The Well-Being Journal

Alabama's Anniston Star Gets It

Sandy Cummings

This week, Gallup and Healthways released our analysis of the state of well-being for communities, states and congressional districts in the United States. We've been conducting this research and analysis for six years now, and it always yields interesting tidbits -- for example, Boulder has the nation’s lowest obesity rate at 12.4%, making it the only community in the United States (covered by the report) that meets the Centers for Disease Control and Prevention’s stated goal of 15% obesity rate or lower.

The analysis generates some media attention each year. After all, we care about where we live, and we want to know how our states and communities fare in the rankings. Does the research echo what we believe to be true about our homes and our experiences?

We were excited to see the news covered this year by USA Today, The Huffington Post, the Boston Globe and many other media outlets -- even Diane Sawyer gave us a shout-out on "ABC World News Tonight." That's heady stuff.

But the editorial board at Alabama's relatively small Anniston Star really captured the reason that we collaborate on the Gallup-Healthways Well-Being Index in the first place. Take a look. It's a quick read, but an important one, because Alabama ranked 47th this year, ahead of only three states — Mississippi, Kentucky and West Virginia.

Well-being isn't the same as being happy, nor is it synonymous with good physical health or wealth. Tom Rath, who literally wrote the book on well-being, describes it as "the interaction between physical health, finding your daily work and interactions fulfilling, having strong social relationships and access to the resources you need, feeling financially secure, and being part of a true community."

In short, in areas where well-being is high, people have a greater tendency to be leading their best lives. And that, in turn, impacts business performance, healthcare costs and many other factors that are vital to helping communities thrive and grow.

Understanding where a population -- a state, a community, a company -- stands when it comes to well-being is the first step toward setting successful strategies for improvement. Because well-being can be improved -- it just takes leadership.

As the editorial board of the Anniston Star put it:

Not everyone in Alabama is obese. Not everyone has habits harmful to his or her health. Not everyone has trouble finding decent housing or healthy food. Not everyone has a fatalistic outlook on life. Yet, we all must work together.

Alabama is an example of what happens in the absence of leadership. Too many of its residents are denied an opportunity at the American Dream.

Past performance doesn't lock us into this prison forever. Everyone has a stake in seeing these conditions improve. Our prosperity as a state depends on it.

Topics: Well-Being Links of the Week Basic Access In the News Healthcare Community Well-Being Index Gallup Leadership

Provo-Orem, Utah, Leads U.S. Communities in Well-Being

James Kanka

San Jose-Sunnyvale-Santa Clara, Calif., tops large communities
by Dan Witters, Gallup

WASHINGTON, D.C. -- Provo-Orem, Utah, has the highest Well-Being Index score (71.4) in the U.S. across 189 communities Gallup and Healthways surveyed in 2012-2013. Also in the top 10 are Boulder, Colo.; Fort Collins-Loveland, Colo.; Honolulu, Hawaii; and San Jose-Sunnyvale-Santa Clara, Calif.

Top 10 Communities Overall Well-Being

At 59.5, Huntington-Ashland, W.Va.-Ky.-Ohio, is the only community with a Well-Being Index score below 60. Huntington-Ashland also trailed all other metros in 2008, 2010, and 2011; its score of 58.1 in 2010 remains the lowest on record across five reporting periods spanning six years of data collection.

Charleston, W.Va., has the second-lowest score of 60.0. Redding, Calif.; Spartanburg, S.C.; Beaumont-Port Arthur, Texas; and Hickory-Lenoir-Morganton, N.C.; round out the bottom six -- with the last three communities tied with a score of 62.2. None of these metro areas are strangers to the bottom 10 list, with each community having appeared at least once on the list in a prior reporting period.

Bottom 11 Communities Overall Well-Being

The regional breakdown in well-being scores is largely consistent with Gallup and Healthways state-level results, which find well-being generally higher in the Midwest and West, and lower in the South. West Virginia, which is home to at least a portion of the two lowest-rated metro areas (Huntington-Ashland and Charleston), ranked last in the nation for well-being among states for the fifth consecutive year in 2013. The state of California ranked 17th in overall well-being in 2013, but nevertheless boasts three metros in the top 10 for 2012-2013.

