Summary measures of overall health status and health-related quality of life (HRQOL) provide information on the health of a population. People’s subjective assessment of their physical and mental health status and level of disability is important because when people feel healthy, they are more likely to participate socially and economically in their community. Areas with unhealthy populations lose productivity due to lost work time. Healthy residents are essential for creating a vibrant and successful community. Healthy People 2030 organizes their Overall Health and Well-Being Measures into 3 tiers: well-being, healthy life expectancy, and summary mortality and health.1 In general, measures to evaluate overall health status can include physical and mental health and disability status (covered separately here).
Why It’s Important
Overall health and well-being is an important outcome measure that tells us how the population perceives their own general health. Self-assessed health status is a measure of how an individual perceives their health‒rating it as excellent, very good, good, fair, or poor. Self-assessed health status has been validated as a useful indicator of health for a variety of populations and allows for broad comparisons across different conditions and populations. Understanding a population’s self-assessed state of wellness is beneficial to multiple stakeholders.2
Studies indicate that well-being is associated with:2
- Decreased risk of disease, illness and injury
- Better immune functioning
- Improved mental health
- Increased productivity
- Higher contribution to the community
What Is Known
Health Status: 11.2% of adults in Hawai‘i reported their health status to be fair or poor (BRFSS 2020) compared to 14.7% of adults in the United States (US).3 In Hawai‘i, prevalence varied by several factors such as:
- Income: 25.5% among those in households earning between $10,000 to $14,999 compared to 6.3% in those earning $75,000 or more (BRFSS 2020)
- Race/Ethnicity: 19.3% of Black and 16.0% of Native Hawaiian and Other Pacific Islanders compared to 7.8% of Caucasians and 6.1% of Chinese (BRFSS 2020)
Physical Health: 7.3% of adults in Hawai‘i reported 14 or more days of poor physical health, compared to 9.9% in the US (BRFSS 2020). In Hawai‘i, prevalence varied by several factors including:
- Education Level: 10.7% among those with less than a high school diploma compared to 5.5% among college graduates (BRFSS 2020)
- Income: 15.1% among households earning less than $10,000/year compared to 4.4% among those earning $75,000/year or more (BRFSS 2020)
Mental Health: 10.7% of adults in Hawai‘i reported 14 or more days of poor mental health compared to 13.1% in the US (BRFSS 2020). In Hawai‘i, prevalence varied by several factors such as:
- Age: 13.5% among those 25-34 years old compared to 6.9% among those 75 years and older (BRFSS 2020)
- Race/Ethnicity: 23.4% among Others and 14.5% among Native Hawaiian compared to 7.5% in Filipino (BRFSS 2020)
Chronic Diseases: Chronic diseases are defined as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living. In the US, 60% of adults have a chronic disease and 40% have two or more. Chronic conditions such as heart disease, cancer, and diabetes are the leading causes of death and disability in the US and factor largely into the nation’s $4.1 trillion in annual health care costs.4
Who Is at Risk
There are multiple determinants of individual well-being such as good health, positive social relationships, and availability and access to basic resources.2
Although many studies have explored the associations between well-being and its predictors, results have been inconsistent due to different methodologies and measures of well-being. Life satisfaction appears to be more dependent on having basic needs met such as food, shelter, income and modern conveniences such as electricity. Supportive relationships appear to be a predictor for pleasant emotions. 2
- Personality traits such as optimism, extraversion and good self-esteem are strongly associated with well-being.
- Men and women tend to have similar levels of well-being.
- The relationship between well-being and age has a U-shaped distribution. Younger and older adults tend to have higher well-being than middle-aged adults.
- Studies show a complex relationship between income and well-being. Depending on the measures used and comparisons made, income only modestly correlates with well-being. The relationship between income and well-being (when measured in terms of life satisfaction) tend to be stronger for individuals at lower economic levels, although some studies have also shown effects for those at higher incomes levels. Unemployment negatively impacts short- and long-term well-being. Paid employment has a positive effect on well-being by enabling access to resources, and feelings of satisfaction and purpose.
- Supportive relationships are one of the strongest predictors of positive well-being.
Page last updated August 1, 2022
1Overall Health and Well-Being Measures. Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/overall-health-and-well-being-measures Accessed July 21, 2022.
2Health-Related Quality of Life (HRQOL). Centers for Disease Control and Prevention. https://www.cdc.gov/hrqol/wellbeing.htm Updated October 31, 2018. Accessed July 21, 2022.
3Adults Who Report Fair or Poor Health Status by Race/Ethnicity 2020. Kaiser Family Foundation. https://www.kff.org/other/state-indicator/percent-of-adults-reporting-fair-or-poor-health-status-by-raceethnicity/?currentTimeframe=0&selectedRows=%7B%22wrapups%22:%7B%22united-states%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22All%20Adults%22,%22sort%22:%22desc%22%7D Accessed July 21, 2022.
4About Chronic Diseases. National Center for Chronic Disease Prevention and Health Promotion. https://www.cdc.gov/chronicdisease/about/index.htm. Accessed August 1, 2022.