A state of well-being

When Jenni Prokopy, founder and editor of ChronicBabe.com, recently asked bloggers to submit stories of techniques and coping strategies for how to live well with chronic disease, she received an impressive collection.

A young woman with type 2 diabetes described the importance of having a consistent morning routine. Another blogger, who has rheumatoid arthritis, shared how she deals with winter weather that makes her symptoms worsen. A woman with lupus recounted her longing to be involved in sports when she was in high school and the solution she came up with.

In purely medical terms, each of these bloggers is sick with a chronic condition. But when it comes to living their lives, they’ve figured out how to achieve a state of well-being.

What does it mean to be healthy, anyway? Is good health merely the absence of disease, or is it something more?

Researchers have been trying to define this for many years. The questions are both intriguing and difficult to answer. Which is more important - to live long or to live well? Is obesity the main measure of health or are there other indicators that matter too? Is it possible to have a chronic condition but still be healthy? Can you be healthy after cancer, heart attack or traumatic brain injury? What makes people resilient?

Some of the most interesting studies come from the field of healthy aging. They have identified a number of things that people who age well have in common: moderation in calorie intake and alcohol consumption, daily physical activity, the ability to manage stress and weather the pain of grief, and plain old zest for living.

The propensity for disease and shortened lifespan is at least partly determined by genetics, of course. The Long Life Family Study, for instance, a multi-center project that tracks families who have multiple members with exceptionally long lives, suggests there may be phenotypes associated with extreme longevity. Compared to control groups, they and their children were less likely to have diabetes, lung disease or peripheral artery disease. Both their cognitive functioning and physical functioning were better as they aged.

But other factors besides a favorable genetic profile may be at work as well. For example, the researchers noted that the participants enrolled in the Long Life Family Study were, on average, relatively well educated and had a low incidence of smoking.

An even more fascinating study comes from China, where researchers attempted to measure whether people who achieve extreme old age are somehow more resilient than those who die sooner. What they found was that individuals who had managed to survive into their 90s, were married, enjoyed better health, had pension benefits and at least one year of schooling were more likely to become centenarians.

The study’s authors observe:

When individuals reach very advanced ages, accumulated negative conditions such as health deterioration and bereavement of loved family members represent serious challenges. Thus, nonagenarians who are more resilient may have stronger capacities and potentials for dealing successfully with these serious challenges, constraints and adversities to subsequently survive to age 100+.

Several equally interesting studies have explored the role of conscientiousness on health – and here’s where those who’ve been dealt an unfavorable hand of cards can have a positive impact on their own health. Many of these studies single out traits such as self-discipline and perseverance as important predictors for health-related behavior. A study carried out in the U.K., for instance, found that young people with diabetes (most of the youths in this particular study had type 1 diabetes) and who scored well on personality tests measuring conscientiousness, emotional stability and openness to new experiences were more likely to practice good self-care, especially when they perceived their diabetes treatment was helping them control the disease.

Can you measure well-being like you’d measure your blood pressure or pulse rate? The folks at Gallup, the well-known polling group, have given it a try, releasing their annual national well-being index earlier this week.

The state-by-state poll is based on responses to several key questions: How do you feel about your life? What do you anticipate for your life five years from now? Are you satisfied with your job? Do you laugh often? Do you feel stressed out, angry or depressed? Do you have health problems that interfere with daily life? Do you eat fruits and vegetables and get regular exercise? Do you have access to clean water? Do you have enough money for food, shelter and health care? Do you feel safe walking alone at night? Do you believe your community is becoming a better place to live?

According to the results, the national well-being index is 66.8 out of 100 possible points. The best states were in the Upper Midwest and Great Plains, and included Minnesota, North Dakota and South Dakota (Iowa and Wisconsin didn’t quite make the cut). The worst were in the South and the so-called Rust Belt.

How does this apply to individuals? Since the 1950s, Gallup has polled people around the world, in search of the universal elements of well-being that matter to people regardless of country or culture. Here’s what they identified:

- Career well-being, or liking what you do every day.

- Social well-being, including having strong relationships and love in your life.

- Financial well-being.

- Physical well-being, or having good health and energy.

- Community well-being, or feeling engaged with where you live.

Surprisingly (or not), the biggest obstacle to achieving well-being is ourselves, according to Gallup authors Tom Rath and James K. Harter. By making short-term decisions, people often override what’s in their long-term best interests, they wrote. People who reported the highest levels of well-being, on the other hand, often lived in a way that was intentional rather than impulsive or focused on instant gratification. The authors conclude, “If we can find short-term incentives that are consistent with our long-term objectives, it is much easier to make the right decisions in the moment.”

Image credits: Photos, Wikimedia Commons; logo, Troy Murphy, West Central Tribune

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