What Is Wellbeing? A Brief Review of Current Literature and Concepts

• Journal List
• Popul Health Metr
• v.11; 2013
• PMC3852954

Popul Health Metr. 2013; 11: nineteen.

Mental, social, and physical well-existence in New Hampshire, Oregon, and Washington, 2010 Behavioral Hazard Cistron Surveillance Arrangement: implications for public wellness inquiry and exercise related to Healthy People 2020 foundation health measures on well-being

Rosemarie Kobau, ¹ Carla Bann,² Megan Lewis,² Matthew M Zack,¹ Angela M Boardman,³ Renee Boyd,^iv Kim C Lim,⁵ Tommy Holder,ⁱⁱ Anastacia KL Hoff,³ Cecily Luncheon,^ane William Thompson,¹ Willi Horner-Johnson,⁶ and Richard E Lucas⁷

Rosemarie Kobau

¹Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-K78, Atlanta, GA 30341, USA

Carla Bann

²RTI International, Research Triangle Park, 3040 Cornwallis Road, Durham, NC 27709-2194, USA

Megan Lewis

^twoRTI International, Research Triangle Park, 3040 Cornwallis Road, Durham, NC 27709-2194, USA

Matthew M Zack

¹Centers for Illness Control and Prevention, 4770 Buford Highway NE, MS-K78, Atlanta, GA 30341, USA

Angela M Boardman

³Washington State Section of Wellness, Information Quality and Statistical Services (DQSS) Middle for Wellness Statistics, P.O. Box 47814, Olympia, WA 98504-7814, USA

Renee Boyd

^ivOregon Health Say-so, Office of Disease Prevention and Epidemiology, Eye for Health Statistics (Survey Unit of measurement), 800 NE Oregon St., Suite 225, Portland, OR 97232, USA

Kim C Lim

^fiveNew Hampshire Division of Public Wellness Services, Bureau of Public Wellness Statistics and Informatics, 29 Hazen Drive, Concord, NH 03301-6504, USA

Tommy Holder

²RTI International, Research Triangle Park, 3040 Cornwallis Road, Durham, NC 27709-2194, USA

Anastacia KL Hoff

³Washington State Department of Health, Information Quality and Statistical Services (DQSS) Center for Health Statistics, P.O. Box 47814, Olympia, WA 98504-7814, Usa

Cecily Luncheon

¹Centers for Disease Command and Prevention, 4770 Buford Highway NE, MS-K78, Atlanta, GA 30341, U.s.a.

William Thompson

^aneCenters for Affliction Control and Prevention, 4770 Buford Highway NE, MS-K78, Atlanta, GA 30341, U.s.a.

Willi Horner-Johnson

⁶Institute on Evolution and Inability, Oregon Wellness & Science University, Portland, OR 97239, U.s.a.

Richard E Lucas

^sevenDepartment of Psychology, Michigan State University, East Lansing, MI 48824, U.s.a.

Received 2012 Aug 27; Accepted 2013 Sep 5.

Abstruse

Background

Well-being is now accepted as ane of 4 cross-cut measures in gauging progress for Healthy People 2020. This shift to population indicators of well-being redresses notions of health that take focused on absenteeism of illness (negative wellness) as a chief or sufficient indicator of positive functioning. The purpose of this study was to estimate mental, social, and physical well-being in three US states using new measures piloted on the 2010 Behavioral Risk Cistron Surveillance Survey System (BRFSS). Baseline estimates were provided for states overall, and within states for demographic subgroups, those with chronic wellness conditions or disabilities, and those with behavioral adventure factors.

Methods

Ten validated questions designed to assess mental (e.yard., satisfaction with life, satisfaction with life domains, happiness), physical (east.thousand., satisfaction with free energy level), and social dimensions (e.g., frequency of social back up) of well-existence were selected with land input for inclusion on BRFSS. xviii,622 individuals responded to the BRFSS surveys administered past New Hampshire (N = iii,139), Oregon (N = 2,289), and Washington (N = xiii,194). Multivariate adapted proportions of positive responses to well-being items were examined.

Results

After adjustment for confounders, almost 67% of adults in these states had high levels of well-being, including >fourscore% reporting experiencing happiness. Most adults were satisfied with their piece of work, neighborhood, and pedagogy, but pregnant differences were seen in subgroups. Well-being differed by demographic characteristics such every bit marital status, health behaviors, chronic conditions, and disability status, with those who reported a inability and smokers consistently experiencing the worst well-existence.

Conclusions

Well-being is accepted as one of four cross-cutting measures in gauging progress for Healthy People 2020. Well-being differs by important sociodemographic factors and health weather (due east.g., historic period, employment, smoking, disability status). These findings provide baseline estimates for the three states to apply in gauging improvements in well-beingness and tin can serve as a model for other state-level or national surveillance systems. These findings as well assist states in identifying vulnerable subgroups who may benefit from potential interventions such as those in the National Prevention Strategy that focus on enhancing well-being where such disparities be.

Advances in the measurement of subjective well-being underlie the growing interest in monitoring this outcome in populations [1]. Well-being attempts to balance perspectives that have predominantly emphasized negative emotional states or outcomes equally a way to empathize functioning, or the primary use of economical indicators to measure out population well-existence [2]. The benefits of using well-being equally a common framework for broad public policy accept been described [1-5]. For the first time in its 3-decade history, Healthy People 2020 (HP2020), a ten-year Usa federal initiative designed to appoint multiple public and private sectors to ameliorate population health, now supports monitoring population well-being as a cross-cut measure out to track progress in meeting HP2020 goals for preventing disease and injury, eliminating disparities, promoting healthy development, and improving quality of life [6]. This shift in how some wellness promotion goals volition be measured now matches seminal declarations describing health as more than the absence of illness ("negative health") [7-x], and is aligned with contemporary perspectives on positive health, inclusive of physical, mental, and social resources that actively promote well-beingness [11-15].

Well-existence has been defined as evaluating life as satisfying and generally experiencing more positive states and emotions than negative ones [xvi,17]. Such evaluations may include pregnant and purpose, affective reactions such equally joy and sadness, and satisfaction with life as a whole as well equally in domains such as work, family life, and housing [iii]. These subjective evaluations and positive life orientations and experiences are related to a wide range of health outcomes including cardiovascular disease [18,nineteen], immune functioning [20], and bloodshed [17,21]. Academic researchers have long studied well-beingness and its antecedents and consequences, but only recently have public health practitioners begun to focus on the importance of assessing well-being for resiliency, adaptation to illness, disease progression, and other health outcomes both within the United States [13,22-24] and internationally [one,vii,25-27].

This focus is motivated past evidence showing that well-being is causally related to health and longevity [17]. Such assets or protective factors (east.g., positive touch on, satisfaction, vitality) that etch well-being domains might serve to mediate protective physiological responses that are health enhancing (e.g., lower cortisol levels) or to more effectively moderate stressful responses (quell negative arousal), minimizing allostatic load (wear and tear on the body) [28-30]. Over time, these protective factors and processes may confer advantages such as greater resiliency associated with more successful age-related transitions over the life course [13,29].

Despite the burgeoning evidence linking well-being to health outcomes, including longevity [17], few surveillance systems in the U.s.a. take nerveless extensive well-being data or examined variation by demographic factors, health behaviors, or atmospheric condition of interest to public wellness programs. Some surveillance systems have included single-item measures of global life satisfaction, happiness, and social or emotional support satisfaction [31]. These studies have related lower life satisfaction levels, operationalized with a single question, with greater prevalence of poor health, disability, smoking, obesity, and physical inactivity [31]. Moreover, the prevalence of smoking, obesity, concrete inactivity, and heavy drinking increases every bit levels of social and emotional support subtract [32]. Other studies take revealed regional differences in well-being [33,34]. These difference may be associated with measurement issues (due east.g., concept equivalence, response styles), cultural values (e.g., individualism vs. collectivism), socioeconomic factors (e.g., income levels, equality), or the interaction of these and other factors [35,36]. Widely used scales and items used in many countries and groups, such as the Satisfaction with Life Scale (SWLS), and overall happiness have been studied in relation to these cross-cultural issues [37-39]. The SWLS is one of the most extensively used and cantankerous-culturally validated instruments in well-being enquiry, demonstrating that request people almost what they remember and how they feel about their lives offers valid information near an private'southward life circumstances and social context relative to other groups [38]. The SWLS besides has shown adequate convergent and discriminant validity with both subjective and objective well-beingness indicators [38]. Domain-specific life satisfaction items were developed for cross-cultural utilise, and take been shown to be robust measures [40]. Including multiple questions that tap into dissimilar well-being domains is useful for cross-cultural research [35]. Similarly, for US states, knowing whether certain demographic factors, health behaviors, or societal conditions are linked with well-being domains would provide a more detailed understanding of the experience of population well-beingness and could identify disparities in well-being among states, communities, and groups to guide local activity [41]. This understanding could back up future public health research and focus interventions and evaluations on enhancing population wellness.

