The Well-Being Journal

Lifestyle Changes Could Prevent Four Out of Five Heart Attacks in Men

Madison Agee

Many men adopt healthier habits to get ready for a major life event, such as a family wedding, class reunion or once-in-a-lifetime vacation. But lifestyle changes such as a healthier diet and more exercise can also help you avoid another major life event – a heart attack.

According to a new study in the Journal of the American College of Cardiology, a healthy lifestyle could prevent four out of five coronary events in men.

The study followed more than 20,000 Swedish men aged 45-79 for 11 years, and assessed lifestyle choices related to tobacco use, diet, alcohol consumption, physical activity and waist size. Men who combined a healthy diet and moderate alcohol consumption with not smoking, being physically active and maintaining a low amount of abdominal fat had an 86 percent lower risk of heart attack.

According to the authors, each individual lifestyle factor correlated with a clear reduction in risk, but a combination of the low-risk behaviors had the greatest impact. However, even incremental changes yielded improvement – not smoking, for example, decreases risk by 35 percent.

Dr. Dean Ornish also recommends combining multiple behavior changes to achieve maximum results in addressing heart disease and heart attack risk. His program is the first program that is scientifically proven to reverse heart disease by making changes in four areas. In addition to nutrition and fitness, the Ornish program also focuses on stress management and social and family support.

Changes in diet and lifestyle not only reduce your risk of a life-threatening event. Research shows that they also make a powerful difference in heart function and overall well-being. Patients in the Ornish cardiac rehabilitation program report that they feel more energized, enjoy a higher quality of life, can exercise longer and manage stress more effectively.

As patients, providers and employers are looking for ways to maximize well-being and minimize healthcare costs, preventing heart disease and modifying risk-related behaviors should be a priority. Heart disease is the leading cause of death in the United States, and 620,000 people suffer a first-time heart attack every year. According to the American Heart Association, direct and indirect costs of cardiovascular disease and stroke total more than $315.4 billion annually, including health expenditures and lost productivity.

Help is available to individuals who want to make a change. Many high-risk patients qualify for intensive cardiac rehabilitation programs such as the Ornish program, which is covered by Medicare and many other commercial insurance plans. Workplace programs that incorporate a holistic approach to well-being should offer assessments and interventions to improve cardiac health. The American Heart Association also offers extensive guidelines and tips on nutrition, physical activity and stress management.

To learn more about the Ornish program, please visit www.undoitwithornish.com.

World Faces Shortage in Purpose Well-Being

Madison Agee

Latin Americans have highest well-being in this area
By: Melanie Standish and Dan Witters

Fewer than one in five adults worldwide can be considered thriving -- or strong and consistent -- in levels of purpose well-being, as measured by the inaugural Gallup-Healthways Global Well-Being Index in 2013. Residents living in the Americas are the most likely to be thriving in this element (37%), while those in Asia and the Middle East and North Africa are the least likely (13%).

Purpose Well-Being, by Region

The Global Well-Being Index measures each of the five elements of well-being -- purpose, social, financial, community, and physical - through Gallup's World Poll. Purpose well-being, which is defined as people liking what they do each day and being motivated to achieve their goals, was the lowest performing element of the five elements of well-being. Global results of how people fare in 135 countries and areas in this element, as well as the four other elements, have been compiled in the State of Global Well-Being report.

Latin Americans Have Highest Purpose Well-Being

Nearly all the countries with the highest thriving rates of purpose well-being in the world are in Latin America. Culture may play a role in these perceptions -- Latin Americans generally report higher levels of positive daily emotions and have a better outlook on the job market than any other regional group. Denmark was the sole non-Latin American country in the top 10 countries with the highest percentage of the population that is thriving in purpose well-being.

Purpose Well-Being, Highest Ranked Countries

Panama led the world in four of the five well-being elements -- including purpose well-being. Two in three Panamanian adults were thriving in purpose well-being. Panama's strong and growing economy with an unemployment rate of 4.5% in 2013, coupled with investments in national development could be contributing to these high levels of thriving in well-being. Neighboring Costa Rica followed at 50%, despite relatively high unemployment for the region -- nearly 9% in the third quarter of 2013.

