The Well-Being Journal

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 Productivity Science and Research Workplace Well-Being

Power of Yoga to Improve Cardiovascular Risk

Amy Katz

Is yoga good for your heart? It could be as healthy for your heart as cycling.

According to a new study in the European Journal of Preventive Cardiology, yoga may be as beneficial as more traditional physical activities such as walking or biking in reducing the risks of cardiovascular disease.

Investigators from the United States and Netherlands conducted a systematic review of 37 randomized controlled trials, which included 2,768 subjects. The aim of the analysis was to examine whether yoga is beneficial in managing and improving cardiovascular disease risk factors and whether it could be an effective therapy for cardiovascular health.

The study compared those who practiced yoga with those who didn’t. Those who practiced yoga had:

  • Lower blood pressure
  • Lower LDL (bad cholesterol)
  • Lower body mass index (BMI)
  • Increased HDL (good cholesterol)

Results showed that risk factors for cardiovascular disease improved more in those practicing yoga than in those not taking part in any aerobic exercise. In fact, yoga had an effect on risk factors comparable to aerobic exercise.

The study’s authors write, “This finding is significant, as individuals who cannot or prefer not to perform traditional aerobic exercise might still achieve similar benefits in [cardiovascular] risk reduction.” They go on to observe that “Yoga has the potential to be a cost-effective treatment and prevention strategy given its low cost, lack of expensive equipment or technology, potential greater adherence and health-related quality of life improvements, and possible accessibility to larger segments of the population.”

The prevalence and cost of cardiac disease is growing. As the number 1 cause of death in America, heart disease accounts for some 600,000 deaths per year. Indeed, 40 percent of the U.S. population is expected to have some form of cardiovascular disease in the next 20 years, according to the American Heart Association. The cost of heart disease in healthcare services, medications, and lost productivity tops $109 billion per year, according to the Centers for Disease Control.

The American Heart Association still recommends 150 minutes of aerobic exercise per week, but this study could lead to yoga as a recommended therapy for patients with risk factors for cardiovascular disease.

Linking yoga to cardiovascular health is not a new concept—for over 30 years, Dr. Dean Ornish has recommended yoga for reducing stress. In fact, the Dr. Dean Ornish Program for Reversing Heart DiseaseTM includes yoga as one of the fundamental activities for reversing heart disease. To learn more about the Ornish program, please visit

Topics: Prevention Science and Research Health Status Ornish Lifestyle Medicine

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

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:


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


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


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


  • 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.


  • 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