Consistent with advances in the measurement of well-existence, salutogenic approaches to health promotion [10,42], and in support of HP2020, the United states Centers for Illness Control and Prevention (CDC) supported an initiative in 2007 to examine the feasibility of examining well-beingness beyond the use of single items for surveillance and health promotion [23]. For the first fourth dimension, and with direct input on the selection of well-being questions from health departments in Oregon, New Hampshire, and Washington State, CDC included an expanded prepare of items from the SWLS, four domain-specific life satisfaction items selected by land wellness departments (e.g., satisfaction with present job, neighborhood, instruction, and energy level), and frequency of social/emotional support. The selected items were included on the 2010 Behavioral Risk Factor Surveillance Arrangement (BRFSS) as a pilot study. Measuring multiple domains that reflect social, mental, and physical functioning is consequent with public wellness definitions of well-being [viii,23,43].

The nowadays written report extends previous well-being research by: (1) obtaining, for the starting time time, state-level baseline estimates of multiple well-being domains, including domain-specific life satisfaction, in representative populations; (two) assessing well-being as positive rather than negative performance, using an expanded set of measures not previously used on BRFSS; (3) identifying population disparities in well-being within states to guide local prevention and promotion efforts; and (iv) demonstrating the feasibility of using an expanded but brief set of measures that can be used by public health surveillance systems.

Methods

Survey

BRFSS is an ongoing, state-based, random-digit–dialed phone survey of the civilian, non-institutionalized population aged 18 or older that tracks the prevalence of key wellness and condom-related behaviors and characteristics [44]. The questionnaire consists of (1) core questions asked in all l states, the District of Columbia, and United states territories; (two) supplemental modules (i.due east., a series of questions on specific wellness topics); and (iii) state-added questions. Core questions are included in 22 sections, followed by supplemental modules and state-added questions. Each state decides which supplemental modules and land-added questions to include. Standardized questions on sociodemographic and behavioral characteristics as well as self-reported chronic diseases and activity limitations are included. The BRFSS survey is available at http://www.cdc.gov/brfss[44]. Data are weighted to reverberate the historic period, sex, and racial/ethnic distribution of the state's estimated population during the survey year [44].

Measures

Mental well-being: Satisfaction with Life Scale

Mental well-being was assessed with a modified, validated version of the SWLS [37,45]. To account for the critical demand for brevity on lengthy surveillance surveys or other program evaluation surveys concerned with respondent burden, CDC pilot tested a modified version of the SWLS (i.east., four items vs. five items, five-point vs. vii-point response scale, use of "my" [life] vs. "your" [life] in questions) for telephone surveillance purposes. The reliability remained acceptable (Cronbach blastoff = 0.89 [CDC, unpublished data]), and use of a four-item scale is more than viable for surveillance purposes (Ed Diener, personal communication, May, 2009) [23]. Confirmatory factor analysis testing the modified SWLS with other gold standard measures supported its validity [45]. The iv-item SWLS asked respondents to indicate how much they concord with the post-obit statements on a calibration from 1 (strongly hold) to v (strongly disagree): (ane) "In most ways my life is close to ideal," (two) "The atmospheric condition of my life are excellent," (3) "I am satisfied with my life," and (iv) "So far I accept gotten the important things I want in life." Scores for the overall SWLS are calculated as the mean of the items.

Mental well-being: global life satisfaction and domain-specific life satisfaction

Domain-satisfaction is a valid dimension of well-being, serving every bit a key indicator for population well-existence assessment [40]. Participating states recommended previously validated, specific life domains for inclusion [23]. States selected four of 13 possible domains previously examined in a nationally representative survey [23]. To maintain compbility with the global life satisfaction item, respondents were asked to rate how satisfied they were with the following components of their lives using a rating scale of 1 (very satisfied) to iv (very dissatisfied): nowadays task or work, neighborhood, education, and free energy level.

Mental well-being: global happiness

BRFSS as well includes a global life satisfaction question ("In general, how satisfied are you with your life?") with response options from 1 (very satisfied) to four (very dissatisfied) [31,44]. The current study included a global happiness item equally used on the 2001 National Health Interview Survey and other international surveys ("All things considered, would you lot say you are…") with responses of ane (very happy) to 5 (not happy at all) [39,46].

Social well-being

The BRFSS social support particular asks participants, "How often do you lot become the social and emotional support yous demand?" (this includes support from any source) [32]. Response options range from i (e'er) to five (never).

Concrete well-being: self-rated health

The BRFSS self-rated health question asks participants, "Would y'all say that in general your health is fantabulous, very good, proficient, fair or poor? Responses are rated from i (excellent) to 5 (poor). As office of this study, they were as well asked about their vitality, an of import physical domain indicator [47]. "In general, how satisfied are yous with your energy level?" (Possible responses range from 1 (very satisfied) to 4 (very dissatisfied).

Standardized BRFSS variables for sociodemographic and behavioral characteristics (e.g., smoking, exercise) were used [44]. The physical well-being detail, "self-rated health," is the showtime question, in Section one (health condition) of the BRFSS core survey, asked of all respondents. The BRFSS questions on social support and global life satisfaction were too part of the BRFSS cadre survey in 2010. These two questions were asked in Department 22 of the survey, as the terminal questions on the BRFSS cadre, preceding state-added modules. The question on satisfaction with social and emotional back up was asked first, followed by the question on life satisfaction. The airplane pilot well-being module, which included the global happiness item, the SWLS, domain-specific life satisfaction items, and the vitality item asked in this society, was the concluding module on BRFSS administered to respondents. The well-beingness module took an average of 105 seconds to administrate.

Statistical methods

Responses to well-existence items were dichotomized into those indicating positive well-existence (e.g., satisfied/very satisfied, hold/strongly agree) and those indicating negative well-being (e.g., dissatisfied/very dissatisfied, disagree/strongly disagree). For overall SWLS, scores of 4 or higher, corresponding to ratings of satisfied or very satisfied, were considered positive. Considering other studies have found that sex, age, race/ethnicity, education, employment status, and related factors are correlated with well-being [23,36], we adjusted for these factors to avoid confounding. Adjusted percentages of positive responses to each item for demographic subgroups were estimated using logistic regression afterwards controlling for country, gender, age, race/ethnicity, education, marital status, employment status, income, disability condition, veteran status, chronic health status (diabetes, middle attack, angina/coronary heart disease, stroke, or asthma), exercise, smoking, and obesity [48]. Adjusted percentages present estimates for all levels of an independent variable rather than for all but one level relative to a reference category (e.thousand., using white as a racial/ethnic reference group), and removes the difficulties of interpretation of measures of clan [48]. Nosotros examined the percentages of the characteristics of respondents for each state and overall with respect to gender, age, race/ethnicity, educational activity, marital status, employment status, income, disability condition, veteran status, chronic health condition, physical activity, smoking status, and overweight/obesity. Not-overlapping 95% confidence intervals of adjusted percentages identify statistically pregnant differences in such percentages across subgroups, mostly compble to a statistical significance level of 0.007, that partially accommodate for multiple comparisons (like to aligning factors used when computing p-values in multiple comparisons) [49]. Analyses were conducted using the SUDAAN statistical software programme to account for the BRFSS's circuitous survey design and sampling weights [fifty].

