Well-Being Disparities in the U.S.
based on Gallup-Healthways Well-Being Index® findings
Presented by Nikki Duggan
March 3, 2011
The Gallup-Healthways Well-Being Index
• 25-year commitment, initiated January 2, 2008
Six Domains:
• Telephonic-based for “community” survey
1.
Life Evaluation
• 1,000 completed surveys per day/7 days/week
2.
Emotional Health
• 1,100,000+ surveys completed as of February 2011
3.
Physical Health
4.
Healthy Behavior
5.
Work Environment
6.
Basic Access
•
The maximum 95% margin of sampling error is ±0.3
percentage points
• Science-based design, support and oversight:
•
Behavioral economists
•
Psychologists
•
Experts in psychometric statistical analysis
• Largest and most comprehensive well-being survey
of its kind
2
Life Evaluation, Emotional Health and
Physical Health Domains
Life
Evaluation
Evaluation of present and
anticipated life situation 5
years from now
• Evaluate current life by imagining
themselves on a ladder with
steps 1-10
• Evaluate where they expect to be
on the ladder in 5 years
Physical
Health
Emotional
Health
Composite of experiences;
yesterday, from the morning
until the end of the day
History of disease and daily
health experiences
• Sick days in the past month
•
Smiling or laughter
• Disease Burden
•
Learning or doing something
interesting
• Health problems that get in the
way of normal activities
•
Being treated with respect
• Obesity
•
Enjoyment
• Feeling well-rested
•
Happiness
• Daily energy
•
Worry
• Daily Colds
•
Sadness
• Daily Flu
•
Anger
• Daily headaches
•
Stress
•
Diagnosed Depression
Based on the Cantrill Ladder Scale (Cantrill, 1966)
3
Healthy Behavior, Work Environment and
Basic Access Domains
Healthy
Behavior
Life style habits with
established relationships to
health outcomes
• Do you smoke?
• Did you eat healthy yesterday?
• Fruits-vegetables
• Exercise
Work
Environment
Job satisfaction and
engagement
• Are you satisfied or dissatisfied
with your job or the work you do?
• At work, do you get to use your
strengths to do what you do best
every day, or not?
• Does your supervisor at work treat
you more like he or she is your
boss or your partner?
• Does your supervisor always
create an environment that is
trusting and open, or not?
Basic
Basic
Access
Access
Access to food, shelter,
healthcare, and a safe and
satisfying place to live
• Satisfaction with community and
area as a place to live
• Clean water
• Medicine
• Safe place to exercise
• Affordable fruits and vegetables
• Feel safe walking alone at night
• Enough money for food
• Enough money for shelter
• Enough money for healthcare
• Visited a dentist recently
• Have a doctor
• Have health insurance
4
Application at the Personal Level
Gallup-Healthways Well-Being Index™
Life
Evaluation
Healthy
Behavior
Work
Quality
Emotional
Health
Basic
Access
Physical
Health
5
Healthways Well-Being Assessment™
Health
Risk
Assessment
Life
Evaluation
Healthy
Behavior
Work
Quality
Emotional
Health
Biometrics
Basic
Access
Physical
Health
Performance
And
Productivity
Well-Being Relationship to Hospital Utilization
Impact of Well-Being on Event Frequency
-49%
Percent
-83%
20
15
10
5
0
0-50
(n=109)
Low
>50-60
(n=151)
>60-70
(n=347)
>70-80
(n=582)
Well-Being Score (Composite)
Admission
ER Visit
Source: Wellmark Data, Healthways Center for Health Research Analysis (n=2,235)
6
Confidential and
Proprietary
6
>80-90
(n=683)
>90-100
(n=363)
High
Well-Being Relationship to Medical Costs
Annual Medical and Rx Claims Cost
Annual Costs
(Indexed)
4.0
Low:High Well-Being = ~3.5x more cost
3.0
2.0
1.0
0-50
(n=109)
Low
>50-60
(n=151)
>60-70
(n=347)
>70-80
(n=582)
Well-Being Score (Composite)
Source: Wellmark Data, Healthways Center for Health Research Analysis (n=2,235)
7
Confidential and
Proprietary
7
>80-90
(n=683)
>90-100
(n=363)
High
U.S. WELL-BEING SAMPLE STATE
DATA
www.healthways.com
8
Well-Being in Georgia
2008
Result
2009
2008
Rank
2009
2010
2010
66.0
66.1
66.1
23
25
31
Life Evaluation
44.5
48.8
51.8
7
7
8
Emotional Health
79.2
79.1
