Well-Being Improvement:
The Path to Population Health

Madison Agee

At the 15th Population Health Colloquium in March in Philadelphia, PA, innovators across the health care industry gathered to discuss building a culture of health and examine real world examples of population based care being implemented by leading companies and organizations. Participants discussed the value of having a scientifically validated measurement of well-being in order to enable public- and private-sector leaders to know where they stand and how best to develop and prioritize strategies that help their populations live their best lives. All attendees received a copy of the ‘‘Best of Population Health Management’’ supplement, which compiled the most requested articles of 2014. The introduction to that supplement was authored by Ben R. Leedle Jr., President and CEO of Healthways, and appears in its entirety below. It is reprinted with permission of Population Health Management.


Introduction by: Ben R. Leedle Jr., former President and CEO, Healthways

Measurement is the first step that leads to control and eventually to improvement. If you can’t measure something, you can’t understand it. If you can’t understand it, you can’t control it. If you can’t control it, you can’t improve it.”

— H. James Harrington, Ph.D., performance improvement expert

The United States is facing an unprecedented health crisis. Rising costs, declining quality of life, lost productivity, stress, care provider shortages and an aging population continue to place a heavy burden on the American economy, on the vitality of our communities, on the viability of our enterprises and on individuals in need of both health improvement and services to optimize their care. How do we effectively, sustainably reverse these trends?

Our industry has been grappling with this question for some time now, a question that propels us to bring our research to increasingly more rigorous levels, to collect richer data from myriad perspectives, to continuously refine metrics of value and to innovate at a faster pace than ever before. Where we collaborate on these endeavors, the best results ensue.

On January 2, 2008, Healthways began a journey with Gallup to define and measure well-being. Our goal was to understand what is fundamentally important to people, how we experience our day-to-day lives, how we make thousands of decisions every day, and what we think our lives will be like in the future. This information would help us look beyond just physical health and more fully explore its multifaceted nature, including what causes our behaviors and habits to move in positive or negative directions.

The concept of health encompassing more than overt physical symptoms or disease was nothing new, but organizations like ours that deliver population health interventions largely had physical health data — primarily retrospective effect data — to direct our efforts. Without a deeper understanding of what distinguishes a thriving life from one spent suffering, we realized, those interventions would fall short of our three aims: to keep healthy people healthy, to reduce or eliminate lifestyle risks, and to optimize care for those with known conditions or chronic disease. In other words, we needed to uncover and address other aspects of life that either reinforce or work against our best intentions — we needed real-time root cause data.

Decades of clinical and behavioral economics research as well as experience delivering interventions aimed at positively changing behaviors formed the foundation of what eventually became the Gallup-Healthways Well-Being Index®, an in-depth, real-time view of how individuals, organizations, communities, states and countries perceive their well-being. Why are perceptions valuable? Measures such as unemployment, GDP and health statistics are essential, but they do little to help us understand why people change or do not change. Without that information, determining how best to support the improvement of their health and well-being is impossible.

Since 2008, we have fielded millions of well-being surveys around the world. This accumulated data has enabled research indicating us that improving well-being is the best — indeed, the only way — to positively influence populations, and to sustain positive change. When we have a strong sense of purpose, supportive relationships, financial confidence, and strong connections to our community in addition to good physical health, we truly thrive. Scientifically proven and published in the pages of Population Health Management as well as other peer-reviewed journals, this fact is also basic common sense.

Having a scientifically validated measurement of well-being enables public- and private-sector leaders to know where they stand and how best to develop and prioritize strategies that help their populations live their best lives. As David B. Nash, MD, MBA, Dean of the Jefferson School of Population Health, noted recently, “Researchers, policy makers and healthcare leaders need good information about the well-being of populations that they serve. Well-being sheds light on the issues that drive quality, cost and productivity. A well-being metric also supports the creation of an action plan for our nation, in order to achieve sustained improvement in the health of our citizens.” Well-being measurement affords diagnostic, design, process and value outcome specificity and clarity. Perhaps most importantly in terms of creating the change we all want, such measurement ensures the accountability of leadership.

Population health is important work for us all. In fact, our recent analysis of global well-being revealed that only 17% of the world’s population is thriving in 3 elements of well-being or more[1]. This tells us much work remains to be done to improve well-being and population health around the globe. Insights and best practice for improving well-being are universal — applying to all humans — and transcend the traditional boundaries for understanding health that are often ascribed to a population’s education, demographics, location and economy.

Encouragingly, population health is getting the recognition it deserves as a strategic competence for healthcare and other organizations. As just one example, businesses are now hiring chief population officers. The need for the expertise, evidence and next-generation of leadership underscores the importance of the work being performed at the Jefferson School of Population Health. Another example of dynamic growth in the field is the new partnership formed between the Jefferson School of Population Health and the Population Health Alliance. The relationship blends the best of each group and assures the development and execution of innovative solution in our field.

Healthways is proud to support these organizations and sponsor this inaugural “Best of Population Health Management” supplement, which compiles the most requested articles of 2014. Clearly, the rising incidence of chronic disease both in the United States and throughout the world shows that we are ready for a new approach, and these articles highlight some of the exciting advancement in our collective study. Together, we are learning from those on the front lines of population health practice and discovery, collaborating with greater transparency than ever before, and establishing the best practices in total population health that will truly transform health and care.

[1] As defined by Gallup and Healthways, the five elements of well-being are: 1) purpose (liking what you do each day and being motivated to achieve your goals), 2) social (having supportive relationships and love in your life), 3) financial (managing your economic life to reduce stress and increase security), 4) community (liking where you live, feeling safe and having pride in your community), and 5) physical (having good health and enough energy to get things done daily).

Topics: Well-Being Well-Being Index Gallup Science and Research