Results

Study participants

The current study included 18,622 adults who responded to the BRFSS surveys administered by New Hampshire (Northward = 3,139), Oregon (Northward = ii,289), and Washington (Due north = 13,194) (Table1). 50-1 pct are women; 53% are 45 years quondam or older; 83% are white, not-Hispanic; 69% have more than a high school education; 67% are currently married; 56%, are currently employed; 54% have annual household incomes of $l,000 or more; 27%, are disabled; 13% are military veterans; 27% take a chronic health condition; 82% had exercised in the by thirty days; 15% are current smokers; and 62% are overweight or obese. The 3 states did not differ in these characteristics except for greater percentages in New Hampshire than in Oregon of the employed and those with annual household incomes of $75,000 or more, and greater percentages in New Hampshire than in Washington of white, non-Hispanics.

Tabular array one

Demographic profile of respondents—Behavioral Hazard Factor Surveillance Organization, New Hampshire, Oregon, and Washington, 2010

Characteristic	All	New Hampshire	Oregon	Washington
	%	%	%	%
Number	eighteen,622	3,139	2,289	xiii,194
Gender
Male	48.9	48.7	48.4	49.2
Female	51.1	51.3	51.half dozen	fifty.8
Age
18–24	11.1	9.3	11.6	11.2
25–34	17.3	13.nine	16.3	18.ane
35–44	eighteen.v	21.2	16.4	eighteen.8
45–54	19.9	21.four	19.7	19.viii
55–64	sixteen.2	xvi.0	17.v	15.seven
65–74	nine.v	x.0	ten.ane	9.ii
75 or older	7.5	8.2	eight.3	7.1
Race/ethnicity
White	86.nine	94.9	ninety.7	84.5
Blackness	ane.five	0.8	1.0	1.8
Hispanic	vi.1	2.0	four.two	vii.4
Asian	3.four	i.i	1.7	4.iv
American Indian/Pacific Islander	1.2	0.5	0.8	1.four
Other	0.8	0.viii	i.6	0.6
Education
Less than high school	6.1	4.3	5.4	6.7
High schoolhouse graduate	24.ix	26.7	27.v	23.vii
More than high school	69.0	69.0	67.0	69.7
Marital condition
Married/living with partner	66.7	69.half-dozen	65.5	66.8
Divorced/septed	10.half-dozen	9.seven	xi.vii	10.3
Widowed	v.1	5.6	v.five	4.nine
Never married	17.six	15.0	17.iv	18.i
Employment status
Employed	56.3	62.8	49.eight	57.eight
Unemployed/unable to work	13.six	11.4	15.2	thirteen.three
Retired	17.one	xvi.five	xix.one	16.v
Homemaker/educatee	thirteen.0	ix.4	15.nine	12.five
Income
< $xv,000	six.iii	five.0	7.5	6.1
$15,000–$nineteen,999	five.ii	5.0	vi.7	4.7
$20,000–$24,999	nine.1	half dozen.nine	10.iii	9.0
$25,000–$34,999	x.1	ix.0	nine.half dozen	10.4
$35,000–$49,999	14.8	xv.0	16.0	xiv.four
$50,000–$74,999	xix.0	18.three	twenty.0	xviii.vii
≥ $75,000	35.iv	40.7	29.ix	36.6
Disabled	27.ii	22.3	29.vi	27.0
War machine veteran	xiii.0	xiv.3	13.3	12.7
Chronic health condition	26.v	25.7	28.6	25.nine
Exercise in past 30 days	82.0	79.ii	82.5	82.ii
Electric current smoker	15.two	16.0	xv.0	15.ii
Overweight/obese	61.7	61.9	61.six	61.7

Annotation: Chronic health conditions include self-reported dr.-diagnosed diabetes, heart set on, angina/coronary heart disease, stroke, and asthma. Percentages are weighted.

On boilerplate, less than ii% of responses to the mental, social, and concrete well-existence items were classified as "don't know/refused".

Mental well-being

Life satisfaction

Based on the modified SWLS, after decision-making for land, demographic and health characteristics, 68% of respondents reported positive life satisfaction (Table2). At the item level, 73% reported that their lives were close to platonic, 76% thought the conditions of their lives were excellent, 83% reported existence satisfied with their lives, and eighty% felt they had gotten the important things in life (Figure1). Demographic differences in life satisfaction were generally similar across individual items and the overall scale; findings for the overall scale follow.

Table ii

Adjusted proportions of agreement with Satisfaction with Life Scale items and overall Satisfaction with Life Scale by demographic characteristics, chronic health status condition, select behavioral risk factors, and state—Behavioral Chance Gene Surveillance Organisation, New Hampshire, Oregon, and Washington, 2010

