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June 27, 2018

How happy is your community? These 12 factors can predict the answer.

Daily Briefing

    Researchers have identified 12 factors that explain more than 90% of the variation in community well-being in the United States, according to a study published Wednesday in PLOS ONE.

    Explore 4 steps to build the business case for effective community partnerships

    Study details

    For the report, a Yale School of Medicine-led group of researchers examined the association between well-being and 77 community attributes related to clinical care, demographics, health behaviors, social and economic status, and the physical environment. The researchers drew community attributes data from several sources, including the Robert Wood Johnson Foundation County Health Rankings. The researchers measured well-being using data from the Gallup-Sharecare Well-Being Index.

    The researchers noted several other potential factors, such as lower median income and lower education, are highly correlated. But they wanted to determine what factors had an effect on well-being independently.

    The study methodology did not allow researchers to determine causality, according to Brita Roy, assistant professor of medicine at the Yale School of Medicine and lead author of the study.


    The researchers found 12 factors that independently affected well-being and explained 91% of the variation in well-being across the United States:

    • Three clinical factors—percentage of eligible women obtaining a mammogram, preventable hospital stays per 100,000 population, and number of federally qualified health centers;
    • One demographic factor—higher percentage of black residents;
    • Two factors related to the physical environment—percentage of bicycle commuters and percentage of public transit commuters; and
    • Six social and economic factors—percentage of residents with a bachelor's degree, percentage of residents with a high school diploma/equivalent degree, percentage of residents with ninth-12th grade education, mean household income, percentage divorced, and child poverty rate.


    The researchers concluded that their findings "have important policy implications and can inform local communities in developing and testing targeted programs to enhance well-being." Roy said that while the study does not show causality, "it certainly provides us with a first step in understanding what perhaps we should test."

    Regarding the finding about the relationship between percentage of black residents and well-being, Roy said the study "shows greater diversity is actually better for all of us."

    However, Anita Chandra, director of RAND Justice, Infrastructure, and Environment, said the share of black residents in a community does not serve as an overall measure of diversity. Chandra said diversity exposure is a better measure because it calculates how a racial or ethnic group is situated and exposed to other groups within a community.

    Further, Chandra said the study serves as a call for additional and better data to become available on the factors that affect well-being. "We collect a lot of data, but we still have these gaps in our understanding of community and individual well-being," she said. Some of the data should center on large-scale community and civic well-being, which is "where policy makers and practitioners can make decisions about resource allocation and where to put time and investment and policies in place." However, she noted that the study does provide new insight and "there are things that communities can do that make it more possible for people to feel more positive about their community"(Bate, "Shots," NPR, 5/23; Roy et al., PLOS ONE, 5/23).

    Explore 4 steps for building effective community partnerships

    To be successful, population health programs must invest heavily in partnerships with local organizations and health departments.

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