Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America.
PLoS One. 2018 May 23;13(5):e0196720. doi: 10.1371/journal.pone.0196720. eCollection 2018.
Well-being is a positively-framed, holistic assessment of health and quality of life that is associated with longevity and better health outcomes. We aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being.
We performed a cross-sectional study examining associations between 77 pre-specified county attributes and a multi-dimensional assessment of individual US residents' well-being, captured by the Gallup-Sharecare Well-Being Index. Our cohort included 338,846 survey participants, randomly sampled from 3,118 US counties or county equivalents.
We identified twelve county-level factors that were independently associated with individual well-being scores. Together, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic (% black); social and economic (child poverty, education level [<high school, high school diploma/equivalent, college degree], household income, % divorced); clinical care (% eligible women obtaining mammography, preventable hospital stays per 100,000, number of federally qualified health centers); and physical environment (% commuting by bicycle and by public transit).
Twelve factors across social and economic, clinical care, and physical environmental county-level factors explained the majority of variation in resident well-being.
幸福感是对健康和生活质量的一种积极的整体评估，与长寿和更好的健康结果有关。我们旨在确定与个体幸福感的全面、多维评估独立相关的县属性。
我们进行了一项横断面研究，调查了 77 个预先指定的县属性与美国居民幸福感的多维评估之间的关联，该评估由盖洛普-沙尔卡健康幸福感指数捕捉。我们的队列包括来自 3118 个美国县或县同等地区的 338846 名随机抽样的调查参与者。
我们确定了 12 个与个体幸福感评分独立相关的县级因素。这 12 个因素共同解释了个体幸福感评分 91%的差异，它们代表了四个概念上不同的类别：人口统计学（%黑人）；社会和经济（儿童贫困、教育水平[<高中、高中文凭/同等学历、大学学位]、家庭收入、%离婚）；临床护理（%有资格获得乳房 X 光检查的女性、每 10 万人中可预防的住院治疗次数、合格的联邦医疗保险中心数量）；以及物理环境（%骑自行车和乘坐公共交通工具通勤）。
社会经济、临床护理和物理环境县一级的 12 个因素解释了居民幸福感变化的大部分原因。