Characteristic	Satisfaction with Life Scale individual items				Satisfaction with life
	"In most means my life is close to ideal"	"The weather condition of my life are excellent"	"I am satisfied with my life"	"And so far I take gotten the important things I desire in life"	Scale (Overall)
	Percent (95% CI)	Percent (95% CI)	Percent (95% CI)	Percent (95% CI)	Pct (95% CI)
North	18,339	18,391	xviii,447	18,394	18,527
Overall	73.1 (71.9, 74.2)	75.8 (74.seven, 76.8)	82.seven (81.7, 83.6)	79.7 (78.6, 80.8)	67.eight (66.6, 69.0)
Gender
Male	72.7 (70.9, 74.4)	75.two (73.4, 76.eight)	82.ane (80.5, 83.half dozen)	77.five (75.8, 79.2)	66.1 (64.2, 67.9)
Female	73.5 (71.ix, 75.0)	76.4 (74.9, 77.8)	83.2 (81.8, 84.5)	81.viii (lxxx.4, 83.1)	69.v (67.8, 71.1)
Age
xviii–24	75.i (69.1, lxxx.3)	79.0 (73.5, 83.7)	85.8 (81.0, 89.6)	79.2 (74.0, 83.7)	71.4 (65.1, 76.9)
25–34	72.1 (68.6, 75.iv)	75.ane (71.7, 78.2)	81.half-dozen (78.3, 84.v)	76.9 (73.iv, 79.9)	66.5 (62.eight, 69.9)
35–44	72.9 (70.three, 75.iii)	74.5 (72.0, 76.8)	81.i (78.viii, 83.2)	78.6 (76.ii, 80.eight)	67.0 (64.four, 69.six)
45–54	69.1 (66.9, 71.2)	71.one (69.0, 73.ii)	79.0 (77.0, 80.8)	78.3 (76.3, eighty.2)	62.7 (threescore.five, 64.9)
55–64	73.3 (71.5, 75.1)	76.2 (74.4, 77.9)	82.seven (81.1, 84.two)	81.iv (79.8, 83.0)	68.0 (66.0, 69.9)
65–74	77.iii (74.8, 79.6)	80.two (77.9, 82.3)	86.5 (84.5, 88.iii)	84.8 (82.iv, 86.8)	73.5 (71.0, 75.ix)
75 or older	77.9 (74.7, 80.eight)	lxxx.8 (77.9, 83.4)	88.3 (85.ix, 90.three)	84.vi (81.seven, 87.1)	73.five (70.i, 76.5)
Race/ethnicity
White	72.9 (71.6, 74.1)	75.v (74.three, 76.7)	82.4 (81.4, 83.5)	fourscore.1 (78.nine, 81.ii)	67.six (66.3, 68.nine)
Blackness	65.1 (55.6, 73.6)	76.8 (68.0, 83.seven)	79.ix (71.three, 86.four)	71.6 (62.9, 79.0)	65.0 (55.8, 73.2)
Hispanic	79.0 (73.8, 83.five)	78.9 (73.9, 83.ii)	88.3 (84.2, 91.5)	82.iv (77.5, 86.4)	73.ii (67.vii, 78.1)
Asian/Pacific Islander	71.3 (62.8, 78.5)	75.8 (67.1, 82.8)	79.8 (70.6, 86.vii)	68.iv (60.vii, 75.two)	61.5 (53.iv, 69.0)
American Indian/Alaskan Native	71.v (59.2, 81.iii)	73.8 (62.v, 82.7)	82.3 (72.4, 89.1)	80.8 (71.2, 87.8)	68.iii (56.4, 78.two)
Other	76.8 (65.v, 85.3)	79.ane (69.0, 86.6)	81.4 (71.iv, 88.4)	81.6 (71.3, 88.vii)	75.0 (63.seven, 83.vii)
Education
Less than high schoolhouse	70.2 (64.5, 75.iii)	74.0 (69.0, 78.v)	82.0 (77.4, 85.8)	80.vii (76.i, 84.6)	65.3 (59.5, seventy.7)
High school graduate	73.2 (71.0, 75.iv)	74.8 (72.six, 76.8)	83.7 (81.nine, 85.4)	79.1 (77.0, 81.1)	67.4 (65.0, 69.seven)
More than than high school*	73.three (71.nine, 74.6)	76.three (75.0, 77.6)	82.iii (81.0, 83.5)	79.9 (78.v, 81.1)	68.1 (66.vii, 69.5)
Marital status
Married/living with partner	77.ii (75.9, 78.v)	79.0 (77.7, lxxx.3)	85.ix (84.viii, 86.9)	84.five (83.3, 85.seven)	72.9 (71.5, 74.3)
Divorced/septed	64.half dozen (61.iv, 67.vii)	67.4 (64.iv, 70.3)	74.half dozen (71.v, 77.four)	71.ii (68.0, 74.3)	56.7 (53.iv, 59.ix)
Widowed	lxx.0 (66.3, 73.4)	72.1 (68.5, 75.iv)	79.ii (75.6, 82.four)	76.3 (72.5, 79.vii)	62.8 (59.0, 66.4)
Never married	63.two (59.one, 67.ii)	70.4 (66.half dozen, 73.9)	77.2 (73.nine, eighty.i)	68.8 (65.0, 72.4)	55.1 (l.7, 59.5)
Employment status
Employed	73.2 (71.half-dozen, 74.7)	76.5 (75.0, 77.nine)	83.8 (82.5, 85.0)	79.9 (78.5, 81.three)	67.7 (66.1, 69.3)
Unemployed/unable to piece of work	65.five (61.7, 69.0)	66.8 (63.1, 70.3)	74.2 (70.8, 77.2)	73.2 (69.eight, 76.4)	58.1 (54.ii, 62.0)
Retired	78.4 (76.i, eighty.half dozen)	lxxx.2 (77.9, 82.iii)	86.3 (84.2, 88.one)	85.0 (82.8, 87.0)	74.4 (72.0, 76.vii)
Homemaker/student	74.1 (70.2, 77.7)	77.1 (73.five, lxxx.4)	84.0 (lxxx.4, 87.0)	80.four (76.half dozen, 83.7)	69.three (65.ii, 73.2)
Income
< $fifteen,000	68.7 (63.6, 73.four)	66.half-dozen (61.4, 71.4)	79.seven (75.9, 83.0)	72.ii (67.4, 76.6)	60.nine (55.4, 66.one)
$fifteen,000–$nineteen,999	66.5 (threescore.viii, 71.7)	63.9 (57.7, 69.6)	77.7 (72.8, 82.0)	71.6 (66.3, 76.3)	57.1 (50.9, 63.0)
$20,000–$24,999	63.four (58.8, 67.eight)	66.4 (61.nine, lxx.6)	76.3 (72.1, lxxx.0)	73.seven (69.5, 77.5)	58.iii (53.half dozen, 62.9)
$25,000–$34,999	65.6 (61.9, 69.i)	68.0 (64.5, 71.4)	77.3 (73.ix, eighty.4)	75.4 (71.vii, 78.7)	60.6 (57.0, 64.ii)
$35,000–$49,999	71.one (68.4, 73.7)	74.8 (72.3, 77.2)	81.8 (79.iv, 83.9)	75.5 (72.6, 78.two)	64.1 (61.2, 66.viii)
$50,000–$74,999	73.7 (71.0, 76.2)	77.3 (74.nine, 79.6)	83.4 (81.2, 85.4)	82.two (79.7, 84.4)	68.half-dozen (65.9, 71.ii)
≥ $75,000	80.4 (78.three, 82.3)	84.2 (82.3, 85.9)	87.9 (86.ane, 89.four)	86.6 (84.7, 88.2)	76.3 (74.1, 78.3)
Disability status
Aye	62.9 (60.5, 65.iii)	65.4 (63.0, 67.vii)	74.0 (71.6, 76.2)	74.2 (72.0, 76.4)	57.2 (54.8, 59.half dozen)
No	76.9 (75.half-dozen, 78.2)	79.8 (78.6, 81.0)	86.2 (85.1, 87.2)	81.ix (eighty.six, 83.0)	71.7 (70.3, 73.0)
Veteran
Yes	71.five (68.four, 74.5)	74.vii (71.6, 77.6)	81.seven (78.7, 84.4)	78.seven (75.9, 81.2)	65.two (62.1, 68.iii)
No	73.three (72.one, 74.v)	75.9 (74.8, 77.1)	82.eight (81.seven, 83.8)	79.9 (78.7, 81.0)	68.2 (66.9, 69.4)
Chronic health condition
Yeah	73.4 (71.2, 75.four)	75.8 (73.8, 77.half-dozen)	83.0 (81.3, 84.6)	79.4 (77.v, 81.3)	67.9 (65.half-dozen, 70.0)
No	73.0 (71.vi, 74.3)	75.eight (74.5, 77.0)	82.5 (81.3, 83.half dozen)	79.8 (78.5, 81.1)	67.8 (66.4, 69.one)
Exercise in past xxx days
Yes	73.seven (72.four, 74.ix)	76.ii (74.9, 77.3)	83.ii (82.1, 84.3)	79.9 (78.7, 81.ane)	68.2 (66.9, 69.5)
No	seventy.5 (68, 73.0)	74.ii (71.ix, 76.4)	lxxx.iv (78.three, 82.4)	79.0 (76.7, 81.ane)	66.0 (63.3, 68.v)
Current smoker
Yep	63 (59.seven, 66.2)	67.1 (64.1, lxx.one)	77.3 (74.vi, 79.8)	72.9 (69.9, 75.seven)	58.i (54.7, 61.3)
No	75 (73.viii, 76.2)	77.5 (76.4, 78.7)	83.8 (82.8, 84.nine)	81.two (80.0, 82.three)	69.six (68.iii, 70.nine)
Obesity
Normal/underweight	73.one (71.2, 74.9)	75.5 (73.7, 77.2)	81.8 (80.one, 83.3)	80.1 (78.4, 81.7)	67.5 (65.6, 69.4)
Overweight	74.iii (72.4, 76.1)	77.1 (75.iv, 78.8)	84.0 (82.5, 85.5)	80.seven (79.0, 82.3)	69.one (67.two, 71.0)
Obese	71.half-dozen (69.4, 73.6)	74.5 (72.v, 76.iii)	82.i (80.3, 83.7)	78.0 (75.9, 80.0)	66.4 (64.2, 68.six)
Country
New Hampshire	71.6 (69.ii, 73.9)	71.8 (69.4, 74.0)	79.6 (77.iv, 81.6)	78.iv (76.i, 80.6)	65.six (63.1, 68.0)
Oregon	73.4 (seventy.iv, 76.2)	76.9 (74.i, 79.4)	83.5 (81.0, 85.8)	81.four (78.6, 83.eight)	69.ix (66.eight, 72.eight)
Washington	73.2 (71.nine, 74.4)	76.0 (74.8, 77.ii)	82.viii (81.vii, 83.eight)	79.three (78.1, 80.v)	67.4 (66.1, 68.7)

Overall percent understanding with well-existence domains, 2010 BRFSS pilot study, NH, OR, WA. SWLS = Satisfaction with Life Scale [37]. For overall SWLS ("SWLS_Scale"), scores of 4 or college, corresponding to ratings of satisfied or very satisfied, were considered positive. SWLS_Scale is based on positive responses to the four items used in this study: "In most ways, my life is close to platonic; The conditions of my life are excellent; I am satisfied with my life; And so far, I accept gotten the important things I want in life".