79.3
21
18
15
Physical Health
78.0
77.2
77.0
11
20
21
Healthy Behavior
63.1
62.3
62.9
27
30
29
Work Environment
49.4
48.9
46.0
37
25
41
Basic Access
81.6
80.1
79.6
39
38
37
Well-Being Overall
TOP QUINTILE
2ND QUINTILE
3rd QUINTILE
9
4TH QUINTILE
5TH QUINTILE
Well-Being in Georgia Cities
>Lopx;lc
Atlanta-SandySavannah,
Springs-Marietta,
GAChattanooga,
GA
TN-GA
Augusta-Richmond County, GA
Atlanta
Savannah
Chattanooga
Augusta
Overall Rank
Life Evaluation
Emotional Health
Physical Health
Healthy Behavior
Work
Environment
Basic Access
TOP QUINTILE
5,376,285
329,329
514,568
528,519
STATE
2010
43
68
80
112
31
2009
43
165
156
78
25
2008
50
66
125
91
23
2010
17
37
56
51
8
2009
21
136
129
50
7
2008
21
11
95
55
7
2010
35
20
80
25
15
2009
49
109
178
18
18
2008
61
34
179
44
21
2010
26
37
164
68
21
2009
9
91
183
39
20
2008
9
62
162
91
11
2010
112
116
99
104
29
2009
96
73
145
132
30
2008
71
140
126
131
27
2010
92
125
34
161
41
2009
84
184
52
109
25
2008
116
133
69
135
37
2010
125
116
108
158
37
2009
133
147
136
134
38
2008
120
116
119
103
39
2ND QUINTILE
10
3rd QUINTILE
4TH QUINTILE
5TH QUINTILE
Well-Being in Atlanta
Strengths & Opportunities in Atlanta Congressional Districts
Georgia Congressional District #7
Georgia Congressional District #6
CD Description: Alpharetta, Roswell, Dunwoody
Strengths
Atlanta Congressional Districts
CD Description: Mountain Park, Snellville, Buford
Strengths
Opportunities
Opportunities
Least Obesity
Highest Cholesterol
Most Smiling
Highest Stress
Least Smoking
Least Fruit / Vegetable
Intake
Most Job Satisfaction
Fewest Exercising
Most City Satisfaction
Least Happiness
Least Disease Burden
Most Struggling
Georgia Congressional District #13
Georgia Congressional District #4
CD Description: Smyrna, Douglasville, Riverdale
Strengths
CD Description: North Atlanta, Scottdale, Belvedere Park
Opportunities
Least Stress
Highest Depression
Highest Trusting Work
Environment
Highest Smoking
Lowest Cholesterol
Lowest City
Progression
Strengths
Georgia Congressional District #5
CD Description: Metro Atlanta, Druid Hills, Decatur
Strengths
Opportunities
Least Neighborhood
Safety
Most "Thriving"
TOP QUINTILE
Least Depression
Least Collaborative
Supervision
Most Exercise
Least Health
Insurance Coverage
2ND QUINTILE
3rd QUINTILE
11
4TH QUINTILE
Opportunities
Most Energy
Highest Obesity
Least Physical Pain
Highest Diabetes
Most With Personal
Doctor
Least Job Satisfaction
5TH QUINTILE
U.S. WELL-BEING DISPARITIES
BY DEMOGRAPHIC VARIABLES
www.healthways.com
12
U.S. Well-Being Disparities
Monthly Income
Well-Being Index
Composite Score
(2010) = 66.80
Variance from National Score (points)
Composite Score
Six domains:
1. Life Evaluation
2. Emotional Health
3. Physical Health
4. Healthy Behavior
5. Work Environment
6. Basic Access
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
13
U.S. Well-Being Disparities
Age
Well-Being Index
Composite Score
(2010) = 66.8
Variance from National Score (points)
Composite Score
Six domains:
1. Life Evaluation
2. Emotional Health
3. Physical Health
4. Healthy Behavior
5. Work Environment
6. Basic Access
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
14
U.S. WELL-BEING DISPARITIES
BY ETHNICITY MEASURES
www.healthways.com
15
U.S. Well-Being Disparities
Ethnicity
Well-Being Index
Composite Score
(2010) = 66.8
Variance from National Score (points)
Composite Score
Six domains:
1. Life Evaluation
2. Emotional Health
3. Physical Health
4. Healthy Behavior
5. Work Environment
6. Basic Access
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
16
Well-Being Disparities: Life Evaluation
Ethnicity
Life Evaluation
Score (2010) = 49.8
Variance from National Score (points)
Life Evaluation
“Please imagine a ladder with
steps numbered from zero at
the bottom to ten at the top.
The top of the ladder
represents the best possible
life for you and the bottom of
the ladder represents the
worst possible life for you.
On which step of the ladder
would you say you personally
feel you stand at this time?
