Article Text
Abstract
Objectives Well-being is a holistic, positively framed conception of health, integrating physical, emotional, social, financial, community and spiritual aspects of life. High well-being is an intrinsically worthy goal for individuals, communities and nations. Multiple measures of well-being exist, yet we lack information to identify benchmarks, geographical disparities and targets for intervention to improve population life evaluation in the USA.
Design Using data from the Gallup National Health and Well-Being Index, we conducted retrospective analyses of a series of cross-sectional samples.
Setting/participants We summarised select well-being outcomes nationally for each year, and by county (n=599) over two time periods, 2008–2012 and 2013–2017.
Main outcome measures We report percentages of people thriving, struggling and suffering using the Cantril Self-Anchoring Scale, percentages reporting high or low current life satisfaction, percentages reporting high or low future life optimism, and changes in these percentages over time.
Results Nationally, the percentage of people that report thriving increased from 48.9% in 2008 to 56.3% in 2017 (p<0.05). The percentage suffering was not significantly different over time, ranging from 4.4% to 3.2%. In 2013–2017, counties with the highest life evaluation had a mean 63.6% thriving and 2.3% suffering while counties with the lowest life evaluation had a mean 49.5% thriving and 6.5% suffering, with counties experiencing up to 10% suffering, threefold the national average. Changes in county-level life evaluation also varied. While counties with the greatest improvements experienced 10%–15% increase in the absolute percentage thriving or 3%–5% decrease in absolute percentage suffering, most counties experienced no change and some experienced declines in life evaluation.
Conclusions The percentage of the US population thriving increased from 2008 to 2017 while the percentage suffering remained unchanged. Marked geographical variation exists indicating priority areas for intervention.
- health policy
- public health
- epidemiology
Data availability statement
The dataset used for this study is available on Dryad (doi:10.5061/dryad.fqz612jsf).
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
The dataset used for this study is available on Dryad (doi:10.5061/dryad.fqz612jsf).
Supplementary materials
Supplementary Data
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Footnotes
Twitter @Carley_Riley, @hmkyale, @Broy3445
Contributors CR and BR participated in the initial conception of this study. JH, RL and DL performed the analyses. All authors (CR, BR, JH, RL, BH, DL, DW and HMK) contributed to the study design, interpretation of data, drafting and revising the article, and its final approval. All authors are guarantors. The authors affirm that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted.
Funding This study was supported by The Institute for Integrative Health (www.tiih.org). There is no award/grant number to report; CR and BR are current Fellows of TIIH.
Disclaimer The funders had no role in the design or execution of this study.
Map disclaimer The depiction of boundaries on the map(s) in this article does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.
Competing interests CR and BR receive funding from the Institute for Healthcare Improvement and Heluna Health to support their effort in developing and implementing the measurement framework for the 100 Million Healthier Lives initiative and Well-being in the Nation; BR additionally receives grant funding for the Robert Wood Johnson Foundation. HMK reports personal fees from UnitedHealth, IBM Watson Health, Element Science, Aetna, Facebook, Siegfried & Jensen Law Firm, Arnold & Porter Law Firm, Ben C. Martin Law Firm and National Center for Cardiovascular Diseases, Beijing; HMK reports ownership of HugoHealth, ownership of Refactor Health, contracts from the Centers for Medicare & Medicaid Services, and grants from Medtronic and the Food and Drug Administration, Medtronic and Johnson and Johnson, and Shenzhen Center for Health Information, outside the submitted work. JH reports funding from Centers for Medicare & Medicaid Services. DL and DW are current employees of Gallup and BH was an employee of Sharecare during the conduct of this study, the companies that developed the measure of well-being and acquired the data used in this study. VL has nothing to disclose.
Provenance and peer review Not commissioned; externally peer reviewed.
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