According to the latest report arising out of the Gallup–Sharecare State of American Well-Being series, 186 communities were ranked based on their Well-Being Index scores for 2016-2017. The index is a metric that measures areas of physical health, financial security, community pride, social connections, and purpose. For the third consecutive year, Naples-Immokalee-Marco Island, Florida, came in first.
Which parts of the country score highest where residents in different communities feel great about their overall well-being, and for the areas that score low, what can they focus on to improve?
The latest report arising out of the Gallup—Sharecare State of American Well-Being series ranked 186 communities based on their Well-Being Index scores for 2016-2017. The index is a metric that measures areas of physical health, financial security, community pride, social connections, and purpose.
Last month, Gallup-Sharecare released a report measuring this well-being metric across states, with 21 seeing a drop in one’s sense of purpose, social connections, community pride, financial security, and physical health. No state saw an improvement. It was the largest drop since the Great Recession.
Gallup and Sharecare, the health and wellness engagement company, are research partners in the project. This latest report is a dive into metropolitan statistical areas (MSAs).
For the third consecutive year, Naples-Immokalee-Marco Island, Florida, had the highest overall well-being in the nation, with a score of 67.6. It is also the first community to some in first or second across all 5 elements of well-being.
Barnstable Town, Massachusetts, was number 2, followed by Boulder, Colorado; Santa Cruz-Watsonville, California; and Charlottesville, Virginia.
All of the top communities in 2016-2017 have made past top 10 lists.
About half of the lowest 25 well-being communities are located in the South, a region that saw significant declines in statewide well-being last year.
Fort Smith, Arkansas-Oklahoma, had the lowest overall well-being score (58.2), marking the third consecutive period that it was among the 2 lowest communities.
Most of the lowest-ranked communities have consistently been among the bottom since 2008. These include Canton-Massillon, Ohio; Hickory-Lenoir-Morganton, North Carolina; Gulfport-Biloxi-Pascagoula, Mississippi; and Flint, Michigan. However, this is the first time that the South Bend-Mishawaka, Indiana-Michigan, community slipped into the bottom 10 well-being communities.
The companies said the results can be used “to benchmark and identify opportunities for well-being improvement.”
As an example, the companies shared the experiences of NCH Healthcare System, a nonprofit healthcare organization based in top-ranked Naples. NCH joined a healthy living initiative known as the Blue Zones Project, which seeks to prevent disease through lifestyle changes. NCH sponsored the project, gathering support from local worksites (including NCH), local government, schools, restaurants, grocery stores, and faith-based organizations to create a better healthy living environment.
Partners then focused on different areas where they could make an impact, such as:
If some of this language seems a bit familiar with the idea that social determinants of health (SDH) can influence one’s health more than the time spent inside the walls of a medical office—that is, access to food, healthcare, transportation, and other things have a great influence on one’s life—Gallup—Sharecare said there are some similarities, but that their metric also looks at other outcomes.
In an email exchange with the The American Journal of Managed Care®, Dan Witters, Gallup-Sharecare Well-Being Index (GSWBI) research director, explained, “The GSWBI certainly shares characteristics with most SDOH models, but we ordinarily wouldn’t describe it that way. While we do use 'well-being' to discern—and explain differences–in health among individuals, health outcomes are just one type of many outcomes that our research model concerns itself with. (And, of course, BMI, disease burden, and daily affect are all a part of our WBI model, not simply outcomes predicted by it). Other outcomes include performance at work, absenteeism, likelihood to change jobs, turnover itself, resiliency, adaptability, and life evaluation, among many others.”
Some communities maintained high rankings even in states where well-being overall slid during the same time period. Two such examples are Ann Arbor, Michigan, and Lancaster, Pennsylvania. Both are in the top 25 list of well-being communities despite the fact that their respective states fell in the bottom half of the state rankings in 2017.
“Setting aside a look at individual metrics, I think the main thing that insulates many communities from a downturn during tumultuous times like these is having a strong culture of well-being,” said Witters. “Culture is simply ‘this is the way we do things around here,’ and it is a very real and very significant factor in the communities that have it. Once embedded, it takes on a life of its own, so leaders are usually just a product of it and reflect its values. In the absence of it, building culture is a critical component of any community’s well-being intervention program. This part is driven heavily by leadership providing a sustained voice emphasizing well-being’s importance, using a shared and consistent definition of well-being, and using the bully pulpit to set policy and assign resources to help make well-being affirming choices more likely for residents.”
The research also found that residents of larger communities have higher well-being, chiefly because they have generally better physical health than do those who live in small towns and rural areas, which have higher rates of obesity and other chronic diseases.
Residents of large communities are more likely to engage in healthy behaviors such as visiting the dentist and not smoking, and are more physically fit, possibly attributable to cultural norms and more readily available infrastructure such as parks, bike paths, and fitness centers.
People living in rural areas tend to have lower median household incomes, lower levels of postsecondary education, and are less likely to have health insurance. Access to healthcare can also be an issue.
The results are based a subset of 337,690 telephone interviews with US adults across all 50 states and the District of Columbia, conducted between January 2, 2016 and December 30, 2017. The survey included a variety of questions about health, health habits, weight, exercise, and attitudes about where one lives and other matters.