Struggling Economies and Conflict Zones
Dominate Low Purpose Well-Being

Asia and the Middle East and North Africa performed worst in purpose well-being, with only 13% of adults in these regions thriving in this element. However, when looking at adults' perceptions at the country level, trends among countries emerge and the lowest percentages appear to be associated with conflict zones and countries with poor economic performance.

Afghanistan and Syria struggled most in this element and had the lowest levels of purpose well-being, with 3% or less of adults thriving in this element. These two countries along with Tunisia, and to a lesser extent, Armenia, are embroiled in armed conflicts, which have disrupted daily lives and prevented portions of the population from carrying out normal functions.

Purpose Well-Being, Lowest Ranked Countries

Poor economies may also have affected purpose well-being. With only 7% of the population thriving in purpose, Greece is grappling with an economy that has yet to recover from the European debt crisis. Croatia has also suffered negative GDP growth since 2009 and high unemployment rates compared with Western European countries.

High Purpose Well-Being Influenced by Demographics of
Education, Wealth, and Youth

Worldwide, demographics play a role in the likelihood that people are thriving in purpose well-being. Those who were in domestic partnerships or who had completed four years of education beyond high school were more likely to be thriving in purpose well-being (27%) than the global population as a whole (18%).

The wealthiest quintile, urban residents, the young, and office workers were also more likely to be thriving than their poorer, more rural, older, or non-office worker counterparts. Globally, however, there was no difference in the level of thriving between men and women. Eighteen percent of each were thriving in this element.

Purpose Well-Being and Global Demographics, Highest %

Certain Employment Sectors and Less-Educated
Have Low Purpose Well-Being

Globally, adults who were employed in the fishing, forestry, and agriculture sectors were the least likely group to be thriving in purpose well-being, with 11% of respondents providing responses that placed them in this category. Those with an elementary education or less followed at 13%.

Purpose Well-Being and Global Demographics, Lowest %

The only region where education levels did not significantly affect people's likelihood to thrive in purpose well-being was the Middle East and North Africa region, where 14% of those who have completed at least four years of education beyond high school are thriving in purpose, matching the 14% whose education did not go beyond the high school and tertiary level. In every other region surveyed, more highly educated respondents were significantly more likely to be thriving in purpose well-being than their less-educated counterparts in this element.

Women were significantly less likely to be thriving in purpose well-being (16%) than their male counterparts (20%) in former Soviet Union countries. The Americas saw women (36%) with slightly lower levels of purpose well-being thriving rates than their male counterparts (38%). There were no differences between genders in any of the remaining regions.

Implications

Purpose well-being is high when people like what they do each day and are motivated to achieve their goals. This is true whether they work for a company, are self-employed, care for family members, pursue education, work on a farm, or engage in charity work. Those with high well-being in this element also tend to be highly engaged in their work. They are emotionally invested in what they do and focus on creating value through their efforts.

When people are unable to find work or achieve other personal measures of success and well-being with respect to their purpose, it can impact areas beyond the individual and affect society as a whole. Such conditions fed the Arab Spring uprisings and fueled protests in European countries that enacted severe austerity cuts. In Panama, residents who have high purpose well-being (66% thriving) were more than twice as likely (at 37%) to have donated money to charity in the last year than were Mexicans (16%), whose purpose well-being level was only at a 33% thriving rate.

"It is important for any stakeholder who is interested in improving the health of their population including governments, community leaders, employers, insurers and other international organizations to understand the impact that purpose well-being has on overall well-being," says Peter Choueiri, President, Healthways International. "Our research shows that purpose well-being has a high correlation with social, financial, community, and physical well-being. In other words, investments in purpose well-being improvement will likely also lift the other elements of well-being resulting in lower medical costs and an improvement in productivity across whole populations."

Survey Methods

Results for the Gallup-Healthways Global Well-Being Index are based on telephone and face-to-face interviews on the Gallup World Poll, with a random sample of approximately 133,000 adults, aged 15 and older, living in 135 countries and areas in 2013.

For results based on the total sample of national adults, the margin of sampling error is less than ±1 percentage point at the 95% confidence level. For results based on country-level samples, the margin of error ranges from a low of ±2.1 to a high of ±5.3.