No differences in positive responses to the SWLS were seen between men and women. The youngest (aged 18 to 24) adults had greater life satisfaction than those between the ages of 45 and 54 years. Fewer adults aged 45 to 54 reported positive life satisfaction compared with older groups. Positive life satisfaction was more mutual among married adults than adults who were divorced/septed, widowed, or never married. Unemployed adults were less likely to be satisfied, and retired adults more than likely to be satisfied, than employed adults (Tableii; Figure2). Greater life satisfaction was also associated with household incomes of $75,000 or more than. Adults without a disability and those who were non-smokers were more than probable to report positive responses on the SWLS (Table2; Figures3 and ​ 4).

Pct agreement with well-being domains past employment condition, 2010 BRFSS pilot written report, NH, OR, WA. SWLS = Satisfaction with Life Scale [37]. For overall SWLS ("SWLS_Scale"), scores of 4 or college, corresponding to ratings of satisfied or very satisfied, were considered positive. SWLS_Scale is based on positive responses to the 4 items used in this study: "In near ways, my life is close to ideal; The weather condition of my life are excellent; I am satisfied with my life; So far, I accept gotten the important things I want in life".

Percentage agreement with well-existence domains by inability status, 2010 BRFSS pilot study, NH, OR, WA. SWLS = Satisfaction with Life Scale [37]. For overall SWLS ("SWLS_Scale"), scores of 4 or higher, corresponding to ratings of satisfied or very satisfied, were considered positive. SWLS_Scale is based on positive responses to the 4 items used in this written report: "In most ways, my life is shut to platonic; The conditions of my life are excellent; I am satisfied with my life; So far, I have gotten the important things I want in life".

Percent agreement with well-existence domains by smoking status, 2010 BRFSS airplane pilot report, NH, OR, WA. SWLS = Satisfaction with Life Scale [37]. For overall SWLS ("SWLS_Scale"), scores of 4 or college, corresponding to ratings of satisfied or very satisfied, were considered positive. SWLS_Scale is based on positive responses to the four items used in this study: "In virtually ways, my life is shut to ideal; The conditions of my life are excellent; I am satisfied with my life; So far, I have gotten the important things I desire in life".

In response to the global life satisfaction item, 95% of respondents reported being satisfied or very satisfied with their lives (Table3; Effigy1). As with the SWLS, more than positive responses to the global life satisfaction particular were associated with being married, having incomes of $75,000 or more, not smoking, and not existence a person with a disability. Adults who reported exercising (vs. not exercising) were more than likely to report beingness satisfied with their lives, whereas those who were unemployed/unable to work (vs. employed or retired) were less probable to written report being satisfied (Figure2).

Table 3

Adjusted proportions of global life satisfaction, global happiness, and domain-specific life satisfaction by demographic characteristics, chronic health condition status, select behavioral chance factors, and state—Behavioral Risk Factor Surveillance System, New Hampshire, Oregon, and Washington, 2010

Characteristic	Global		Domain-specific
	Life satisfaction	Happiness	Work	Neighborhood	Education
	Percent (95% CI)	Percent (95% CI)	Percent (95% CI)	Pct (95% CI)	Percent (95% CI)
N	18,489	xviii,530	9,696	18,442	18,396
Overall	94.6 (93.nine, 95.ii)	88.6 (87.7, 89.iv)	87.7 (86.half-dozen, 88.viii)	92.viii (92, 93.five)	88.8 (88.0, 89.half-dozen)
Gender
Male	94.3 (93.i, 95.3)	87.half dozen (86.ane, 88.9)	86.vi (84.8, 88.2)	93.2 (92.0, 94.3)	88.8 (87.5, xc.1)
Female	94.9 (94.0, 95.7)	89.five (88.4, ninety.5)	89.i (87.6, 90.4)	92.4 (91.two, 93.5)	88.eight (87.6, 89.eight)
Age
18–24	94.6 (91.1, 96.7)	xc.four (86.3, 93.4)	88.9 (82.four, 93.2)	87.4 (79.3, 92.6)	87.five (81.one, 92.0)
25–34	93.7 (91.2, 95.vi)	87.7 (84.9, 90.ane)	84.6 (fourscore.9, 87.seven)	89.2 (86.3, 91.5)	86.8 (84.1, 89.1)
35–44	93.7 (92.0, 95.0)	87.4 (85.4, 89.2)	86.0 (83.vi, 88.ane)	91.8 (90.0, 93.three)	86.ane (84.0, 87.9)
45–54	94.2 (93.0, 95.1)	86.3 (84.6, 87.8)	87.6 (85.seven, 89.2)	93.8 (92.6, 94.9)	88.9 (87.3, 90.3)
55–64	95.0 (94.2, 95.viii)	88.half-dozen (87.2, 89.8)	90.iv (88.8, 91.7)	95.6 (94.viii, 96.4)	91.3 (90.0, 92.3)
65–74	96.3 (95.1, 97.ii)	91.six (xc.0, 93.0)	94.4 (92.3, 96.0)	96.ii (94.9, 97.1)	92.two (90.four, 93.7)
75 or older	96.ix (95.four, 97.ix)	92.0 (89.9, 93.seven)	98.three (96.6, 99.2)	96.8 (95.2, 97.9)	92.7 (90.5, 94.4)
Race/ethnicity
White	94.7 (94.0, 95.four)	88.six (87.7, 89.5)	87.viii (86.6, 89.0)	92.8 (91.ix, 93.6)	89.0 (88.0, 89.viii)
Black	92.2 (85.1, 96.1)	82.two (73.5, 88.5)	75.ane (63.0, 84.2)	91.4 (84.5, 95.4)	84.3 (74.0, 91.0)
Hispanic	95.1 (91.iv, 97.3)	90.1 (86.4, 92.9)	85.vii (78.3, ninety.nine)	91.ix (87.seven, 94.7)	87.7 (83.7, xc.9)
Asian/Pacific Islander	94.9 (89.8, 97.5)	xc.3 (85.6, 93.five)	92.7 (86.6, 96.1)	95.0 (90.7, 97.4)	90.1 (84.two, 93.ix)
American Indian/Alaskan Native	91.five (84.3, 95.6)	86.5 (78.four, 91.9)	87.7 (75.ane, 94.4)	93.4 (86.8, 96.8)	89.0 (81.6, 93.half-dozen)
Other	92.six (84.8, 96.v)	83.5 (74.0, xc.i)	88.0 (70.nine, 95.7)	95.viii (xc.2, 98.2)	90.2 (81.iii, 95.i)
Education
Less than high school	96.7 (94.9, 97.9)	86.9 (83.i, xc.0)	94.one (90.three, 96.five)	91.four (87.8, 94.0)	69.5 (63.3, 75.1)
High school graduate	95.0 (93.7, 96.0)	88.4 (86.7, 89.8)	88.9 (86.v, ninety.9)	92.7 (91.2, 94.0)	85.3 (83.four, 87.0)
More than than loftier school	94.1 (93.2, 94.9)	88.9 (87.8, 89.nine)	86.7 (85.two, 88.one)	93.0 (92.0, 93.9)	92.0 (91.1, 92.ix)
Marital status
Married/living with partner	96.one (95.3, 96.7)	91.2 (90.3, 92.1)	88.6 (87.3, 89.9)	92.4 (91.2, 93.five)	88.6 (87.4, 89.7)
Divorced/septed	92.1 (90.0, 93.8)	82.9 (80.3, 85.ii)	87.0 (83.3, ninety.0)	92.ii (ninety.1, 93.9)	86.ane (83.half-dozen, 88.three)
Widowed	93.1 (90.ane, 95.3)	84.one (lxxx.5, 87.1)	87.9 (82.5, 91.9)	93.ane (xc.three, 95.ane)	89.8 (87.2, 91.9)
Never married	93.2 (91.3, 94.six)	85.2 (82.4, 87.6)	84.1 (80.1, 87.v)	94.i (91.5, 96.0)	91.1 (88.5, 93.2)
Employment condition
Employed	95.ix (94.8, 96.vii)	90.1 (88.9, 91.1)	--	92.6 (91.vi, 93.5)	89.i (87.9, 90.i)
Unemployed/unable to Work	xc.viii (88.7, 92.five)	82.i (79.2, 84.vi)	--	92.0 (89.7, 93.9)	85.ii (82.3, 87.6)
Retired	96.6 (95.six, 97.3)	91.viii (90.2, 93.2)	--	94.6 (92.8, 96.0)	91.seven (89.7, 93.3)
Homemaker/student	94.6 (91.eight, 96.5)	87.8 (84.iii, 90.five)	--	93.1 (90.1, 95.2)	89.6 (86.6, 91.9)
Income
< $15,000	91.0 (87.2, 93.8)	83.2 (79.1, 86.six)	76.0 (66.7, 83.iv)	90.5 (87.three, 93.0)	87.8 (84.2, xc.7)
$fifteen,000–$19,999	90.6 (86.8, 93.4)	83.3 (79.0, 86.8)	78.one (67.6, 85.9)	90.0 (85.6, 93.1)	84.v (80.4, 87.8)
$xx,000–$24,999	93.0 (90.2, 95.i)	85.one (82.0, 87.vii)	84.six (78.vi, 89.1)	89.four (85.vi, 92.3)	87.1 (84.3, 89.5)
$25,000–$34,999	93.4 (91.2, 95.one)	87.9 (85.4, ninety.one)	83.0 (78.2, 87.0)	91.vii (88.9, 93.viii)	87.2 (84.7, 89.4)
$35,000–$49,999	94.vii (92.nine, 96.1)	88.3 (85.9, 90.3)	85.ii (82.0, 88.0)	92.7 (90.vii, 94.4)	87.3 (85.ii, 89.one)
$l,000–$74,999	96.three (94.nine, 97.3)	90.3 (88.iii, 92.0)	87.ane (84.3, 89.four)	93.iv (91.5, 94.eight)	89.2 (87.1, 91.0)
≥ $75,000	97.5 (96.4, 98.3)	92.v (ninety.9, 93.eight)	91.6 (xc.1, 93.0)	94.8 (93.iii, 96.0)	91.8 (89.9, 93.four)
Inability Status
Yes	91.0 (89.two, 92.v)	83.3 (81.4, 85.1)	82.1 (79.1, 84.vii)	90.1 (88.i, 91.8)	85.2 (83.3, 86.9)
No	96.5 (95.seven, 97.1)	91.0 (90.0, 91.nine)	89.0 (87.7, 90.one)	93.eight (92.9, 94.5)	xc.ii (89.3, 91.1)
Veteran
Yes	94.five (91.9, 96.3)	88.ix (86.7, 90.8)	86.8 (82.9, 89.eight)	92.4 (90.1, 94.three)	88.5 (86.2, 90.5)
No	94.7 (93.9, 95.3)	88.5 (87.6, 89.4)	87.8 (86.6, 88.9)	92.nine (92.0, 93.half-dozen)	88.9 (87.9, 89.7)
Chronic wellness condition
Yes	94.three (93.0, 95.4)	88.1 (86.6, 89.half dozen)	86.5 (83.9, 88.eight)	92.0 (90.3, 93.iii)	89.3 (87.7, 90.6)
No	94.viii (94.0, 95.5)	88.8 (87.7, 89.7)	88.0 (86.8, 89.2)	93.1 (92.2, 94.0)	88.6 (87.6, 89.half-dozen)
Practice in by 30 days
Yes	95.one (94.iii, 95.viii)	89.6 (88.6, 90.4)	87.8 (86.six, 89.0)	92.6 (91.7, 93.4)	89.3 (88.4, ninety.two)
No	93.ii (91.9, 94.3)	84.ix (83.0, 86.vii)	87.2 (84.iii, 89.6)	93.6 (92.0, 94.8)	87.1 (85.ane, 88.8)
Current smoker
Yes	92.4 (xc.iv, 94.0)	84.vi (82.2, 86.vii)	84.vi (81.2, 87.5)	89.8 (87.2, 91.9)	84.9 (82.5, 87.0)
No	95.iii (94.vi, 96.0)	89.half-dozen (88.7, ninety.5)	88.3 (87.ane, 89.iv)	93.5 (92.vii, 94.two)	89.8 (88.ix, 90.seven)
Obesity
Normal/underweight	93.ii (91.8, 94.4)	88.iv (86.ix, 89.seven)	87.5 (85.6, 89.2)	93.1 (91.8, 94.2)	88.8 (87.4, ninety.1)
Overweight	95.v (94.vii, 96.2)	89.5 (88.2, xc.7)	87.6 (85.vii, 89.3)	92.5 (xc.nine, 93.8)	89.0 (87.iv, xc.4)
Obese	95.ii (94.1, 96.1)	87.8 (86.one, 89.3)	88.1 (86.0, 90.0)	92.8 (91.4, 94.0)	88.vi (87.2, 89.9)
Country
New Hampshire	94.three (92.8, 95.six)	86.nine (85.0, 88.6)	84.5 (82.1, 86.5)	93.vii (92.2, 95.0)	89.4 (87.7, 90.9)
Oregon	94.viii (93.0, 96.three)	87.vi (85.3, 89.6)	86.ii (82.4, 89.3)	92.3 (89.8, 94.2)	89.4 (86.ix, 91.four)
Washington	94.6 (93.9, 95.two)	89.ii (88.2, 90.0)	88.nine (87.vi, 90.0)	92.ix (92.0, 93.6)	88.6 (87.6, 89.4)

