Mental, social, and physical well-being in New Hampshire, Oregon, and Washington, 2010 Behavioral Risk Factor Surveillance System: implications for public health research and practice related to Healthy People 2020 foundation health measures on well-being.

BACKGROUND: Well-being is now accepted as one of four cross-cutting measures in gauging progress for Healthy People 2020. This shift to population indicators of well-being redresses notions of health that have focused on absence of illness (negative health) as a primary or sufficient indicator of positive functioning. The purpose of this study was to estimate mental, social, and physical well-being in three US states using new measures piloted on the 2010 Behavioral Risk Factor Surveillance Survey System (BRFSS). Baseline estimates were provided for states overall, and within states for demographic subgroups, those with chronic health conditions or disabilities, and those with behavioral risk factors. METHODS: Ten validated questions designed to assess mental (e.g., satisfaction with life, satisfaction with life domains, happiness), physical (e.g., satisfaction with energy level), and social dimensions (e.g., frequency of social support) of well-being were selected with state input for inclusion on BRFSS. 18,622 individuals responded to the BRFSS surveys administered by New Hampshire (N = 3,139), Oregon (N = 2,289), and Washington (N = 13,194). Multivariate adjusted proportions of positive responses to well-being items were examined. RESULTS: After adjustment for confounders, about 67% of adults in these states had high levels of well-being, including >80% reporting experiencing happiness. Most adults were satisfied with their work, neighborhood, and education, but significant differences were seen in subgroups. Well-being differed by demographic characteristics such as marital status, health behaviors, chronic conditions, and disability status, with those who reported a disability and smokers consistently experiencing the worst well-being. CONCLUSIONS: Well-being is accepted as one of four cross-cutting measures in gauging progress for Healthy People 2020. Well-being differs by important sociodemographic factors and health conditions (e.g., age, employment, smoking, disability status). These findings provide baseline estimates for the three states to use in gauging improvements in well-being and can serve as a model for other state-level or national surveillance systems. These findings also assist states in identifying vulnerable subgroups who may benefit from potential interventions such as those in the National Prevention Strategy that focus on enhancing well-being where such disparities exist.

Evaluation of an arthritis communication campaign to promote physical activity in two cities.

Two communications campaigns (a "standard" campaign and an "enhanced" campaign linked to a physical activity opportunity) are evaluated to increase physical activity among people with arthritis. A pre- (n = 295) and post- (n = 806) intervention random sample telephone survey is conducted in two cities to measure the population effect of the campaigns. There are no changes in overall message awareness, beliefs, or behaviors related to physical activity and arthritis management in either city. Significant changes in message awareness and exercise frequency are found in subgroups in both cities, but the results do not show an advantage to enhancing the campaign with a local physical activity opportunity. An inability to saturate the market may partly explain why no overall significant increase in message awareness is found after the campaign. A high level of message awareness among respondents before the campaign may also have made it more difficult to affect measured outcomes.

The role of adult attachment, parental bonding, and spiritual love in the adjustment to military trauma.

In order to prevent the development of posttraumatic stress disorder (PTSD) and to effectively treat it in active-duty and veteran populations, it is important to identify factors that may protect individuals exposed to significant traumas during military service. This pilot investigation conceptualized significant relationships in terms of attachment theory and explored the salutogenic role of adult attachment, parental bonding, and divine love as protective factors in adjustment to and completed self-report attachment measures. Associations of attachment and perceptions of important relationships with PTSD status were investigated in a convenience sample of 102 veterans. The findings suggest that veterans with current PTSD had lower secure attachment and higher insecure attachment compared to those without PTSD. Hierarchical regression analyses indicated that after controlling for demographics, secure attachment explained an additional 11.2% of the variance and made the greatest predictive contribution to PTSD in this investigation. Group differences (PTSD versus no PTSD) were examined on measures of important relationships, and no significant differences were found related to parental bonding or perceptions of love by God. Veterans with current PTSD had significantly higher insecure romantic attachment compared to the no PTSD group; however, romantic attachment did not make a significant predictive contribution to current PTSD severity. Implications of the results for the treatment of individuals exposed to combat trauma are discussed.