All country-level analyses use country weights. Global and regional analysis uses projection weights that account for country size. Minimum sample sizes of N=300 apply.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

Each element in the Global Well-Being Index contains two questions asked of all respondents:

Purpose

  • You like what you do every day.
  • You learn or do something interesting every day.

Social

  • Someone in your life always encourages you to be healthy.
  • Your friends and family give you positive energy every day.

Financial

  • You have enough money to do everything you want to do.
  • In the last seven days, you have worried about money.

Community

  • The city or area where you live is a perfect place for you.
  • In the last 12 months, you have received recognition for helping to improve the city or area where you live.

Physical

  • In the last seven days, you have felt active and productive every day.
  • Your physical health is near-perfect.

This article is the second of three articles exploring worldwide perceptions of well-being in the five well-being elements measured in the Gallup-Healthways Global Well-Being Index: purpose, social, financial, community, and physical.

Topics: Well-Being In the News Healthcare Well-Being Index Gallup

Infographic: Well-Being Around the World

Madison Agee

The Gallup-Healthways Global Well-Being Index™ provides fascinating insight into how people all around the world feel about their own well-being. The index uses a holistic definition of well-being and self-reported data from individuals to capture the important aspects of how people feel about and experience their daily lives, extending well beyond conventional measures of physical health or economic indicators.

Well-being has five prominent elements:

  • Purpose: Liking what you do each day and being motivated to achieve your goals
  • Social: Having supportive relationships and love in your life
  • Financial: Managing your economic life to reduce stress and increase security
  • Community: Liking where you live, feeling safe and having pride in your community
  • Physical: Having good health and enough energy to get things done daily

Which countries’ residents have strong well-being? And, conversely, where does much work remain to be done in terms of well-being improvement?

Take a look at the infographic below to see a snapshot of well-being around the world. For a more in-depth analysis, download the full report.

Well Being: A Global Snapshot

Download the Global Well-Being Index Report

Topics: Well-Being In the News Well-Being Index Gallup Health Conditions

Country Well-Being Varies Greatly Worldwide

Madison Agee

Panamanians have the highest well-being globally; Syrians and Afghans, the lowest
By: Melanie Standish and Dan Witters, Gallup

One in six adults worldwide are considered thriving -- or strong and consistent -- in at least three of the five elements of well-being, as measured by the inaugural Gallup-Healthways Global Well-Being Index in 2013. Residents of the Americas region are the most likely to be thriving in three or more elements (33%), while those in sub-Saharan Africa are the least likely (9%).

Elements of Well-Being - Worldwide and by RegionEach element of well-being is important on its own, but the elements are also interdependent and well-being is more than the sum of the elements. That only 17% of residents in the 135 countries and areas surveyed are thriving in three or more elements underscores how most of the world is struggling to achieve high well-being.

More adults globally are thriving in community well-being (26%) than in any other element. Residents in the Americas region, with more than one in three (37%) thriving, are most likely to be thriving in this element. Adults in sub-Saharan Africa are the least likely to be thriving (18%).

Fewer adults globally are thriving in purpose well-being than in any other element. Adults in Asia, as well as the Middle East and North Africa, are least likely to be thriving in this element (13% in each region), while those in the Americas again top the list of regions, at 37% thriving in purpose well-being.

Global Well-Being Index Largest Recent Global Study of Well-Being

The Global Well-Being Index is an extension of more than six years of research and 2 million interviews in the U.S. through the Gallup-Healthways Well-Being Index. The Global Well-Being Index is a global barometer of individuals' perceptions of their well-being and is the largest recent study of its kind. Data collected in 2013, across 135 countries and areas, and with more than 133,000 interviews, have been compiled into the State of Global Well-Being, a comprehensive report presenting the global demographics of well-being. The Global Well-Being Index is organized into the five elements:

  • Purpose: liking what you do each day and being motivated to achieve your goals
  • Social: having supportive relationships and love in your life
  • Financial: managing your economic life to reduce stress and increase security
  • Community: liking where you live, feeling safe, and having pride in your community
  • Physical: having good health and enough energy to get things done daily

In analyzing the results of the index, Gallup classifies responses as "thriving" (well-being that is strong and consistent), "struggling" (well-being that is moderate or inconsistent), or "suffering" (well-being that is low and inconsistent).

