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Methodology
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With the goal of providing the world's most up-to-date measure of individual and collective health and well-being, the Gallup-Healthways Well-Being Index tracks the well-being of U.S. residents 350 days a year interviewing no fewer than 1,000 U.S. adults nationwide each day during 2008, with the exception of major holidays.
Survey respondents are asked an in-depth series of questions associated with health and well-being. The Gallup-Healthways Well-Being Index™ segments the data for respondents in both adverse and optimum situations according to household income, location demographics (based on zip code), and personal health status. The results are reported in continuous daily, weekly, and monthly averages.
The survey methods for Gallup-Healthways Well-Being Index relies on live (not automated) interviewers, dual-frame random-digit-dial (RDD) sampling (which includes landlines as well as wireless phone sampling to reach those in wireless-only households), and a random selection method for choosing respondents within a household. Additionally, daily tracking includes Spanish-language interviews for respondents who speak only Spanish, includes interviews in Alaska and Hawaii, and relies on a multi-call design to reach respondents not contacted on the initial attempt. The data are weighted daily to compensate for disproportionalities in selection probabilities and nonresponse. The data are weighted to match targets from the U.S. Census Bureau by age, sex, region, gender, education, ethnicity, and race.
With the inclusion of the cell-phone only households and the Spanish Language interviews, 98% of the adult population is represented in the sample. By comparison, typical landline only methodologies represent approximately 85% of the adult population.
For the 2008 Senate and Congressional District report, 353,039 interviews were aggregated from January 2, 2008 to December 30, 2008 among national adults, aged 18 and older. For results based on overall 353,039 respondents, one can say with 95% confidence that the maximum margin of sampling error is +/- 0.2 percentage points. Sample sizes vary for States and Congressional Districts. For results based on a sample size of 5000, one can say with 95% confidence that the maximum margin of sampling error is +/- 1.4 percentage points. For results based on a sample size of 1000, +/- 3.1 percentage points; for results based on 500, +/- 4.4 percentage points; for results based on 300, +/- 5.7 percentage points.
In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.
Domains Measured
For geographic regions of the United States, the Well-Being Index currently measures six domains. Each one is determined based on scientific study of responses to the survey questions and includes:- Life Evaluation
- Emotional Health
- Physical Health
- Healthy Behavior
- Work Environment
- Basic Access
Life Evaluation
Building on earlier work by Hadley Cantril and The Cantril Ladder Scale, the Well-Being Index asks Americans to evaluate their lives today as well as their lives five years from now by imagining a "ladder" with steps numbered from 0 to 10, where "0" represents the worst possible life and "10" represents the best possible life. Thriving Americans say they presently stand on steps 7 or higher of the ladder and that they expect to stand on steps 8 or higher five years from now. These people have their basic needs (such as food and shelter) met, and they have higher incomes, are less burdened by disease, report fewer sick days and have better work environments. The Life Evaluation Index is composed of two items:- Evaluation of present life situation
- Anticipated life situation five years from now
Based on The Cantril Ladder Scale
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Emotional Health
The Emotional Health Index is a composite of respondents' daily experiences. It includes one item that probes for prior history of diagnosed depression. In the remaining items, respondents are asked to think about yesterday, from the morning until the end of the day, and whom they were with, what they did, and how they felt. The index is based on responses to the following items:- Smiling or Laughter
- Being treated with respect
- Enjoyment
- Happiness
- Worry
- Sadness
- Anger
- Stress
- Learning or doing something interesting
Physical Health
The projected cost of American healthcare by 2017 has been estimated at over $4 trillion. At least 50% of these costs will be due to preventable disease, including diabetes, cardiovascular conditions, and strokes.The Physical Health Index is comprised questions related to:
- Estimates of Body Mass Index
- Disease burden
- Sick days
- Physical pain
- Daily energy
- History of disease
- Daily health experiences
Healthy Behavior
The Healthy Behavior Index includes items measuring lifestyle habits with established relationships to health outcomes. The index is based on key items related to smoking, a healthy diet and exercise.- Do you smoke?
- Did you eat healthy yesterday?
- Weekly consumption of fruits and vegetables
- Weekly exercise frequency
Work Environment
The Well-Being Index surveys people on several factors to gauge their feelings and perceptions about their work environment. Prior large-scale meta-analyses have shown important linkages between worker engagement and several organizational performance outcomes, such as attendance, retention, productivity, profitability, safety and customer ratings.Positive work environments are characterized as those where workers express satisfaction with their work, report using their strengths in their area of work, and work in a culture of trust and partnership. Conversely, negative work environments lack satisfying work and are characterized by poor supervision. The Index consists of questions workers answer each day:
- Are you satisfied or dissatisfied with your job or the work you do?
- At work, do you get to use your strengths to do what you do best every day, or not?
- Does your supervisor at work treat you more like he or she is your boss or your partner?
- Does your supervisor always create an environment that is trusting and open, or not?
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Basic Access
The Basic Access Index is based on items that measure people's access to food, shelter, healthcare and a safe and satisfying place to live.- Satisfaction with community or area
- Area getting better as a place to live
- Clean water
- Medicine
- Safe place to exercise
- Affordable fruits and vegetables
- Feel safe walking alone at night
- Enough money for food
- Enough money for shelter
- Enough money for healthcare
- Visited a dentist recently
- Have a doctor
- Have health insurance
Note About Congressional Districts
The Congressional District analysis is based on over 355,000 interviews conducted as part of the Gallup-Healthways Well-Being Index. The objective of the daily Well-Being Index tracking is to obtain a nationally representative sample of all U.S. adults, and is based on a random digit dial (RDD) sample, including interviews with respondents on land-line telephones (for respondents with a land-line telephone) and cellular phones (for respondents who are cell-phone users only). The analysis includes estimates of well-being for states and congressional districts.
There are challenges in any approach to assigning individual respondents interviewed by telephone to Congressional Districts, and no method is perfect. Given the fact that the underlying Well-Being Index sample is RDD rather than listed or based on registered voter lists, Gallup's approach uses available geographic information for each respondent as the basis for determining Congressional District residence. Each respondent is initially assigned to a district on the basis of their phone area code and exchange, using procedures developed by Survey Sampling, Inc., which assigns each phone exchange in America to one and only one Congressional district. In situations in which a phone exchange straddles more than one Congressional District, the exchange is assigned to the district in which the plurality of residents lives. Respondents whose phone exchange does not match their self-reported zip code are assigned to a Congressional district based on their zip code rather than phone exchange, again assigning respondents to the district in which a plurality of residents of that zip code live. In general, accuracy in assignment of respondents to Congressional Districts has been maximized within the RDD methodology. Corroborating evidence is provided by the finding that median income estimates from the current survey correlate highly with census estimates across Congressional Districts (r=.94).
Click here to download the formal methodology and Well-Being Index research report.