In five years?”
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
17
Well-Being Disparities: Emotional Health
Ethnicity
Emotional Health
Score (2010) = 79.3
Variance from National Score (points)
Emotional Health
Composite of experiences;
yesterday, from the morning
until the end of the day
• Smiling or laughter
• Learning or doing
something interesting
• Being treated with
respect
• Enjoyment
• Happiness
• Worry
• Sadness
• Anger
• Stress
• Diagnosed Depression
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
18
Well-Being Disparities: Physical Health
Ethnicity
Physical Health
Score (2010) = 76.9
Variance from National Score (points)
Physical Health
History of disease and daily
health experiences
• Sick days in the past
month
• Disease Burden
• Health problems that get
in the way of normal
activities
• Obesity
• Feeling well-rested
• Daily energy
• Daily Colds
• Daily Flu
• Daily headaches
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
19
Well-Being Disparities: Healthy Behaviors
Ethnicity
Healthy Behavior
Score (2010) = 64.1
Variance from National Score (points)
Healthy Behavior
Life style habits with
established relationships to
health outcomes
• Do you smoke?
• Did you eat healthy
yesterday?
• Fruits-vegetables
• Exercise
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
20
Well-Being Disparities: Work Environment
Ethnicity
Work Environment
Score (2010) = 48.2
Variance from National Score (points)
Work Environment
Job Satisfaction and
Engagement
• Are you satisfied or
dissatisfied with your job
or the work you do?
• At work, do you get to
use your strengths to do
what you do best every
day, or not?
• Does your supervisor at
work treat you more like
he or she is your boss or
your partner?
• Does your supervisor
always create an
environment that is
trusting and open, or
not?
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
21
Well-Being Disparities: Basic Access
Ethnicity
Basic Access Score
(2010) = 82.3
Variance from National Score (points)
Source: Gallup-Healthways Well-Being Index Community Survey 2010, n= 352,840
22
Basic Access
Access to food, shelter,
healthcare, and a safe and
satisfying place to live
•
Satisfaction with community
and area as a place to live
•
Clean water
•
Medicine
•
Safe place to exercise
•
Affordable fruits and
vegetables
•
Feel safe walking alone at
night
•
Enough money for food
•
Enough money for shelter
•
Enough money for healthcare
•
Visited a dentist recently
•
Have a doctor
•
Have health insurance
WELL-BEING ASSESSMENT
DRIVING DEEPER INSIGHT
www.healthways.com
23
Sample Business Unit Heat Mapping
TOP QUINTILE
24
2ND QUINTILE
3rd QUINTILE
4TH QUINTILE
5TH QUINTILE
Sample Business Unit Heat Mapping
Well-Being Assessment Results by Business Unit
Overall
Caterpillar
BU #16
BU #17
BU #18
BU #19
BU #20
BU #21
BU #22
BU #23
BU #24
BU #25
68.4
68.6
68.6
68.1
67.8
66.3
66.2
65.8
65.7
65.5
64.5
TOP QUINTILE
25
Life
Evaluation
Emotional
Health
Physical
Health
Healthy
Behavior
60.9
76.4
78.1
62.6
46.9
85.5
61.6
75.5
76.8
65.2
46.4
86.2
59.6
76.3
80.3
66.4
44.4
84.8
59.9
77.9
78.9
61.5
45.3
85.0
58.0
75.7
78.1
63.9
43.4
87.7
58.3
74.7
76.4
59.2
46.0
83.3
52.4
75.0
76.9
61.1
45.4
86.5
59.1
76.4
75.8
53.4
45.6
84.2
57.3
73.9
76.8
61.7
40.1
84.2
56.8
76.3
76.7
56.8
43.2
83.4
52.5
73.0
75.3
60.2
42.4
83.8
2ND QUINTILE
3rd QUINTILE
Work
% at Optimal
Environment Basic Access
Income
4TH QUINTILE
5TH QUINTILE
41.7%
51.8%
41.6%
40.8%
57.2%
31.7%
37.9%
28.4%
36.6%
28.3%
26.8%
Conclusions
High Costs of Doing Nothing
• Both medical and productivity costs impose heavy financial burdens on communities and companies
• Without interventions, these costs can be expected to grow and compound
The Primary Sources of These Costs are Known
• Chronic conditions cause people to seek care (medical costs) and reduce their ability to work
(productivity)
• While behaviors do not have costs associated with them, the conditions they create and exacerbate
can have substantial costs
Intervening in Modifiable Behaviors Reduces Costs
• Curtailing or eliminating behavioral risks can reduce costly chronic conditions
• Addressing risks before they become conditions can be a significant source of savings
Confidential and
Proprietary
26