Large communities have much better physical health than small towns
Communities of all sizes have suffered similar well-being declines in 2017
General life ratings improving for those in small towns and rural areas
WASHINGTON, D.C. -- Residents of highly populated communities have better
overall well-being than their counterparts in less populated areas, based
on their overall scores on the Gallup-Sharecare Well-Being Index. Overall,
large communities have a Well-Being Index score of 61.7 so far in 2017,
compared with 61.4 for midsized communities and 61.0 for small towns and
rural areas.
Well-Being Index Score, by Community Population Size
Large communities
Medium large communities
Medium small communities
Small towns and rural
Large communities vs. small towns/rural
WBI
61.7
61.4
61.4
61.0
+0.7
Jan. 2-Sept. 30, 2017
Gallup-Sharecare Well-Being Index
These data are drawn from more than 121,000 interviews with U.S. adults
across all 50 states from Jan. 2-Sept. 30, 2017. The large sample size
means that even small differences in Well-Being Index scores are statistically
significant.
The four reporting groups in this article are based on the following definitions:
Large communities: metropolitan areas with populations of at least 1 million
Medium large communities: metropolitan areas with populations ranging from 250,000 to less than 1 million
Medium small communities: metropolitan and "micropolitan" areas with populations ranging
from 13,000 to less than 250,000
Small towns and rural: towns of under 13,000 and those residing in rural areas
The
Gallup-Sharecare Well-Being Index is calculated on a scale of 0 to 100, where 0 represents the lowest possible
well-being and 100 represents the highest possible well-being. The Well-Being
Index score is made up of metrics drawn from each of the five essential
elements of well-being:
Purpose: liking what you do each day and being motivated to achieve your goals
Social: having supportive relationships and love in your life
Financial: managing your economic life to reduce stress and increase security
Community: liking where you live, feeling safe and having pride in your community
Physical: having good health and enough energy to get things done daily
Small Towns and Rural Areas Lag Behind in Physical Well-Being
The main reason residents of larger communities have higher well-being
is because they have much better physical health, with a score of 61.3
vs. 58.7 in small towns and rural areas. However, residents of smaller
communities do have advantages on other key elements of well-being. For
example, medium small communities have better purpose and financial well-being
than the other three groups, while those who live in small towns and rural
areas easily have the best community well-being.
Well-Being Index Element Scores, by Community Population Size
Large communities
Medium large communities
Medium small communities
Small towns and rural
Large communities vs. small towns/rural
Purpose
59.4
59.8
60.1
59.8
-0.4
Social
60.0
60.0
59.7
59.4
+0.6
Financial
61.3
60.9
61.6
60.4
+0.9
Community
61.5
61.9
62.2
63.6
-2.1
Physical
61.3
60.2
59.8
58.7
+2.6
Jan. 2-Sept. 30, 2017
Gallup-Sharecare Well-Being Index
Residents of large communities have higher physical well-being, primarily
because of lower rates of obesity and other chronic diseases. They also
are more likely to engage in healthy behaviors such as visiting the dentist
and not smoking.
On the other hand, residents of small towns and rural areas are more likely
to report that they always feel safe and secure, to feel their area is
"perfect" for them and to be recognized for volunteering in
a way that improves the areas where they live.
Well-Being Advantages and Disadvantages: Large Communities vs. Small Towns
and Rural Areas
Large communities
Small towns and rural
Large communities vs. small towns/rural
%
%
pct. pts.
