When Gallup and Healthways made a pact to improve the health of the American people in late 2007, we knew we needed a broader definition of health. Our intuition told us there was more to impacting the lives of people than just badgering them into preventing disease. After all, the past collective efforts of the field had not produced stellar results. Think about the current statistics: 67% of adult Americans are overweight or obese; 60% don’t exercise; 82% report having at least moderate stress, 21% still smoke and 56% have at least one chronic illness. Albert Einstein was widely quoted as saying, “The definition of insanity is doing the same thing over and over again and expecting different results.” Unfortunately, it seems that in improving the health of Americans over the last 40 years we are all guilty of a little insanity. So, Healthways and Gallup wanted to think bigger and broader. But then came the dilemma. What was it we were trying to impact and measure? The answer – well-being.
In our view, well-being was broader and more encompassing than just health but a complete definition still proved illusive. Then, one of our board members took us back to 1946 and the preamble to the constitution of the World Health Organization. In this document we found the following statement:
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Knowing what I know now I might change it just slightly to say, “Well-being is a state of complete physical, mental, and social health and not merely the absence of disease or infirmity.” Either way, you get the drift. This definition really helped us get our head around well-being. However, we still needed a little more meat on the bones. Working with Gallup we identified six domains of well-being which include the following:
- Life Evaluation – on a scale of 1 – 10, how a person feels about their general life today and how they think they will feel in five years
- Physical Health – the amount of acute and chronic illnesses people experience
- Emotional health – how much people experience happiness, stress, anger, and even depression, among other emotions
- Healthy Behavior – how often people exercise, eat properly, consume alcohol, smoke and observe other proper or improper health habits
- Work Environment – how much support people receive at work and how they perceive they are treated
- Basic Access – the access people have to basic necessities such as food and shelter, but also the access they have to elements of a supportive environment, such as a safe place to exercise or affordable fresh fruits and vegetables
This basic definition of well-being gave birth to the Gallup Healthways Well-Being Index® (WBI). Since January 2008, the WBI surveys 1,000 adults nationwide each day (major holidays excluded) which takes over 26,000 calls per day to complete. We recently launched the WBI in the UK and Germany as well. In the US we now have over 1.5 million surveys completed which has continued to help us define well-being and understand what improving it means, both in terms of health impact and in terms of personal and business performance. While our definition will continue to be fine tuned, we already have some incredible insights that I will share with you through future blogs. For starters, take a look at the path analysis performed using WBI data and presented in the graphic below as an example:
Body Mass Index (BMI) is a concern to which we can all relate. Simple physics tells us that controlling BMI is strictly a matter of balancing calories consumed versus calories burned. But more recently we have accepted findings that stressors can cause other physiological changes in the body that make our systems more conducive to gaining weight. Fair enough. This still has an explanation rooted in physiology. Yet, as you can see from the graphic above, we have been able to correlate many other social and emotional factors to BMI. Is it likely for instance that the amount of recognition a person gets at work changes their physiology to the point that he or she gains or looses weight? Probably not! But does it have a correlation to BMI? According to this path analysis, unequivocally yes! So does this tell us we have a lot more to learn – absolutely! Does this show incredible promise in understanding how to improve the well-being of Americans including their physical health? Without a doubt!
Just by looking at BMI we can see the definition of well-being must be broad because its reach is extensive. The WBI continues to demonstrate that well-being is a state of complete physical, mental, and social health and not merely the absence of disease or infirmity, and the inter-related nature of its domains are immense. I will provide much more on our findings and the topic of well-being in the months ahead. In the meantime, soak this in and give me your thoughts.
Does this resonate with you conceptually? Do you put credence in what the WBI is telling us thus far? Do you have any reason to think this is totally off base? Do you have some examples to share of well-being in action? We really want to know!