Notes: CI = confidence interval. Percentages are adjusted for the following variables: gender, age, race/ethnicity, education, marital status, employment status, income, disability status, veteran status, chronic health condition, exercise, smoking, obesity, and state. Chronic wellness conditions include self-reported doctor-diagnosed diabetes, heart attack, angina/coronary heart disease, stroke, and asthma. Employment condition is excluded from the satisfaction with work model because this item is only applicative to participants who are employed.

Satisfaction was mostly high (≥87%) beyond specific life domains (Figure1), with no differences by sex (Tablethree). Older adults (≥65 years) reported more satisfaction from piece of work than did younger adults (25 to 64 years). Adults with incomes of $75,000 or more were more likely to be satisfied with their work, whereas those who were black (vs. white or Asian-Pacific Islanders) were less likely to be satisfied with their work. More adults with less than a high school caste were satisfied with work compared to those with some college or technical school and college graduates. Significantly fewer adults with a inability were satisfied with work than adults without disability (Figureiii). New Hampshire adults were less satisfied with work than Washington adults. Greater neighborhood satisfaction was reported among respondents 55 years of age and older compared to those 44 years of historic period and younger (Tabular array3). Adults with incomes of $75,000 or greater were more satisfied with their neighborhoods than adults living in households earning $24,999 or less. Adults with disabilities or who smoked reported less satisfaction with their neighborhoods (Figures3 and ​ 4). Satisfaction with education improved with age (55 or older vs. 25–44 years), higher levels of education, and among those with incomes of $75,000 or more, merely worsened amongst those who were unemployed/unable to work, current smokers, and adults with disabilities.

Happiness

Equally with life satisfaction, a sizable bulk (89%) reported beingness happy or very happy (Table3; Figure1). Being married, having an income of $75,000 or more, and exercising were positively related to happiness, whereas those who were unemployed/unable to work (Effigy2), adults with disabilities (Figure3), or current smokers were less happy (Effigy4).

Social well-being

More than than three-quarters of respondents (84%) reported usually or always having the social or emotional support they need (Table4; Figure1). The following groups were more likely to have adequate social or emotional support when needed: those who had more than than a loftier school educational activity (vs. less than a high school instruction), were currently married (vs. non currently married), had higher incomes, or had exercised in the past 30 days. Meanwhile, these groups were less probable to written report having social or emotional support: Hispanic or Asian-Pacific Islanders (vs. white), people with disabilities (Figure3), and current smokers (Figure4).

