Health Care and Human Resources

The state of American well-being

Policy changes are needed before Michigan will fare better in a national survey.

February 27, 2015
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treadmill well being
Michiganders could stand to hit the treadmill more often, as well as enhance their education and portfolios. ©Thinkstock.com

Although a number of factors such as the rate of uninsured and life evaluation have improved across the country, Gallup-Healthways’ latest State of American Well-Being places Michigan among the bottom 10 states.

Gallup Inc., a research-based management consulting company, and Healthways, a well-being improvement company, released the seventh annual well-being survey Feb. 19, ranking Michigan 42nd in the country based on overall well-being in five categories.

The State of American Well-Being: 2014 State Well-Being Rankings calculates a composite score to benchmark overall well-being from state to state using data from more than 176,000 interviews with U.S. adults in 2014.

The Well-Being Index score is then calculated on a scale of zero to 100 from the data across five elements: purpose or being motivated to achieve goals; social and having support relationships; financial stability; community; and having good physical health.

Michigan’s ranking by category: 45th for purpose, 37th for social, 38th for financial, 39th for community and 38th for physical.

Since Gallup-Healthways launched the Well-Being Index in 2008, Michigan has finished in the bottom 10 three times.

Laura Kennett, assistant professor of exercise science at Grand Rapids Community College, said although she would like to see more detail regarding the design of the survey, she was not surprised by Michigan’s results.

“Unfortunately, Michigan has ranked low for awhile, and part of the reason it doesn’t surprise me is because the information we have around chronic disease in Michigan — what are called ‘preventive health behaviors’ among Michigan adults — is lower than many other states,” said Kennett. “If people are not engaging in these preventive health measures, then obviously their health is not going to be well.”

Highly ranked elements related to well-being are correlated to a number of health outcomes, including lower rates of health care utilization, high performance and low absence in the workplace, and change in obesity status, according Gallup-Healthways.

Well-being can also impact employee engagement, turnover and workplace safety in a business setting, and “is also strongly related to important societal outcomes,” including graduation rates, charitable giving and teen pregnancy.

One social determinant often overlooked is income level and the resources available to an individual, according to Kennett.

“People don’t realize there are more people in Michigan living at or below the poverty line than other states. Unfortunately, there is plenty of research, plenty of data that shows we can predict people’s health outcomes based on how much money they make and their education,” said Kennett.

“When people think about health indicators, they immediately think about personal health choices, which are very important, but what they don’t think about are those social determinants. The choices we make are really dictated by the choices we have.”

Gallup’s State of the States series, which uses data from the Gallup Daily tracking survey, indicated 10.8 percent of respondents from Michigan are uninsured and 36.1 percent are worried about finances. The survey also revealed only 50.9 percent of respondents exercise frequently and only 56.8 percent eat produce frequently.

Kevin Callison, assistant professor of economics at Grand Valley State University, said while most of the index categories in the Gallup-Healthways survey seem subjective, it likely captures more objective underlying factors related to general well-being such as individual income and health.

Callison said he ran a simple regression to measure the correlation between the indicated ranking and objective measures such as obesity rates, unemployment rates and educational attainment.

“It turns out that these three factors alone explain approximately 60 percent of the variation in the Gallup rankings,” said Callison. “This is good news from a policy perspective because, while it may be difficult to measure ‘likes’ and ‘feelings,’ it’s very easy to obtain objective measures of personal health, education and income.”

The national study is meant to provide policymakers, business leaders and community members with information on the well-being in a population and use the five elements as “focal points in designing and implementing initiatives” to improve healthy lifestyles or community life.

“In the case of Michigan, if the low Gallup ranking is a concern and merits action, then the obvious course would be to improve population health, educational attainment and employment opportunities,” said Callison. “Unfortunately, this is easier said than done, but if we’re capable of making progress in these areas, then we should see subsequent improvement in these subjective measures of well-being.”

One statewide healthy initiative was introduced in June 2012 by the Michigan Department of Community Health, known as the Michigan Health and Wellness 4X4 plan. It was designed to implement a strategy to improve the health of Michigan residents by focusing on four healthy behaviors and four health measures.

Although the MDCH does have comprehensive programs in place, Kennett said the state needs systematic processes and programs to promote and protect overall health and well-being.

“It really does come down to the need in Michigan to look at our health policy. Do we have policies in place that are protecting and promoting health in the residents — because individual choices can only go so far,” said Kennett.

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