Hawaiians have highest well-being rating for 4th year

For many people a vacation in Hawaii would be a dream, but living there might be even better. Hawaiians agree.

Hawaii ranks No. 1 for the fourth year in a row as the state where residents report the best sense of overall well-being, based on physical health, outlook on life, job satisfaction and other factors that affect quality of life, according to the annual Gallup-Healthways Well-Being Index, released Wednesday.

Other states that have consistently ranked in the top 10 on the well-being index every year from 2008 to 2012 include Utah, Minnesota, Colorado and Montana.

Folks in these states tend to have lower rates of obesity and fewer medical problems such as type 2 diabetes, heart disease, chronic pain. They also report enjoying their jobs more, have lower rates of smoking, and exercise more often than residents in states that rank lower on the list.

Five states that have always been in the bottom 10 with the lowest well-being score every year from 2008 to 2012: West Virginia, Kentucky, Ohio, Arkansas and Mississippi.

Overall, 53% of adults rated their lives as "thriving" in 2012, about the same percentage as 2010 and 2011. The rest of those surveyed in 2012 feel that they are struggling (43.5%) or suffering (3.5%).

Almost 60% of those in Hawaii consider that they are thriving vs. about 45% in West Virginia.

Healthways, a well-being improvement company which sponsors the research, works with people, families, businesses and communities to improve well-being to lower health care costs and improve productivity.

For the well-being index, Gallup conducted phone surveys from a random sample of 1,000 people daily for 350 days a year. People answered questions about their physical health (chronic health conditions, obesity); lifestyle behaviors (smoking, diet and exercise); emotional health (outlook on life, sadness); work environment (enjoying their jobs, relationship with supervisors); basic access (health care, food); and life evaluation (how they rate their lives). The survey measures 50 metrics of overall health and well-being. Gallup then analyzed the results to develop the annual index, which began in 2008.

Residents of the states that are lowest in the rankings tend to be heavier, less active, smoke more and have more medical problems, says Jim Pope, a cardiologist and chief science officer at Healthways.

Some states had dramatic changes in their rankings between 2011 and 2012. North Dakota went from the second position in 2011 to No. 19 in 2012; Alaska went from No. 4 to No. 31; Kansas went from No.7 to No. 17. Meanwhile, Delaware went from No. 47 in 2011 to No. 26 in 2012.

"Delaware made improvements across the board, particularly in emotional health and life evaluation," Pope says.

Overall, "the economic downturn has put a lot of stress on a lot of people," Pope says. "In response, people often adopt unhealthy behaviors that fuel a downward spiral in well-being, all leading to lower productivity and ultimately a higher cost of medical care."

Pope says that states can use this information for a "prescription" on what needs to be changed in their communities. "Some places like Iowa, North Texas and several beach cities in California are already doing this," he says. "Businesses in collaboration with the government are working to create a healthier, more productive workforce to come up with a healthier community and state."

Experts who weren't involved in the index say there are steps people can take to improve their sense of well-being. "We tend to think we won't be happier until big things in our lives change, but research contradicts that," says Joseph Grenny, author of Change Anything: The New Science of Personal Success and one of the founders of coachalba.com, a website that helps people succeed in making changes. "Surprisingly, the fastest way to increase your level of happiness is to spend time with a friend, offer service to someone else, take a walk or simply sit and ponder five things you're grateful for. All of these create an immediate shift in your mental state."

Joe Burgo, a psychologist who wrote Why Do I Do That? and the founder of afterpyschotherapy.com, says, "While most of us don't have the option of moving to one of those states that has a higher sense of well-being, we can do what we can to alter our immediate environment to get as close as possible to those conditions. That might involve the company we keep. Do we choose to hang around with people who have healthy lifestyles or do we stick with people who support our bad habits?

"Every state has opportunities for physical exercise, a huge contributor to the sense of well-being. Joining some kind of group whose focus is on physical activity provides us with exercise and also gives us the chance to associate with other people who have healthy lifestyles."

Other findings of the well-being index:

-- Residents of West Virginia reported the worst health habits (high smoking rate, not eating healthy, a disproportionate number of people do not feel well-rested) in 2012 and those living in Vermont reported having the best ones. Residents of many states with poor health habits, including West Virginia and Mississippi, also have high obesity rates.

-- People's views of their jobs/workplaces got worse in 2009 during the recession and haven't recovered yet.

-- Americans' overall health and emotional health have stayed about the same over the past five years. Colorado residents report the best physical health overall in 2012; West Virginia residents report the worst health, just like they've done every year since 2008.

-- Residents of Massachusetts had the best access to basic necessities (such as easy and affordable access to healthy foods, feeling safe when walking alone at night, access to preventative care) in 2012. Mississippi residents had the worst access to basic necessities last year, as they have had every year since 2008.

-- Folks in Texas remain the least likely to have health insurance; those living in Massachusetts are the most likely to have it.

Here's a look at the overall state rankings based on how residents described their sense of well being in 2012:

1. Hawaii

2. Colorado

3. Minnesota

4. Utah

5. Vermont

6. Montana

7. Nebraska

8. New Hampshire

9. Iowa

10. Massachusetts

11, Maryland

12. South Dakota

13. Wyoming

14. Virginia

15. Washington

16. Connecticut

17. Kansas

18. California

19. North Dakota

20. Wisconsin

21. Maine

22. Idaho

23. Arizona

24. Oregon

25. New Mexico

26. Delaware

27. Texas

28. Illinois

29. Pennsylvania

30. New York

31. Alaska

32. New Jersey

33. Georgia

34, Florida

35. North Carolina

36. Michigan

37, Rhode Island

38. Missouri

39. Nevada

40. South Carolina

41. Oklahoma

42. Indiana

43. Louisiana

44. Ohio

45. Alabama

46. Arkansas

47. Tennessee

48. Mississippi

49. Kentucky

50. West Virginia