People who live in communities with 12 specific characteristics — especially ethnic diversity, easy access to preventive health care, and the ability to commute to work via public transit or by bike — tend to report higher levels of well-being and quality of life than those living in communities without those attributes, according to a Yale University study published recently in the journal PLOS One.
The study is based on data collected from more than 338,000 U.S. adults who participated in a national survey — the Gallup-Sharecare Well-Being Index — between January 2010 and December 2012. The survey measures people’s perceptions of various aspects of their daily lives, including their standard of living and their satisfaction with their community, work, relationships and personal health. The Yale researchers compiled this well-being data into scores for each of the counties across the United States.
Using other data sets, such as the Robert Wood Johnson Foundation County Health Rankings, the researchers then collected county-level data on 77 characteristics believed to contribute to people’s well-being — such things as household income, marital status, number of accessible health clinics and the ability to commute to work by public or “active” (walking or biking) transportation.
A comparison of the well-being data with the characteristics data identified 12 attributes that were strongly — and independently — linked at the county level with well-being and life satisfaction. A further analysis also revealed that, collectively, these 12 attributes accounted for a remarkable 91 percent of the variation in individual well-being scores.
This finding is important because, as background information in the study points out, feelings of well-being and satisfaction with life are strongly associated with better health and greater longevity.
Inclusiveness and accessibility
One of the attributes that contributed the most to the variations in the well-being scores — after accounting for income and education — was living in a county with a higher percentage of racial and ethnic diversity. In this study, that specifically meant living in a county with a higher percentage of black residents.
The finding shouldn’t be particularly surprising, however. As the Yale researchers note, other studies have also found an association between measures of community racial and ethnic inclusiveness and positive well-being.
“Taken together, the results of these studies and our suggest that greater tolerance may raise well-being for all community members,” they write.
Counties with easier access to primary and preventive care — measured in this study as having more primary care clinics and more women who had received mammography screening — was also strongly associated with people’s positive perceptions of their daily lives.
“These findings extend prior observations that beyond income, perceived access to healthcare is a strong predictor of well-being,” the researchers write. “Notably, even in countries with universal healthcare coverage, perceived access to healthcare is correlated with well-being.”
“Though it is possible that access to primary care is simply a marker of an unknown confounder related to higher well-being, it is also plausible that access to healthcare mediates increased well-being by providing greater ‘peace of mind’ and necessary support for preventive health and general self-management behaviors,” they add.
The study also found that two transportation-related factors — specifically, being able to easily commute to work by either bicycle or public transit — were strongly linked to people’s feelings of well-being.
“Our results clarify prior observations that long commutes and commuting alone by automobile are correlated with low levels of positive affect and life satisfaction and suggest potential solutions,” the researchers write. “Commuting and workplace policies such as flexibility to work from home and availability of protected bicycle lanes should be evaluated to assess their impact on well-being of residents.”
The remaining community attributes independently linked to greater well-being in the study were lower rates of preventable hospital stays, fewer children living in poverty, fewer divorced people, and greater levels of education (more people with a college degree and fewer people with only a high school diploma or GED or with less than a high school diploma).
‘An idea worth testing’
This study is observational, and therefore can’t prove a cause-and-effect link between the 12 community attributes and well-being. Also, the survey data for the study was collected in the years immediately following the Great Recession — a factor that may have influenced the study’s results.
Still, the researchers believe that the correlations they found were significant and therefore shouldn’t be arbitrarily dismissed.
“These findings suggest that promotion of diversity as well as targeted investments in education, transportation and primary care may lead to higher well-being of community residents, an idea worth testing,” they write.
The study’s findings also underscore that efforts to promote well-being must be multipronged — in other words, they need to address factors across all categories of community attributes.
“To improve the well-being of a community, you need to work across multiple sectors and fields, to include the economy and health care and urban planning and transportation,” says Dr. Brita Roy, the study’s lead author and an assistant professor of medicine at Yale University, in a released statement.
“Working across different groups in coalitions, has the greatest potential to improve health and quality of life,” she adds.
FMI: The study can be read in full on the PLOS One website.