassion: Common ground?

2025-09-26T13:44:04+00:00

Compassion has received limited attention in epidemiological research despite its relevance as a social norm and its potential for fostering human flourishing. This conceptual review illustrates how conceptual frameworks and methodological approaches from the epidemiology of resilience can inform the emerging field of epidemiology of compassion. Similar to resilience, compassion is often engendered by environmental stimuli such as suffering and adversity and is shaped by individual traits, cultural norms, and contextual factors. Drawing from resilience literature, we explore whether compassion can be conceptualized as a trait, a state, or a dynamic process, and suggest that it is best understood through social-ecological models that account for multi-level influences.

Methodologically, we emphasize the need for culturally sensitive measures and the incorporation of suffering as a contextual trigger for compassion. By drawing conceptual and methodological parallels with resilience epidemiology, this article raises questions and suggests some useful ways to approach the investigation of compassion as a measurable population-level construct. This framing opens important avenues for research and policy aimed at promoting and sustaining compassion across systems and contexts.

Contributions towards a positive epidemiology of compassion: Exploring the transmission dynamics of acts of microkindness

2025-12-17T07:02:27+00:00

Recent years have seen enthusiasm for a “positive epidemiology,” extending the standard focus on disease in epidemiology to encompass positive health-related qualities and states, including an epidemiology of compassion. We seek to contribute towards the latter by considering a prosocial state that is closely related to compassion, namely kindness. More specifically, we advocate for attention to a form of kindness which has received minimal attention, but which we consider potentially important, namely microkindnesses: small gestures motivated by genuine warm feelings for others that benefit another, where small refers both to (a) duration (i.e., lasting less than five seconds) and (b) personal consequence to the actor (i.e., involving minimal personal harm or expense). In particular, we focus on the possibility of microkindnesses being transmitted among people, drawing on literature around collective emotions and research on kindness more broadly. We conclude by proposing an epidemiological approach to studying transmission dynamics of microkindnesses, concentrating on smiling and the potential for using AI and emotion recognition software to explore these dynamics.

Benefactors across person, time, and place: The environments that help prime wellbeing and compassion

2025-11-03T06:12:14+00:00

Situational variables influence behavior across domains of health, decision-making, and morality. A key situational factor that influences compassion includes the presence of benefactors within one’s internal emotional processing of the environment. Benefactors refer to people, moments, and places that elicit experiences of care, wellbeing, and safety. In this article, I draw on literature from attachment theory, contemplative psychology, and concept formation to develop a theoretical framework to inform 1) how benefactor experiences help prime and shape compassionate states and prosocial action, and 2) how people can attune to situations that evoke care and safety so as to construct care more readily across settings and environments. This provides a framework for understanding how compassion is transmitted across groups and populations.

Public health and compassion: Exploring the interface

2025-10-17T11:46:38+00:00

Many parts of society are experiencing declining compassion, while there is increasing evidence from the health sector on the benefits of compassion. Public health approaches are a practical and effective means of taking population-level action on issues that challenge health and wellbeing, such as communicable and non-communicable disease, substance misuse, gambling, and violence. A public health approach to compassion therefore merits exploration, although existing literature speaks little to this issue. Drawing on public health approaches to issues affecting health and wellbeing, we propose a three-pronged conceptual approach to public health and compassion, noting the need to understand compassion and its determinants through application of epidemiological methods, implement targeted and universal interventions, and scale successful interventions while leveraging related public health initiatives. This approach, which builds on guiding principles of social justice, equity, solidarity and participation, provides a starting point for understanding public health approaches to compassion.