Association between population well-being and health behaviors

Background: Well-being is a comprehensive assessment of thriving—comprising physical, mental, and social health. Well-being both encourages and is fostered by health promoting behaviors, and is influenced by the community environment. Hence, population well-being may be important for maintaining population health. We examined the association between a novel measure of population well-being and health behaviors.

Methods: We used data from Gallup-Healthways Well-being Index (GHWBI, 2010), comprised of 55 self-reported items organized into 6 domains: life evaluation (LE); emotional health (EH); work environment (WE); physical health (PH); healthy behaviors (HB); and basic access (BA). Individuals >18y were randomly selected for survey in English or Spanish via landline or cellular telephone (n=348,846). Data were aggregated by Congressional District (CD) and weighted by 2009 Census Bureau Population Survey estimates. Prevalence of health behaviors were determined from 2011 and 2012 Behavioral Risk Factor Surveillance System (BRFSS) sub-group study (224 counties). We used weighted linear regression to assess difference in rates of behaviors across GHWBI quintiles and independent association of 6 GHWBI domains with behaviors, reported as t-scores.

Results: Higher population GHWBI scores were positively associated with daily fruit and vegetable intake, never smoking, being physically active, obtaining age-appropriate cancer screening, obtaining a flu shot, and always wearing a seat belt (p<0.05 for all associations). Specific domains were also related to health behaviors, for example, LE was positively associated with vegetable intake, not smoking, obtaining a flu shot, and wearing seatbelts (p<0.05 for all associations).

Conclusion: A comprehensive measure of well-being and its specific domains were strongly associated with multiple positive health behaviors.