The science of thriving has informed an easy-to-use, realtime survey that measures well-being and has the ability to both catalyze change and assess progress on what matters most in communities—all people and places thriving, no exceptions. Use of these well-being measures provides an invaluable and highly-responsive complement to regular community needs assessments, population health indicators, and other social determinants of health that can take years to see measurable change. Rather than solely tracking individual health outcomes, a holistic approach that measures well-being provides a north star—one which diverse groups can rally around together.
Through either a 12- or 24-question, self-report survey, communities can get a better understanding of who in a community is thriving, struggling or suffering, and in what ways. The Institute for Healthcare Improvement, Healthy People 2030, and multi-sector partnerships around the country are leading and informing what it means to measure well-being, and to use that deeper understanding to transform neighborhoods and lives.
What is the science of thriving?
The social determinants of health emerged in the early 2000s as a framework for thinking about our physical health in a new way that acknowledged that it is strongly impacted by economic and social conditions. Over the last decade, and especially more recently, the field has expanded this thinking in a number of ways, including a strong emphasis on the interconnectedness of our mental and physical health, as well as the importance of equity considerations. The term “health” is now often used in conjunction with the term “well-being”, and Healthy People 2030’s definition of health and well-being is: “how people think, feel, and function—at a personal and social level—and how they evaluate their lives as a whole.”
This updated approach to health and well-being has led to many positive impacts in the way we think about advancing equitable community well-being. It has also created a new challenge: how to measure health and well-being aside from the traditional approach of examining health outcomes alone. The science of thriving is using an equitable data and measurement system to assess the degree to which people and communities are thriving, one that brings to light inequities and values how people think and feel about their own lives. Measuring well-being can inform a path forward towards all people and places thriving—no exceptions.
Why is measuring thriving important?
Emerging evidence suggests that well-being is a protective factor against disease and is tied to extending life expectancy. By closely monitoring self-reported well-being, we can get a pulse of our communities, implement early interventions when needed, and tailor interventions accordingly. In fact, an effort is underway to create a measure of Well Being Adjusted Life Years, which combines life expectancy and well-being to underscore the reinforcing nature of well being and health.
How is thriving measured?
Cantril’s Ladder of Life Evaluation
Developed in 1965, this validated tool is among the first self-evaluative measures of well-being. Cantril’s Ladder measures thriving, struggling or suffering based on a 2-item assessment. Gallup has adopted and adapted the tool, and makes national-level data available to provide a pulse of our collective well being. Cantril’s Ladder has proven exceptionally sensitive to external events such as the Great Recession and COVID-19.
The instrument includes several questions that through a simple analysis classifies an individual as “thriving,” “struggling” or “suffering.” Respondents who rate their current and future life high on the ladder are “thriving”. “Suffering” means that respondents rate both their current and future life low on the ladder. And struggling is any other combination of placement.
Additional demographic data are collected as part of the instrument illuminating critical well-being gaps among populations. Below is a national view of life-evaluation scores for US adults, broken down for white, black and hispanic Americans. The graph shows that Black Americans’ life evaluation and self-reported well-being has precipitously declined over the past 10 years.
An updated approach
Once you know whether and to what extent people are thriving, struggling or suffering in your community, you can identify where and how to best take action to improve well-being. The Vital Conditions for Well-Being offer a framework for understanding current community conditions and identifying the policies, practices, and investments necessary to advance equitable well-being. Examining your community through the Vital Conditions framework in conjunction with the Well-Being Survey can shed light on specific community conditions that are contributing to people thriving and/or suffering—that are likely contributing to a community’s well-being score. Essentially, the Vital Conditions can help tell the story behind the well-being score, and therefore inform a path towards improvement. The Springboard for Thriving Together (2020), organized by Vital Conditions, offers a series of actionable pivotal moves and trend bending ideas for transforming knowledge into action and achieving widespread equitable well-being.
The Well Being Assessment draws on questions that are independently validated. The Assessment itself has been administered and tested in multiple settings and applications. In order to ensure all people are thriving, the assessment can be administered with a set of demographic questions in order to stratify the results by age, race, ethnicity, gender, income, and education.
How have these tools been adopted and used?
Communities, regions, and states around the country are measuring well-being to strengthen their realtime understanding of community needs, and to help catalyze necessary changes. The Fox Cities region of Wisconsin is leading in this work.
Imagine Fox Cities (IFC) is an inclusive, community-wide initiative committed to shaping the future of well-being for Fox Cities residents for generations to come. In late 2018, IFC leaders embarked on a process of deep listening. They invited the community to rate their levels of physical, social, emotional, and financial well-being and asked what ideas there were to ensure all people and places had the opportunity to thrive. Over a six month period IFC community volunteers hosted over 90 community dialogues and collected more than 3,000 well-being surveys.
All residents were encouraged to complete the well-being survey and strategies were employed to ensure strong participation and outreach to those in the community whose voices often go unheard. The survey could be completed online or via paper and was offered in English, Spanish, and Hmong. Community organizations including the library, faith institutions, food pantries, businesses, hospitals, and cultural organizations, among others helped to spread the word.
The well-being survey findings showed 59 percent of community respondents were thriving, while another 41 percent were either struggling or suffering. The findings ran counter to the oft used phrase for Fox Cities– “happy valley” with the percent struggling and suffering higher than the national average and those who identified as multi-racial, Native American or American Indian, and non-binary more likely to be struggling or suffering. Communities, businesses and government leaders saw this as a call to action for advancing belonging and inclusion and strengthening investments in the vital conditions everyone needs every day to thrive.
How can you get started?
The survey can be administered either in print, online, or verbally. It can be used in a variety of settings including schools (using the adapted youth assessment), health care settings, or community events. The survey takes just moments to complete and should be administered on a regular basis to track progress over time. The results can be analyzed using common applications such as Excel and Tableau.
Taking action to improve well being
Once you know whether and to what extent people are thriving in your community, you can identify where and how to best take action to improve the degree to which your community is thriving—to improve the well-being score. The Vital Conditions for Well-Being offer a framework for understanding current community conditions and implementing policies and practices to advance equitable well-being. Examining your community through the Vital Conditions framework in conjunction with the Well-Being Survey can shed light on specific community conditions that are contributing to people thriving and/or suffering—that are likely contributing to a community’s well-being score. Essentially, the Vital Conditions can help tell the story behind the well-being score, and therefore offer a path towards improvement. The Springboard for Thriving Together (2020) offers a roadmap for community renewal organized by the Vital Conditions. It sheds light on actions communities can take to improve community conditions and, in turn, increase those who are thriving and improve the Well-Being score.
Image from the WIN Network: Well Being in the Nation