Poor Wellbeing Linked to Formation of New Chronic Conditions

WASHINGTON, D.C. -- U.S. adult workers who have poor wellbeing across most or all of the five essential elements of wellbeing are about twice as likely to report a major new chronic condition over a 36-month period of successive surveys than are their counterparts who have high wellbeing in no more than one element. Overall:

• Those workers with poor wellbeing (defined as having high wellbeing in one or none of the five elements) developed 450 new chronic conditions per 1,000 persons three years after being initially interviewed. 
• Those workers with inconsistent wellbeing (i.e., high wellbeing in two to four of the elements) added 330 new chronic conditions per 1,000 persons over the three-year period.
• Those workers with holistic wellbeing (i.e., high wellbeing in all five elements) added 230 new chronic conditions per 1,000 persons over three years.

As such, out of every 1,000 full-time working adults with either poor or inconsistent wellbeing, the increased odds of developing or experiencing new diseases or medical conditions are associated with an extra 159 chronic conditions over the 36-month measurement period than what would otherwise be expected if all 1,000 workers had holistically high wellbeing.

The wellbeing classification is based on the wellbeing of each respondent at the start of the three-year window. The increased disease rate for high-wellbeing respondents is statistically lower than the rates for their lower-wellbeing counterparts.

Gallup’s five essential elements of wellbeing are:

• Career wellbeing: You like what you do every day.
• Social wellbeing: You have meaningful friendships in your life.
• Financial wellbeing: You manage your money well.
• Physical wellbeing: You have energy to get things done.
• Community wellbeing: You like where you live.​

Eight disease diagnoses were tracked in this research: high blood pressure, high cholesterol, diabetes, depression, anxiety, back pain, insomnia and suffering a heart attack.

These results are based on two surveys of the same 3,654 U.S. working adults administered over a three-year period as part of the Gallup Panel. In addition to wellbeing measurement in the successive surveys, respondents were asked to report if a doctor or nurse had told them that they had any of the eight diseases.

The new incidence rates, therefore, are based on reports of newly diagnosed disease states in the 36 months following the initial wellbeing measurement. The results isolate the impact of wellbeing on disease diagnoses by controlling for the effects of other factors associated with health: age, annual household income, education, gender, race, ethnicity and marital status, as well as the number of studied conditions already present at the onset of the 36-month experiment period.

Even among high-wellbeing individuals, the odds of adding new disease states grow with aging. But these chances are elevated among lower-wellbeing individuals, resulting in incremental increases in disease states and costs that would not otherwise be expected if all had holistic wellbeing.

Nationally, 9% of working adults have holistic wellbeing, compared with 47% who have inconsistent wellbeing and 44% who have poor wellbeing. Out of every 1,000 full-time workers, poor wellbeing was associated with 220 new diagnoses in the 36-month period, while inconsistent wellbeing was associated with another 100 new diagnoses than what would otherwise be expected if all had holistic wellbeing.

Assuming 132.5 million full-time American workers, this amounts to an estimated 19.1 million new chronic conditions across the entirety of the U.S. full-time working population in the three years as a function of poor or inconsistent wellbeing at the beginning of that period.

Additional New Conditions Add an Estimated $101 Billion

Using conservative estimates for the cost of care for each disease state, workers with holistic wellbeing are estimated to add an average of $1,058 per year in new healthcare costs due to the additional chronic conditions that had accrued over the prior three-year time window. This amount rises to $1,740 annually among those with inconsistent wellbeing and to $2,049 annually among those with poor wellbeing. Projected across the entire full-time U.S. workforce, the elevated amounts for those with lower wellbeing add an estimated $101.5 billion in new annual healthcare costs by the end of the three years than what would be expected if all workers had holistic wellbeing.

Implications

The high cost of healthcare has become a public health issue itself in America, with extraordinary economic ramifications. In 1960, health spending was 5% of the U.S. GDP -- rising to 18.3% in 2021, with national health expenditures swelling to $4.3 trillion, or $12,914 per person. According to the CDC, at least 75% of healthcare spending is for preventable chronic conditions, and life expectancy in the U.S. is falling amid surges in these chronic illnesses.

The economic impact of disease burden extends beyond healthcare costs and includes workplace productivity. Prior Gallup research has linked above-normal weight and associated chronic conditions among workers to $153 billion in unplanned absenteeism, which projects to $209 billion in lost productivity in 2023 dollars.

The data highlighted here underscore the likelihood that achieving high wellbeing across the five elements will reduce the chances of developing new diseases over a three-year period, thus realizing an estimated $101 billion in savings in healthcare expenditures each year.

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