Table four

Adapted proportions of positive responses to social back up and physical well-being items by demographics, chronic health condition status, behavioral risk factors, and state—Behavioral Risk Gene Surveillance System, New Hampshire, Oregon, and Washington, 2010

	Social	Physical
Characteristic	Social and emotional support (Always/usually)	Health status (Excellent/very good/practiced)	Energy level (Very satisfied/satisfied)
	Percent (95% CI)	Percent (95% CI)	Percent (95% CI)
Northward	xviii,302	18,622	18,588
Overall	83.nine (82.9, 84.8)	87.3 (86.vi, 88.1)	78.9 (77.ix, 79.viii)
Gender
Male person	82.7 (81.1, 84.2)	87.2 (86.ane, 88.2)	81.8 (eighty.3, 83.3)
Female person	85.i (83.7, 86.iii)	87.5 (86.4, 88.4)	75.9 (74.4, 77.3)
Historic period
18–24	87.6 (83.0, 91.2)	93.4 (89.1, 96.one)	82.1 (75.ix, 86.9)
25–34	84.4 (81.4, 87.0)	xc.3 (88.1, 92.2)	77.viii (74.4, 80.8)
35–44	82.0 (79.7, 84.ane)	85.9 (83.8, 87.7)	76.1 (73.8, 78.3)
45–54	81.eight (79.9, 83.6)	86.7 (85.1, 88.1)	78.0 (76.2, 79.viii)
55–64	83.9 (82.3, 85.3)	85.vii (84.iv, 86.9)	80.2 (78.6, 81.half dozen)
65–74	85.two (83.0, 87.1)	85.9 (84.3, 87.4)	80.9 (78.8, 82.9)
75 or older	84.9 (82.i, 87.4)	85.4 (83.3, 87.2)	80.7 (77.nine, 83.2)
Race/ethnicity
White	85.i (84.one, 86.one)	87.9 (87.1, 88.6)	78.half-dozen (77.5, 79.half dozen)
Black	79.6 (71.2, 86.0)	82.7 (76.ane, 87.8)	76.5 (68.8, 82.eight)
Hispanic	77.1 (72.0, 81.5)	81.3 (77.7, 84.5)	fourscore.3 (75.1, 84.seven)
Asian/Pacific Islander	69.iv (62.1, 75.viii)	86.nine (81.7, 90.8)	84.5 (77.ix, 89.five)
American Indian/Alaskan Native	80.0 (69.ii, 87.7)	87.5 (81.1, 92.0)	87.0 (79.3, 92.1)
Other	77.7 (66.8, 85.viii)	79.iii (73.5, 84.ii)	72.9 (63.5, 80.7)
Education
Less than high school	78.3 (73.6, 82.3)	79.7 (76.4, 82.7)	81.three (76.nine, 85.0)
Loftier school graduate	83.2 (81.two, 84.9)	85.7 (84.i, 87.i)	78.i (76.ane, 79.9)
More than than high school	84.8 (83.6, 85.9)	88.viii (88.0, 89.half dozen)	79.0 (77.vii, 80.1)
Marital condition
Married/living with partner	86.1 (84.9, 87.ii)	87.0 (86.0, 87.nine)	79.i (77.9, fourscore.3)
Divorced/septed	78.vi (75.eight, 81.two)	88.1 (86.vi, 89.4)	77.nine (75.two, fourscore.4)
Widowed	80.0 (76.8, 82.9)	87.3 (85.v, 89.0)	77.eight (74.7, eighty.6)
Never married	80.9 (77.7, 83.8)	88.0 (85.8, 90.0)	79.0 (75.6, 82.0)
Employment status
Employed	84.0 (82.6, 85.3)	89.3 (88.1, ninety.iii)	79.one (77.7, 80.four)
Unemployed/unable to piece of work	81.4 (78.5, 84.0)	81.vi (79.6, 83.4)	73.3 (70.1, 76.2)
Retired	86.2 (84.ii, 88.0)	87.8 (86.4, 89.one)	81.viii (79.8, 83.7)
Homemaker/educatee	83.4 (79.6, 86.7)	88.4 (85.vii, 90.vi)	80.2 (76.8, 83.3)
Income
< $15,000	75.0 (69.7, 79.6)	84.0 (81.2, 86.5)	76.1 (71.8, 79.8)
$15,000–$19,999	76.2 (71.0, 80.7)	81.3 (77.8, 84.5)	69.0 (63.0, 74.4)
$20,000–$24,999	79.0 (75.0, 82.v)	83.0 (lxxx.7, 85.i)	79.5 (76.6, 82.ii)
$25,000–$34,999	79.4 (75.9, 82.five)	85.1 (82.6, 87.3)	77.5 (74.eight, 80.0)
$35,000–$49,999	83.0 (80.seven, 85.one)	86.8 (85.1, 88.4)	77.two (74.five, 79.7)
$50,000–$74,999	86.1 (83.9, 88.1)	90.6 (89.ii, 91.8)	79.5 (77.ii, 81.6)
≥ $75,000	89.7 (88.one, 91.1)	91.ane (89.seven, 92.iii)	81.9 (80.1, 83.6)
Disability status
Yeah	79.eight (77.six, 81.nine)	75.9 (74.0, 77.7)	62.i (59.7, 64.5)
No	85.6 (84.5, 86.6)	93.5 (92.seven, 94.ii)	85.six (84.six, 86.seven)
Veteran
Yes	82.6 (79.half-dozen, 85.three)	87.four (85.8, 88.9)	eighty.2 (77.half-dozen, 82.half-dozen)
No	84.i (83.1, 85.1)	87.3 (86.5, 88.1)	78.vii (77.6, 79.7)
Chronic health status
Yes	82.8 (81.0, 84.5)	81.8 (lxxx.4, 83.2)	76.7 (74.9, 78.3)
No	84.3 (83.2, 85.four)	ninety.iii (89.five, 91.0)	79.8 (78.six, 80.ix)
Exercise in past 30 days
Yes	84.seven (83.vii, 85.seven)	88.5 (87.7, 89.three)	lxxx.6 (79.5, 81.7)
No	80.8 (78.5, 82.9)	83.six (81.viii, 85.i)	71.viii (69.4, 74.0)
Current smoker
Yes	79.6 (76.eight, 82.ii)	84.8 (82.7, 86.6)	72.8 (seventy.0, 75.5)
No	84.9 (83.8, 85.9)	87.9 (87.1, 88.seven)	80.0 (79.0, 81.1)
Obesity
Normal/underweight	82.7 (81.0, 84.3)	88.2 (87.0, 89.four)	81.viii (fourscore.ii, 83.3)
Overweight	85.4 (83.9, 86.7)	88.9 (87.8, 89.8)	80.7 (79.two, 82.2)
Obese	83.six (81.8, 85.two)	85.0 (83.7, 86.three)	73.3 (71.2, 75.3)
State
New Hampshire	81.8 (79.8, 83.eight)	87.nine (86.2, 89.four)	81.5 (79.6, 83.three)
Oregon	83.viii (81.two, 86.ane)	87.0 (85.three, 88.half dozen)	79.1 (76.6, 81.4)
Washington	84.2 (83.2, 85.2)	87.4 (86.five, 88.1)	78.4 (77.three, 79.5)

Notes: CI = conviction interval. Percentages are adjusted for the post-obit variables: gender, historic period, race/ethnicity, pedagogy, marital status, employment status, income, disability status, veteran condition, chronic health condition, exercise, smoking, obesity, and country. Chronic health conditions include cocky-reported doctor-diagnosed diabetes, heart assail, angina/coronary middle disease, stroke, and asthma.

Physical well-being

On physical well-being items, 87% of respondents rated their wellness as expert to first-class, and 79% were satisfied or very satisfied with their energy levels (Tabular array4; Figure1). Adults aged 18 to 34 years (vs. ≥35 years), and those who had more education were more likely to report proficient to excellent health, whereas Hispanics and other minorities (vs. non-Hispanic whites) and respondents with lower incomes (<$50,000) were less probable to report proficient health. Men and respondents with college incomes (≥$50,000 vs. ≤$nineteen,999) reported more satisfaction with their free energy levels. New Hampshire adults reported more satisfaction with their free energy levels than Washington adults. Adults who exercised reported better health and greater satisfaction with energy levels, whereas the unemployed/unable to work (Effigy2), adults with disabilities (Effigy3), those with a chronic health status, or those who were obese (vs. normal weight or overweight) were less likely to study proficient health and satisfaction with energy levels. Moreover, current smokers were less satisfied with their free energy levels than former smokers and nonsmokers (Figure4).