The Metropolitan Statistical Areas (MSAs) described in this article are defined by the U.S. Office of Management and Budget. In many cases, more than one city is included in the same MSA, and the same MSA can cross state borders (such as Huntington-Ashland). All reported MSAs encompass at least 300 completed surveys in 2012-2013, and Gallup has weighted each of these samples to ensure it is demographically representative of that MSA.

The Gallup-Healthways Well-Being Index score is an average of six sub-indexes, which individually examine life evaluation, emotional health, work environment, physical health, healthy behaviors, and access to basic necessities. The overall score and each of the six sub-index scores are calculated on a scale from 0 to 100, where a score of 100 represents the ideal. Gallup and Healthways have been tracking these measures daily since January 2008.

Ann Arbor Still No. 1 in Life Evaluation; Honolulu Best Off Emotionally

Although Provo-Orem has the highest overall well-being score, it does not lead in any of the six domains of well-being that we measured in 2012 and 2013. Residents of Ann Arbor, Mich., rated their current and future lives the best, for the second year in a row, and those of Huntington-Ashland rated theirs the worst.

Holland-Grand Haven, Mich., is the metro area with the highest Physical Health Index in the nation, displacing Fort Collins-Loveland, Colo., the community that held the spot in 2011. San Luis Obispo-Paso Robles, Calif., has the highest Work Environment Index score. Holland-Grand Haven, Mich., led the nation in access to basic necessities as it did in 2008-2010 (Gallup and Healthways did not conduct enough surveys in Holland-Grand Haven to report on it in 2011).

Best and Worst Scoring Communities, Sub-Indexes

Compare well-being across large, medium, and small metro areas.

Residents of Huntington-Ashland rated their lives about half as well as those in Ann Arbor, and also described their physical health at levels far below what is found among residents of Holland-Grand Haven. Including its nation-leading score of 89.7 in the Basic Access Index, Holland-Grand Haven is the only community to boast a top ranking in more than one sub-index, although lower ratings in Life Evaluation and Work Environment kept it out of the top 10 overall.

Huntington-Ashland had the worst Emotional Health Index score, the third sub-index on which it ranks last nationally. Honolulu has been the top-rated U.S. metro area in the Emotional Health Index each measurement period since 2010 and has never ranked lower than second on this domain.

Healthy behaviors were least prevalent in Charleston and most prevalent in Salinas, Calif. Salinas reclaimed the top spot it occupied in 2010 after dropping to second place in 2011.

McAllen-Edinburg-Mission, Texas, residents reported the worst access to basic necessities for the fourth measurement period in a row, due in part to just 47% of residents who reported having health insurance, by far the lowest percentage in the nation. The metro area in the U.S. with the lowest score on the Basic Access Index has come from the state of Texas across all five reporting periods.

San Jose and San Francisco Top All Large Communities in Well-Being

San Jose-Sunnyvale-Santa Clara residents reported the highest well-being among the nation's 52 largest (1 million or more residents) communities, followed by San Francisco-Oakland-Fremont, Calif., and Washington, D.C.-Arlington-Alexandria, Va.-Md.-W.Va. These three metros are commonly among the top of the list of large cities each year. San Jose-Sunnyvale-Santa Clara's overall rank of fifth across well-being areas of all sizes is the highest ever for a large metro area. Minneapolis-St. Paul-Bloomington, Minn.-Wis., also typically ranks in the top five, while Denver-Aurora, Colo., makes its first appearance on the list this year.

Louisville-Jefferson County, Ky.-Ind., which was ranked 50th among large metros in 2011, took over the bottom spot, displacing Las Vegas-Paradise, Nev., for the large metro area with the lowest well-being, due mostly to its residents' low physical, emotional, and healthy behaviors scores. Jacksonville, Fla., repeated its ranking of 51stfrom 2011.