Advantages for large communities:
Obese
26.1
32.7
-6.6
Diabetes
10.4
14.4
-4.0
High blood pressure (lifetime)
26.0
34.3
-8.3
High cholesterol (lifetime)
21.3
26.0
-4.7
Heart attack (lifetime)
3.5
6.0
-2.5
Clinical diagnosis of depression
17.4
21.2
-3.8
Daily physical pain
24.7
32.0
-7.3
Smoker
16.2
21.7
-5.5
Dentist visit (past 12 months)
69.1
58.9
+10.2
Advantages for small communities:
City or area is perfect for you (% agree)
62.8
66.4
-3.6
Always feel safe and secure (% agree)
75.9
81.3
-5.4
Recognition for improving area (last 12 months) (% agree)
19.5
21.8
-2.3
Jan. 2-Sept. 30, 2017
Gallup-Sharecare Well-Being Index
Communities of All Sizes Experience Well-Being Declines in 2017
While large and small communities have different well-being advantages,
communities of all population sizes have experienced declines in well-being
of roughly equal size this year. Together, these declines contribute to a
drop in well-being for the nation as a whole this year compared with 2016. Before 2017, well-being in the
U.S. had risen for two consecutive years.
Well-Being Index Score, Trended, by Size of Community
Large communities
Medium large communities
Medium small communities
Small towns and rural
2016
62.3
62.1
61.9
61.6
2017
61.7
61.4
61.4
61.0
Change
-0.6
-0.7
-0.5
-0.6
2017 results based on interviews conducted from Jan. 2-Sept. 30, 2017
Gallup-Sharecare Well-Being Index
Life Evaluation Edging Up in Small Towns/Rural Areas
Despite the overall decline in well-being, there is a bright spot for those
living in medium small communities, small towns and rural areas: a meaningful
increase this year in how they evaluate their lives. This measure, known
as life evaluation, is a general rating of one's life today and in
the future. People who rate both their current and their future lives
highly on the steps of an imaginary ladder, based on the
Cantril Self-Anchoring Striving Scale, are considered "thriving."
The same upward trend in life evaluation has not occurred for those who
live in larger communities. Still, as is the case with well-being generally,
life evaluation tends to be higher in more populated areas than in less
populated areas.
Life Evaluation, Trended, by Community Population Size
Large communities
Medium large communities
Medium small communities
Small towns and rural
2016
57.5%
54.9%
53.2%
50.5%
2017
57.8%
55.3%
55.2%
52.0%
Change (pct. pts.)
+0.3
+0.4
+2.0
+1.5
Jan. 2-Sept. 30, 2017
Gallup-Sharecare Well-Being Index
Implications
Well-being is higher for people living in more populated areas than for
those living in sparsely populated areas, but communities of different
population sizes have different well-being advantages and disadvantages.
Notably, community well-being -- liking where you live, feeling safe and
having pride in your community -- is decidedly better as population size
declines. Large communities, in turn, have residents with better physical
well-being, possibly attributable to cultural norms and more readily available
built infrastructure such as parks, bike paths and fitness centers for enhancing physical health.
Those in small towns and rural areas simply have fewer visible healthy
lifestyles to emulate and are arguably less culturally incentivized to
pursue them.
The decline of well-being generally across all sizes of communities
mirrors what is found nationally, but life evaluation more specifically serves as an exception for residents
of more sparsely populated areas of the country. The reasons for the uptick
in life evaluation within these areas are uncertain, but one possible
explanation is that it reflects a more positive reaction to Republican
President Donald Trump occupying the White House. Trump's vote share
was significantly higher in medium to small communities and rural areas,
and prior research has shown that
life evaluation among certain political and demographic groups can change dramatically when control of the White House transitions from
one party to the other.
Survey Methods
Results are based on 121,396 telephone interviews with U.S. adults across
all 50 states and the District of Columbia, conducted from Jan. 2-Sept.
30, 2017. In 2016, a total of 176,702 interviews were conducted from Jan.
2-Dec. 30. Gallup conducts 500 telephone interviews daily, resulting in
a sample that projects to an estimated 95% of all U.S. adults.
The Well-Being Index margin of sampling error for the reported groups is
about ±0.3 points. All reported margins of sampling error include
computed design effects due to weighting.
Each daily sample of national adults for data collected in 2016 comprises
60% cellphone respondents and 40% landline respondents. Daily samples
in 2017 comprise 70% cellphone respondents and 30% landline respondents.
Additional minimum quotas by time zone and within region are included
in the sampling approach.