As the COVID-19 pandemic reached its second year in 2021, Massachusetts again emerged as the healthiest state in the nation, according to a study released by BUSPH and the digital health company Sharecare.
While overall well-being remained generally unchanged at a national level in 2021, the latest Sharecare Community Well-Being Index state rankings report reveals improvements in key domains as COVID-19 vaccines ushered in a sense of normalcy and evolving workforce dynamics took hold across the U.S.
Built on more than a decade of measurement and over four million surveys completed to date, the nationally representative dataset comprising the Sharecare Community Well-Being Index is the most comprehensive assessment of community health in the country. BUSPH’s Biostatistics & Epidemiology Data Analytics Center (BEDAC) conducted the extensive data review and analysis, while BEDAC Executive Director Dr. Kimberly Dukes called the collaboration with Sharecare “a wonderful opportunity for BEDAC to deploy our data science capabilities.”
“We have also been fortunate to closely collaborate with BUMC IS&T to provide storage, retrieval, processing and analytic capabilities to offer big data solutions to our community. We are excited to catalog and share the vast public data stored in our BEDAC data warehouse and have experts at BEDAC who look forward to exciting and impactful collaborations,” Dukes said. Joseph Palmisano, Michael Winter, Tara Tripp, Nina Cesare, Leah Forman and Paige Beliveau will be leading BEDAC’s ongoing data warehouse efforts, Dukes added.
As in previous years, the newly released research assessed the well-being of nearly 500,000 Americans spanning all 50 states in 2021 across individual well-being domains, including physical, social, community, purpose, and financial; and also analyzed more than 600 elements of social determinants of health (SDOH) to identify those data most associated with community health outcomes – healthcare access, food access, resource access, housing and transportation, and economic security.
Massachusetts maintains #1 spot, Mississippi remains at bottom for third year running
The following states achieved the highest and lowest scores in the nation for overall well-being, respectively:
3. New Jersey
5. New York
45. New Mexico
48. West Virginia
The highest-ranked states shared several commonalities. Across the five individual well-being domains studied, the three healthiest states in 2021 – Massachusetts (#1), Hawaii (#2), and New Jersey (#3) – each earned scores among the top five in the nation. These states also achieved best-in-nation scores in the SDOH domain of healthcare access. Nine of the 10 top-ranked states also performed highly in the domain of physical well-being with scores among the 10 highest in the nation.
The analysis of the lowest-ranked states in 2021 also uncovered common challenges in both individual well-being and SDOH domains, with Mississippi earning last-in-the-nation scores in most domains and maintaining its #50 overall ranking for the third year in a row. Each of the bottom 10 states earned lowest-in-nation scores in the well-being domain of community, which measures the extent to which individuals like where they live, feel safe, and have pride in their community. Similarly, nine of the 10 lowest-ranked states landed in the bottom quintile for purpose well-being, defined as liking what you do each day and feeling motivated to achieve your goals.
Dimensions of well-being influenced by COVID-19 vaccine rollout, evolving workforce dynamics
Overall well-being throughout the nation scored 60.9 out of 100, representing minor gains from 60.5 in 2020. However, a detailed review of the domains comprising the Index reveals more dramatic changes from 2019 to 2021.
As the introduction and rollout of several COVID-19 vaccines modified risk tolerance for social gatherings and returning to in-person work, domain scores measuring community and social bonds also increased. In the financial well-being domain, which measures individuals’ ability to manage their economic life to increase financial security and reduce stress, the nation’s score also increased to pre-pandemic levels – reversing a year-over-year decline measured between 2019 and 2020.
Additionally, purpose well-being increased by a statistically significant 5.7 points, from 59.0 in 2019, to 62.7 in 2020, to 64.7 in 2021. Notably, this trend occurred as many people left the workforce or moved to jobs that better aligned with their personal and professional goals; by effect, these behaviors appeared to compound gains observed since the beginning of the pandemic.
Further, an additional analysis of Sharecare’s 2021 rankings, informed by WalletHub’s 2021 workforce resignation rates and trends, captured an association between job resignation rates and several domains impacting states’ overall well-being. Compared to the 10 states with the lowest resignation rates, the 10 states with the highest resignation rates in 2021 ranked on average:
- 19 positions (or approximately 2.8 points) lower in financial well-being.
- 18 positions (or approximately 5.1 points) lower in healthcare access.
- 17 positions (or approximately 1.0 point) lower in community well-being.
“Last year marked a turning point in many ways for well-being across the U.S.,” said Dr. Michael Rickles, vice president of research at Sharecare. “As the pandemic consistently and prominently influenced the year end-to-end – from workforce dynamics to social and community engagement – our research findings underscore the fact that well-being is not an accident, but instead the result of a mix of behaviors and social circumstances that shape our lives. Our hope is that leaders – both in the public and private sectors – can study their states’ performance to understand their strengths and weaknesses across domains so that they can foster healthy, thriving communities.”
“This initial analysis of 2021 data from the Sharecare Community Well-Being Index adds nuance to our ongoing study of the well-being landscape in the U.S.,” said Dr. Kimberly Dukes, executive director of BUSPH’s Biostatistics & Epidemiology Data Analytics Center (BEDAC). “As a new phase of a once-in-a-century pandemic met unique economic forces, the data show that several domains of well-being trended in positive directions, and in one case ‘recovered’ to pre-pandemic levels. Data collected in 2022 will help us understand how community well-being fared as many pandemic-related restrictions were formally loosened and inflation continues to increase.”
To arrive at these results, Sharecare and BUSPH conducted web and mail surveys among 495,783 U.S. residents aged 18 and older throughout 2021 and analyzed more than 600 elements of SDOH data. Results are nationally representative. To read the full report and to learn about the project’s methodology, visit wellbeingindex.sharecare.com/reports.