Las Vegas-Paradise residents again reported the worst access to clean and safe water in the U.S. among large communities -- a recurring pattern for this metro area and a principle reason why it is ranked last nationally in basic access for the fifth-straight reporting period among large communities. In general, the six-point gap in well-being between the highest and lowest-rated large communities is half as large as the 11-point gap found between the highest and lowest scores amid all 189 reportable communities that Gallup and Healthways surveyed.

Top Five and Bottom Five Large Communities, Overall Well-Being

Implications

With about 80% of Americans living in urban or suburban areas, the role of cities in spearheading the well-being of the U.S. is significant. City leadership -- be it government, business, faith-based, community-based, or education -- plays a critical role in the success or failure of a city to embrace and sustain a culture of well-being.

"There are tangible policies that communities can adopt to actively cultivate and improve residents' well-being," said Dan Buettner, National Geographic Fellow and founder of Blue Zones LLC. "Policies that nudge people into healthy activities -- where it is easy to walk to the store, bike to a friend's house, get access to fresh produce, and be surrounded by healthy-minded, supportive friends -- are ones that make the healthy choice, the easy choice. Sustained transformation depends on building an environment and establishing social policies that support and reinforce these programs."

Communities such as Boulder (highest average rank across all reporting periods since 2008), Provo-Orem (most religious city, which helps its overall well-being), and San Jose-Sunnyvale-Santa Clara (the highest-ever rating for a large metro) can serve as best-practice examples for leaders of other cities. Key elements of community well-being, such as learning new and interesting things, providing safe places to exercise, routine trips to the dentist, and smoking cessation, are all key vanguards of high well-being locations. Leaders can leverage these learnings and advocate their execution in their own communities.

View the full report on well-being in the U.S.

Explore and compare complete well-being data by metro area using Gallup's U.S. Community Well-Being Tracking interactive.

Topics: Well-Being Index

North Dakota No. 1 in Well-Being, West Virginia Still Last

James Kanka

Well-being has steadily increased in 11 states since 2010
by Dan Witters, Gallup

North Dakota residents had the highest well-being in the nation in 2013, according to the Gallup-Healthways Well-Being Index. South Dakota trailed its northern neighbor in second place, with its highest score in six years of measurement. Hawaii held the top spot for the previous four years, but fell slightly last year. West Virginia and Kentucky had the two lowest well-being scores, for the fifth year in a row.

Well-Being: Top 10 States in 2013Well-Being: Bottom 10 States in 2013

North Dakota rejoined the top 10 well-being states in 2013 after being among that group from 2009 to 2011. South Dakota was among the top 10 in well-being for the first time since 2010, while Washington last appeared in 2008.

Explore complete state data >

These state-level data are based on more than 178,000 interviews with American adults across all 50 states, conducted from January-December 2013. Gallup and Healthways started tracking state-level well-being in 2008. The Gallup-Healthways Well-Being Index score for the nation and for each state is an average of six sub-indexes, which individually examine life evaluation, emotional health, work environment, physical health, healthy behaviors, and access to basic necessities.

The Well-Being Index is calculated on a scale of 0 to 100, where a score of 100 represents ideal well-being. Well-Being Index scores among states varied within a nine-point range in 2013. The Well-Being Index score for the nation in 2013 dipped to 66.2 from 66.7 in 2012, and matches the previous low, measured in 2011.

U.S. Well-Being Index, 2008-2013

Based on U.S. Census Bureau regions, Midwestern and Western states earned nine of the 10 highest well-being scores in 2013, while Southern states had eight of the 10 lowest well-being scores. The regional pattern of well-being is similar to previous years.

West Virginia at the Bottom on Five Out of Six Key Areas of Well-Being

In addition to North Dakota's having the highest overall Well-Being Index score, it was the top state on two of the six well-being sub-indexes: Work Environment and Physical Health. At the opposite end of the spectrum was West Virginia, which ranked last on all sub-indexes except Work Environment.

Nebraska topped all other states on the Life Evaluation Index, with a score that was 17 points higher than West Virginia's. Alaska boasted the highest Emotional Health Index score, while Vermont led all states in Healthy Behaviors for the second straight year. Massachusetts had the best score on the Basic Access Index for the fourth straight year, which is partially a result of having the highest percentage of residents with health insurancein the nation.