Thriving Rates Highest in Latin American and European Countries

Adults in Latin America are most likely to be thriving in well-being in three or more elements as well as across elements. Latin Americans generally report higher levels of well-being than any other regional group. This is consistent with other Gallup World Poll research that shows residents of Latin America generally evaluating their lives more highly than those in other regional groups, partly reflecting a cultural tendency in the region to focus on the positives in life.

Thriving in 3+ Elements of Well-Being - the 10 Highest CountriesPanama leads not only the region, but the world in four of the five well-being elements -- purpose, social, community, and physical well-being. Sixty-one percent of Panamanians are thriving in three or more elements, 17 percentage points ahead of its second-place neighbor, Costa Rica (44%). Panama's strong and growing economy, an unemployment rate of 4.5% in 2013, and national development may be the most significant factors contributing to its high thriving levels.

Financial well-being is the only element in which other countries' residents top Panama's. Swedes lead the world in financial well-being, with 72% thriving. Financial well-being is high across a range of northern and central European countries, including Austria (64% thriving), Denmark (59%), and the Netherlands (56%).

All Elements of Well-Being - 10 Highest CountriesOnly five countries outside of the Americas and Europe regions have levels of thriving within an element that rank in the top 10 of all countries -- Bahrain in financial well-being (48%), Saudi Arabia in community well-being (43%) and physical well-being (39%), Malta in social well-being (47%), and Sri Lanka (50%) and the United Arab Emirates (49%) in community well-being. No countries outside of these two regions finished in the top 10 in thriving in three or more elements.

Sub-Saharan Africa Least Thriving Region

Adults in sub-Saharan Africa are the least likely to be thriving in three or more elements of well-being (9%), in addition to their low levels of financial well-being (9%), social well-being (16%), community well-being (18%), and physical well-being (20%). Democratic Republic of the Congo (DRC), Chad, Madagascar, Uganda, and Benin residents have some of the lowest levels of thriving in the world. Most of these countries are plagued by war, political turmoil, low levels of development, and endemic corruption. DRC, for example, has been embroiled in nearly continuous conflict since 1996, and is rife with political instability.

Although subjective well-being is dire in many sub-Saharan African countries, the situation is worse in Afghanistan and Syria. In 2013, just 1% of Syrian and Afghan adults were thriving in three or more elements; the two nations share the lowest well-being of the 135 countries and areas in the 2013 survey. Both countries are conflict zones. By the end of 2013, the United Nations High Commissioner for Refugees estimated that 6.5 million of a total population of 22 million Syrians would need humanitarian aid, and 4.25 million of those would be internally displaced.

Thriving in 3+ Elements of Well-Being - the 10 Lowest CountriesAfghans are also awash in uncertainty about the country's future security situation and its relative stability once foreign aid and investments level off. In a 2013 Gallup World Poll survey, more Afghans said their standard of living was getting worse than in any year since 2008, and most Afghans (61%) said it was a bad time for them to find a job. Against this backdrop, Afghans are the most likely of any population in the world not to be thriving in any element of well-being (75%).

All Elements of Well-Being - 10 Lowest Countries
Implications

Objective measures including GDP, life expectancy, and employment statistics are important and useful in assessing a country's "success," as are historical trends over time. However, the concept of subjective well-being encompasses the broader aspects of a life well-lived.

Gallup and Healthways research has shown that people with higher well-being are healthier, more productive, and more resilient in the face of challenges such as unemployment. People with higher well-being bounce back faster, are better able to take care of their own basic needs, and feel better able to contribute to and support the success of their organizations, communities, or countries.

Subjective well-being does not necessarily correlate with GDP, the presence of conflict, or other absolute indicators. Residents in poor countries may report that they have high well-being in certain well-being elements while those in wealthy countries may report that they have low well-being in particular elements. War-torn populations such as those in Syria may have extremely low well-being, but low levels are also found in countries that are relatively stable, such as Croatia and Italy.

There are policy implications for country leadership, development organizations, employers, health insurers (private and governmental), and others in the well-being status of their constituents. For example, Mexico has relatively high physical well-being scores. However, the country overtook the U.S. in 2013 as the most obese country in the Western Hemisphere and grapples with a high rate of diabetes. Diabetes and heart disease are the two most common causes of death in Mexico. While the physical well-being element captures more than just obesity, the high scores on this element in Mexico reveal areas where education is needed to help the population become more aware of health and healthy behaviors, and make better choices.

