The Well-Being Journal

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., 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

St. Joseph Health Expands Workplace Wellness Programs to Improve Employee Well-Being

Madison Agee

At the 2015 Integrated Benefits Institute Annual Forum in San Francisco this week, Elizabeth Glenn-Bottari, Vice President and Chief Operating Officer of Integrative Health St. Joseph Health in Irvine, California, discussed health and productivity management guided by a workforce’s professional, social and emotional well-being. St. Joseph Health has partnered with Healthways to better understand and improve employee well-being, developing a program that has reduced high claims costs, absenteeism and presenteeism. As Glenn-Bottari was quoted in the March 18, 2015 issue of Business Insurance, “we feel that the investment is meaningful, because we can see from the data that we are influencing our employees' health and well-being.”

Click here to read the article (registration may be required, but is complimentary).

Topics: Well-Being In the News Business Performance Workplace Wellness Competitive Advantage

New Report Ranks U.S. States by Their Overall Well-Being

Madison Agee

WBI State InfographicA recently released report from Gallup and Healthways ranks all 50 states in the United States based on their respective well-being, and at the very top of the list is Alaska. While not a newcomer to the top ten states with the highest well-being – it has made an appearance four out of the last seven years – 2014 marks the first time Alaska leads the country in well-being. Rounding out the top five are Hawaii, South Dakota, Wyoming and Montana. Last year’s leading state, North Dakota, tumbled this year to 23rd.

For the sixth consecutive year, West Virginia and Kentucky have the lowest well-being in the United States, ranking 50th and 49th, respectively. Other states that have appeared in the bottom ten all seven years are Arkansas, Ohio and Mississippi.

This information appears in “The State of American Well-Being: 2014 State Well-Being Rankings,” which is based on the Gallup-Healthways Well-Being Index®. The Well-Being Index uses a holistic definition of well-being and self-reported data from individuals across the globe to create a unique view of societies’ progress on the elements that matter most to well-being: purpose, social, financial, community and physical. Read more about the new rankings.

We’re also excited to announce a brand-new way to make sure you’re the first to know when we release new reports based on the Well-Being Index. By subscribing to content from the Well-Being Index, we’ll let you know when we release new reports, insights, analysis and information. Next up, we’ll explore well-being in large communities across the United States.

Topics: Well-Being Well-Being Index Gallup

Improving Well-Being in a Challenging Population

Madison Agee

When you think of the type of organization that implements a well-being improvement program in its workforce population, what comes to mind? If you’re like many people, you’re probably imagining a professional services organization with a predominantly white-collar workforce — the type of environment where employees usually have good healthcare coverage and long employment tenures.

It’s no different when it comes to the scientific literature that has looked at the outcomes of programs such as workplace wellness and employee well-being improvement. Studies have historically focused on professional, white-collar environments, essentially ignoring industries such as retail and warehousing where workers are typically more blue-collar. Thus, the recent publication of a study in the Journal of Occupational and Environmental Medicine (JOEM) provides a much-needed and unique contribution to the scientific body, as it examines the outcomes of a well-being intervention program among a mostly blue-collar employee population.

The study, “Well-being, Health and Productivity After an Employee Well-being Intervention in Large Retail Distribution Centers” was authored by the Healthways Center for Health Research and reveals the positive outcomes that occurred following a Healthways-driven well-being intervention at a large retail employer. Supporting what is perhaps a common assumption regarding blue-collar workers, the participants in this study, on average, faced significantly more challenges than individuals in the surrounding community. These challenges included lower overall well-being scores, physical health, healthy behaviors, basic access and ability to afford food.

Despite these pre-intervention challenges, the employees in the study achieved measurable improvements in overall well-being scores, biometric measurements and workplace productivity over a six-month period. For example, overall well-being improved by nearly 2.5 points, while healthy behaviors improved 12.1 percent. Additionally, total cholesterol dropped an average of 10.8 points, and on-the-job productivity improved by 18.8 percent.

In addition to being traditionally associated with white-collar environments, workplace wellness and well-being intervention programs are often expected to require significant time to produce successful outcomes. Therefore, employers in industries in which high turnover among workers is common (such as retail) may be reluctant to implement programs that are perceived as long-term investments in their workforce. This study shows, however, that after only six months of intervention, participants realized noticeable improvement in all three categories of metrics in the study: well-being scores, biometric measurements and on-the-job productivity.

This may be especially appealing given the significant improvement in productivity that was seen during this study —results similar to the 18.8 percent improvement seen in the study over just a six-month period could be incredibly important in many workplaces. To read more about improving on-the-job productivity, download a copy of Healthways’ eBook 5 Things You Didn’t Know About Improving Productivity in the Workplace.

Topics: Well-Being Business Performance Workplace Wellness Productivity Science and Research