States With the Highest and Lowest Scores on the Well-Being Sub-Indexes

Eleven States' Well-Being Index Scores Have Improved Steadily Since 2010

Well-being has been fairly stable nationally since 2008. However, since 2010, the first full year after the Great Recession officially ended, 11 states' well-being scores have shown year-over-year improvement, with the largest gains seen in Nevada, Montana, Vermont, Nebraska, Iowa, and Maine. Four of these states -- Montana, Vermont, Nebraska, and Iowa -- also were among the top 10 well-being states in 2012 and 2013, making their continued improvement notable given their already high Well-Being Index scores.

States Showing Improvement Each Year Since 2010, and Whether They Finished in the Top 10 in Well-Being in 2012 and 2013

Implications

Overall well-being in the U.S. and within states has been fairly steady since 2008, although the national Well-Being Index score fell in 2013. The nation's well-being declined despite improvement in economic confidence in most states. Still, steady growth in 11 states' well-being scores since 2010 illustrates that sustained improvements in well-being are possible regardless of national trends. Four states in particular -- Montana, Vermont, Nebraska, and Iowa -- demonstrate that steady progress is possible, even among the top 10 well-being states.

Gallup's research has shown that people take a variety of factors into account when evaluating their well-being. Job creation, for example, is related to well-being; Gallup's job creation rankings for 2013 are correlated with the well-being rankings. The 2013 Payroll to Population (P2P) state rankings are also correlated with top and bottom well-being states. North Dakota, which has benefited economically from the surge in its oil industry, was the top state in both job creation and P2P in 2013. And other behavioral factors, such as smoking rates, generally line up with well-being at the state level as well.

Regardless of metrics such as employment and job creation, all states rely on strong leadership to spearhead their well-being efforts. Iowa's Healthiest State Initiative, for example, is a privately led, government-supported program designed to improve Iowa's well-being, and has received Gov. Terry Branstad's support since its inception. This sort of steady advocacy for higher well-being can serve as a positive example for other leaders to follow as states try to improve their residents' well-being in 2014.

Gallup's "State of the States" series reveals state-by-state differences on political, economic, and well-being measures Gallup tracks each day. New stories based on full-year 2013 data will be released in the coming months.

To view the full report on well-being in the U.S., visit this page.

Topics: Well-Being Index

Updates to the Gallup-Healthways Well-Being Index in 2014

James Kanka

As of Jan. 1, 2014, the Gallup-Healthways Well-Being Index® transitioned to an updated version. The Well-Being Index now includes a new set of questions, the Gallup-Healthways Well-Being 5™, which is based on extensive collaborative research by Gallup and Healthways. The updated Well-Being Index measures well-being with even more power and scope than previous well-being measurement tools, including the earlier version of the Well-Being Index.

The updated Well-Being Index now reflects the five essential elements of well-being:

  • 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

These elements replaced the six domains that were previously used (Life Evaluation, Work Environment, Emotional Health, Basic Access, Healthy Behaviors, and Physical Health). The updated tool continues to measure life evaluation (thriving/struggling/suffering) and daily emotions, in addition to the five elements, and all of these will be reported on Gallup.com.

The updated instrument is administered nationwide, with 500 surveys to U.S. households each evening, 350 days per year. During the transitional year of 2014, well-being scores can be computed via the updated instrument using a subset of original question items that are still administered in the updated survey. These scores are comparable to scores from the original Well-Being Index.

As in the past, well-being results reported in early 2014 for cities, states, and the U.S. will use the previous full year of data collected via the original Well-Being Index in 2013. In early 2015, Well-Being Index results for these populations will be available using data collected in 2014 with the updated instrument.

Reporting will continue to include the trending of specific metrics such as obesity status, disease burden, smoking habits, exercise, and eating habits.

Learn more about how the Gallup-Healthways Well-Being Index works here.

Topics: Well-Being Index