Because subjective well-being can correlate with outcomes such as healthcare costs, productivity, and business performance, world leaders should consider well-being, in addition to objective measures such as GDP, to provide a better picture of progress toward specific policy and development goals.

Survey Methods

Results for the Gallup-Healthways Global Well-Being Index are based on telephone and face-to-face interviews on the Gallup World Poll, with a random sample of approximately 133,000 adults, aged 15 and older, living in 135 countries and areas in 2013.

For results based on the total sample of national adults, the margin of sampling error is less than ±1 percentage point at the 95% confidence level. For results based on country-level samples, the margin of error ranges from a low of ±2.1 to a high of ±5.3.

All country-level analyses use country weights. Global and regional analysis uses projection weights that account for country size. Minimum sample sizes of N=300 apply.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

Each element in the Global Well-Being Index contains two questions asked of all respondents:

Purpose

  • You like what you do every day.
  • You learn or do something interesting every day.

Social

  • Someone in your life always encourages you to be healthy.
  • Your friends and family give you positive energy every day.

Financial

  • You have enough money to do everything you want to do.
  • In the last seven days, you have worried about money.

Community

  • The city or area where you live is a perfect place for you.
  • In the last 12 months, you have received recognition for helping to improve the city or area where you live.

Physical

  • In the last seven days, you have felt active and productive every day.
  • Your physical health is near-perfect.

This article is the first in a series of three articles exploring worldwide perceptions of well-being in the five well-being elements of the Gallup-Healthways Global Well-Being Index: purpose, social, financial, community, and physical.


Download the Global Well-Being Index Report

Topics: Well-Being In the News Healthcare Well-Being Index Gallup Science and Research

Creating a Catalyst for Worldwide Change

Madison Agee

By: Ben R. Leedle Jr., President and CEO, Healthways

Ben Leedle Healthways President and CEO Ben Leedle

Almost seven years ago, we started on a journey with Gallup — a journey to measure well-being and explore the dimensions of a life well-lived. Our goal was to understand what is important to people, how we experience our day-to-day lives, and what we think our lives will be like in the future. We wanted to determine what distinguishes a thriving life from one spent suffering, to broaden the perspective that health is more than just physical. And we sought to understand how this more holistic definition of well-being could influence outcomes that are crucial to societies.

Through decades of research and with the help of many leading experts, we’ve been able to scientifically determine the elements of well-being that are the most predictive and actionable. These include our sense of purpose, our relationships, our financial security, our connection to our communities and our physical health. By thinking of well-being in this broader way, we can better understand the conditions affecting any population and, from there, develop targeted interventions that make a meaningful difference.

We’ve shown that even modest improvements in well-being can substantially lower healthcare costs and increase worker productivity within organizations. We’ve proven that scalable change can be realized across communities.

So where are we on our journey?

We continue to advance the science of well-being with Gallup to measure and study the well-being of populations globally. Together, we’ve amassed the world’s largest data set on well-being with more than 2 million surveys of U.S. adults. We’ve extended our reach around the world to create a “golden thread” of well-being information across 135 countries.

We now have a truly global picture of well-being. We can measure the elements that make up well-being, compare the relationships between well-being and other population metrics, and gauge the impact of well-being improvement initiatives in almost any country in the world. Our finding that only 17 percent of the world’s population is thriving in three elements or more tells us there’s much work to be done globally to improve well-being. This work includes promoting sustainable lifestyle changes and making environmental changes to develop communities that encourage high well-being.

We hope you’ll join us on this journey. It’s a journey that fosters thinking beyond traditional metrics that broadens our perspectives to include the essential elements that impact our daily lives. It’s a journey that connects well-being to any population that’s front-and-center for you — be it your employees, your community, your country, or, just as importantly, yourself and your family.

Measuring and understanding well-being matters to the employers that want to improve workforce performance, to the non-profits and international organizations that want to see positive outcomes in their development work, and to the governments that want to strengthen their communities. And it matters to all of us, as individuals who want to live better.


Download the Global Well-Being Index Report

Topics: Well-Being In the News Well-Being Index Gallup Health Conditions Science and Research Health Status