www.Ups tatePhys i c i ansSC . com | www.Hea l thL i nksUps tate. com | 53 will have to involve the whole state community – area governments, the private sector, nonprofits and individual citizens – working together “as partners to improve outcomes.” “That’s the model we’re following here in the Charleston region,” he said, “particularly with regard to food access, which continues to be a real priority throughout our area." To date, the wellness rankings have indicated that, with very few exceptions, almost every state needs improvement in at least one health domain. For example, Hawaii, ranked No. 2 overall, placed far lower than South Carolina in resource access. New York, at No. 5, was below South Carolina in economic security. And Utah, rounding out the top 10, was worse than South Carolina in health care access. “Each year, we expand our available data and the application of novel methods to further the precision in our estimation of CWBI,” said Dr. Kimberly Dukes, executive director of the Boston University School of Public Health Biostatistics and Epidemiology Data Analytics Center. “Since the first year of the study, the 50 states have slightly improved or remained about the same.” She added that while improvements have so far amounted to “very small score increases,” community pockets in many low-ranking states surprisingly outperformed those in higher-ranked states. “In 2021, vulnerable individuals showed more resilience with respect to finding purpose and social engagement within their communities, as compared to those who reported higher well-being,” she said. Whether a state placed first, like Massachusetts, or last, such as Mississippi, or somewhere in between like Kansas, Georgia and South Carolina, both Dr. Dukes and Dr. Rickles said the most important outcome of the rankings is that there is a lot of room for improvement at all levels of U.S. health. “Our rankings reports have shown the impact of many factors driving people to achieve their greatest levels of health and well-being,” Dr. Dukes said. “And for the future, we hope the 2021 findings will enable stakeholders across the health care ecosystem and beyond to discover and build targeted interventions that enhance health, access and opportunity for all.” HOW THE 2021 STATE WELLNESS RANKINGS WERE DETERMINED Research for the 2021 Community Well-Being Index rankings was organized and conducted through a partnership between two organizations: Sharecare, a U.S.-based digital health company that helps employees, health plan members and patients manage all their health in one place; and the Biostatistics and Epidemiology Data Analytics Center at the Boston University School of Public Health. Sharecare and BUSPH collected 495,783 surveys and counted 3,142 U.S. counties plus 383 census-designated metropolitan statistical areas. Factors included individual health risk in each state and an individual’s surroundings and environment – based on the 10 domains to the left. “The CWBI is founded on the world’s largest, continuously collected data source of subjective well-being,” said Dr. Michael Rickles with Sharecare. “With over 4 million surveys collected to date, this data is tied to over 90 peer-reviewed publications showing the efficacy of the information being collected. No other company has collected social determinants of health data at this scale for this long and had their data tied to as many outcomes.” Massachusetts was judged as the healthiest state in the nation for the second straight year. Florida and Virginia were the only Southern states to place in the top 20. And Louisiana, placing 44th, was the only bottom-tiered state to score a top-10 rating in any domain. For future wellness surveys, Dr. Rickles said, “We aim to collect data at scale, using the same measures, so that when people do implement interventions, we can capture those changes and serve as an evaluative component to capture some of the real-time changes that are happening at a community level."
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