Discussion

This study examined mental, physical, and social well-being in population-based samples in three states. After adjustment for confounders, well-existence in mental, concrete, and social domains was generally high in these three states. Withal, almost ane-tertiary of adults in these states were dissatisfied with their lives, and their well-being differed by age, marital status, wellness behaviors, chronic conditions, disability condition, and smoking status. As seen when characterizing employment condition, disability status, or smoking status, these measures can be used to describe well-being outcomes for particular subpopulations. This suggests the measures are useful for identifying well-existence disparities and for identifying subgroups with unmet needs. These findings are consequent with those of previous studies [31] and extend the few state-based studies examining well-beingness [31,32].

Unemployed/unable to work adults, those non currently married, adults with disabilities, current smokers, and those with lower household incomes face low levels of mental well-beingness as measured by the SWLS. Moreover, domain-specific well-being varied past age, marital condition, employment status, race, disability, and smoking status. These differences in satisfaction with work, neighborhood, and teaching are important because each of these variables reflects important social determinants of health [51] and are used as indicators of social gradients and environmental or social opportunities [52]. These findings can inform programs that seek to enhance the health and well-being for specific populations. For instance, virtually 27% of adults in these states have a physical or mental disability, making inability a priority public health event [53]. Good for you People 2020 includes twenty objectives related to people with disabilities; some include reducing barriers to care, increasing social participation, and improving well-beingness.

This written report found a large gap in mental well-being, assessed with the SWLS, in adults with disabilities. This finding tin can be used to track improvements following interventions focused on enhancing mental well-beingness. Findings regarding dissatisfaction with neighborhood in adults with disabilities might prompt examination of the built or social surround for people with disabilities in these states. For example, consistent with the American with Disabilities Act standards [54], are community resource accessible for people with disabilities? Are public transportation services available and accessible? Are neighborhoods safe, and do existing social norms support people with disabilities? Tin people with disabilities participate in meaningful activities in their communities? Answers to these questions could aid in designing interventions that promote well-being for people with disabilities. Domain-specific findings for other subgroups prompt similar questions. For example, are some smokers who are dissatisfied with their neighborhoods living in socially isolated, dangerous, or economically depressed neighborhoods that may prompt unhealthy coping behaviors?

The design of well-being past historic period in this written report pllels research on midlife development [55-57]. Poorer midlife satisfaction, as seen in this study, could be attributed to juggling job roles, family unit roles, and caregiving for children and aging adults [57]. Middle-aged adults are too at increased risk of low and suicide [58]. Identifying middle-aged adults with mental affliction symptoms and very depression well-beingness in particular domains might atomic number 82 to implementation of interventions for those particularly vulnerable. Previous research has also identified black and Hispanic 2007 BRFSS respondents equally reporting lower global life satisfaction than whites [41]. In this study, these disparities in both life satisfaction measures disappeared after adjusting for wellness status, socioeconomic status, and social well-existence, suggesting that these latter factors, which are important indicators of social upper-case letter, may be driving differences in life satisfaction.

More variability existed using the SWLS than the global life satisfaction measure. In general, both measures identified similar subgroups with lower well-being levels. Besides this greater variability in the SWLS, differences at the item level ("conditions of life" vs. "satisfied with life") may reveal important drivers of well-being in unlike subgroups.

Social well-beingness findings plleled those related to mental well-being. In general, adults who were heart-aged, had a inability, or were smokers, divorced, widowed, or never married reported lower social well-existence. Having supportive relationships is one of the strongest predictors of well-being [59], and low social support has been shown to contribute to most as many deaths in the Usa every bit lung cancer [60]. These findings have implications for public health and social service programs. For case, smokers with low social back up levels might exist at increased relapse take chances post-obit quit attempts and might benefit from messaging strategies to meliorate support that validates any cessation attempts and maintenance efforts [61]. Providers that serve adults with disabilities might seek to increment social connectedness for people with disabilities past supporting telephone befriending programs [62], using social media to increase their connexion, or increasing their participation in social activities.

Physical well-existence measures encompassed self-rated wellness condition and free energy level. Health status ratings generally plleled those in groups with better or worse mental and social well-existence. Those with chronic health atmospheric condition and obesity, withal, reporting similar mental and social well-being, too reported significantly lower wellness status and energy levels. Women also reported less satisfaction with their energy level than men. Considering few population-based studies have examined physical well-being in this way, time to come studies that extend and validate these findings are needed.

This study has several limitations. First, information technology was limited to data from iii states that are not necessarily representative of their geographic region or the US adult population. States with lower socioeconomic status and greater income inequality may fare worse. Second, the cross-sectional nature of the study design precludes determining the temporal relationship between well-being and some of the other child-bearing variables. Third, these data were cocky-reported and bailiwick to self-presentation biases [63] that may positively skew well-being reports. Fourth, BRFSS excludes institutionalized adults and requires functional ability to participate in the survey, omitting adults who may have lower well-beingness levels. Fourth, the operationalization of well-being in the mental domain focused primarily on hedonic well-being measures [64]. Yet, the participating states placed greater value on these selected measures for their programmatic needs. 5th, the study was limited to data from iii states, not necessarily representative of more diverse states, limiting comparisons.

Determination

Well-beingness data can aid policymakers ameliorate understand population well-being when considered with more traditional economic or social indicators by providing information non captured past these indicators. These data can help tailor interventions to specific groups and communities within these states, ensuring that programs meet people's needs and shut the gap in disparities. Well-being also reflects personally meaningful outcomes that might help galvanize efforts to improve customs health. The present analysis indicates that more than one-half of adults in these states are faring fairly well across well-being domains. This suggests that some individuals, communities, and states accept resource that confer well-being individually and collectively. Policy, organisation change, and environmental strategies identified in the National Prevention Strategy tin exist cost effective means to better the public'southward health and well-being [5]. Similar resources have been described, only warrant broader dissemination to improve population wellness [65-67].

HP2020 objectives for improving population well-being may galvanize national, state, and local efforts to implement bear witness-based interventions such as those identified in the 2010 National Prevention, Health Promotion and Public Health Council [5,6]. Brief psychometrically sound measures like the ones used in this written report can provide important information to place vulnerable populations, identify population strengths, appraise population changes in well-beingness due to interventions, and provide a basis for evaluating progress toward HP2020 goals.

Competing interest

The authors declare that they have no competing interest.

Authors' contributions

RK adult the original report and coordinated data collection. She developed the analytical plan, assisted in interpretation of the data and results, contributed to writing the initial draft and finalized and approved the manuscript for submission. CMB served as a statistical consultant and led the statistical analysis for the study. She developed the tables for the paper, assisted in drafting the manuscript, and approved the terminal manuscript for submission. ML assisted in study development and conceptual design of the analysis. She developed the initial draft of the manuscript, contributed to critical revision of the manuscript, and approved the final manuscript for submission. MMZ served as the primary statistician for the written report. He assisted in the interpretation of data and results. He contributed to disquisitional revision of the manuscript, and approved the concluding manuscript for submission. AMB was responsible for data collection on the Washington BRFSS. She contributed to interpretation of the findings, critical revision of the manuscript and approved the final manuscript for submission. AKLH assisted with preparing the WA dataset for analysis. She reviewed and canonical the concluding manuscript for submission. RB was responsible for data collection on the Oregon BRFSS. She contributed to estimation of the findings, critical revision of the manuscript and canonical the final manuscript for submission. KL was responsible for NH BRFSS data. He contributed to revision of the manuscript and approved the last manuscript for submission. Th contributed to statistical analysis of the data including preparing final tables. CL contributed to critical revision of the manuscript and approved the concluding manuscript for submission. WT contributed to critical revision of the manuscript and approved the final manuscript for submission. WHJ contributed to critical revision of the manuscript and approved the final manuscript for submission. REL contributed to critical revision of the manuscript and approved the last manuscript for submission. All authors read and approved the final manuscript.

Disclaimer

The findings and conclusions of this study are those of the authors and do non necessarily represent the official position of the Centers for Disease Control and Prevention.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3852954/

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