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“In times of both crisis and calm, measuring well-being should always be considered essential.”
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Using Tools to Measure Well-Being in the Time of COVID-19

By IHI Multimedia Team | Wednesday, June 17, 2020

Measurement COVID

Photo by Morgane Perraud | Unsplash

The COVID-19 pandemic. The ensuing economic distress. Social unrest. Numerous external pressures. Competing priorities. All of these have stretched organizations and communities thin.

We’ve had to focus on what’s “essential,” designating the workers, industries, and activities we deem indispensable. Similarly, there is a strong impulse right now for organizations and communities to measure only what’s required by funders, insurance providers, credentialing associations, and purchasers. However, given what may follow the initial wave of COVID-19, the measurement of well-being — while rarely mandated — should also be deemed essential.

Many experts are predicting a second wave of poor mental health outcomes and despair as a result of the pandemic and its associated impacts on social behaviors, the economy, and community vitality. Consider the following:

This information is critical to understanding the impact of our current crisis and, consequently, where to direct improvement energy. Measuring well-being now can provide insight into the impact of tradeoffs between preventing deaths from COVID-19 and physical distancing policies, which result in social isolation and financial insecurity.

It’s important to remember that well-being extends beyond physical and mental health to include how people think, feel, and function. Well-being drivers and outcomes include mental and emotional health, social belonging and sense of security, and ability to function and engage as an individual and as a member of society. Well-being can be measured at the individual level, in aggregate to assess the state of a community, and to identify inequities within a community or population.

Well-being measurement reflects what is meaningful and matters most to people. The life evaluation component of well-being, which gives the broadest overview of one’s current life situation, is strongly associated with more specific health and socioeconomic outcomes on both the individual and community level, including financial situation and life expectancy on an individual level. In aggregate, life evaluation may also be associated the vitality, opportunity, connectedness, contribution, and inspiration within a community as a whole.

Well-being is a useful measure. It helps us to look at the big picture even during times of crisis when it can be easier to focus narrowly on that which is directly under our control. Additionally, well-being is responsive to real-time changes in how individuals and communities are faring — whether thriving, struggling, or suffering — as demonstrated by the Gallup data. It can also be analyzed alongside other measures, such as unemployment and disease prevalence, to understand how changes in these variables affect well-being. Crucially, well-being measurement can also be used to identify and understand inequities within communities. If we can identify inequities, we can respond and act upon them.  

Many tools exist to help measure well-being. The 100 Million Healthier Lives initiative, convened by the Institute for Healthcare Improvement, has developed two free tools, the Well-being Assessment (Adult – 12 items) and Well-being Assessment (Youth – 12 items). These assessments measure various well-being drivers and outcomes, including the Cantril’s Ladder measure of life evaluation, a simple but powerful measure of well-being used by Gallup, Well-being In the Nation, and 100 Million Healthier Lives. It is also recommended for inclusion as a leading indicator in Healthy People 2030 by the National Academies of Science, Engineering and Medicine.

The assessment instruments also include contributors to well-being such as financial, social, and emotional well-being. They are brief and simple to administer and can be used to assess well-being at a point in time as well to track changes in well-being over time. These assessments also include recommended sociodemographic measures to aid in identifying equity gaps. The Well-being In the Nation (WIN) Network, a multi-sector collaborative, has additional tools for measuring well-being and its components at the local, state, and national levels, including the Well-Being In the Nation Measurement Framework.

In times of both crisis and calm, measuring well-being should always be considered essential. Whether at the individual or community level, assessing well-being is crucial because it helps us understand what matters most to people in their daily lives.

Julia Nagy, Project Manager, Institute for Healthcare Improvement

Marianne McPherson, PhD, Senior Director, Institute for Healthcare Improvement

Matthew C. Stiefel, MPA, MS. Senior Director, Center for Population Health, Kaiser Permanente

Carley L. Riley, MD, MPP, MHS, FAAP, Assistant Professor, University of Cincinnati Department of Pediatrics; Attending Physician, Cincinnati Children’s Hospital

Brita Roy, MD, MPH, MHS, Assistant Professor, Yale School of Medicine; Director of Population Health, Yale School of Medicine

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