EVANSVILLE, Ind. - For many, the news was like a punch in the gut: quick, painful, and unwanted.
The sound-bite version of the story, that Evansville ranks among the nation’s "most miserable cities," was picked up in television news and radio reports. It even inspired some college students to create a public-relations campaign touting Evansville’s positive attributes.
But while the “most miserable” label provoked immediate reactions, the real truth of the story is considerably more complex.
“We at Gallup, and our partners at Healthways, tend to bristle when we see headlines like ‘Happiest place’ or ‘Most miserable city,’” said Gallup researcher Dan Witters.
Witters is the research director of the Gallup Healthways Well-Being Index, which measures U.S. metro areas based on a range of health and wellness factors.
Research company Gallup and health care company Healthways have collected and published Well-Being Index data since 2008.
The “most miserable” phrase came not from Gallup or Healthways, but from third-party descriptions of the index’s findings.
The 2012 index, released late last month, ranked the Evansville metro area 182nd out of 189 U.S. metro areas. The Evansville metro area includes the Indiana counties of Vanderburgh, Warrick, Posey and Gibson, as well as Henderson and Webster counties in Kentucky.
Index data comes from surveys whose questions focus on six different subindex areas: physical and emotional health, health-related habits, access to things like health care and clean water, workplace environments and overall life evaluation.
Respondents are asked more than 50 questions about these six areas, in addition to 17 demographic questions.
Some sample questions:
“Did you smile or laugh a lot yesterday?”
“Do you smoke?”
“Do you have health insurance coverage?”
“This is a pretty broad and comprehensive measure of well-being,” Witters said.
The 2012 index data came from 353,564 randomly selected respondents who were contacted either by phone.
Data was reported only for metro areas in which 300 or more respondents were surveyed. The Evansville area had 546, Witters said.
Based on survey results, metro areas were assigned a Well-Being Index score, then ranked on the basis of that score.
Evansville’s Well-Being Index score was 63.1 out of 100 in 2012. The national average was 66.7.
In comparison, the metro area that ranked 1st out of 189 in 2012 was Lincoln, Neb., with a Well-Being Index score of 72.8. The area that ranked lowest, Charleston, W. Va., had a score of 60.8.
The Evansville area ranked significantly lower in 2012 than in 2011, when it ranked 138th with a score of 65.7.
One of the big reasons for Evansville’s year-over-year drop, Witters said, was that its ranking in the “Work Environment” area of the survey dropped precipitously. Evansville’s 2011 rank in that area was 10th highest of all metros, compared to 159th in 2012.
“That work environment index alone had a lot to do with Evansville’s more respectable ranking in 2011 overall,” Witters said.
Because of the way the work environment index is calculated, Witters said, it tends to jump up and down more dramatically than do some other areas of the index.
The work environment index includes four questions about the respondent’s satisfaction with his or her job and supervisor. Unless a respondent answers affirmatively to all four questions, Witters said, that person’s response does not help boost a metro area’s work environment score.
So as an example, if 100 percent of respondents in a metro area answer affirmatively to three questions but only half answer affirmatively to the fourth question, the metro’s score on the work environment index will only be 50 percent.
In 2011, Witters said, 55.5 percent of Evansville respondents answered affirmatively to all four questions. In 2012, that percentage dropped to 43.4. The national average was 47.2 percent in 2011 and 47.8 percent in 2012.
Some locals cast a skeptical eye on the Well-Being Index and its methods.
One of those skeptics is Elizabeth Tharp, evaluation and research officer at the Welborn Baptist Foundation. Based in Evansville, the foundation makes grants aimed at improving health and well-being in a 14-county Tri-State area.
The foundation publishes periodic reports on the Tri-State’s demographics, health status, educational achievement and other measures, and it looks to various national, state and local sources for this data. But, Tharp said, the Well-Being Index is not one of those sources.
“We’ve made the determination it isn’t really the best measure to tell us how we’re doing,” Tharp said. “It’s just not as accurate as it could be.”
In particular, Tharp said Gallup’s minimum requirement of 300 responses per metro area seems low. In polling, Tharp said, “the more surveys the better.”
Tharp also pointed to a 2010 Gallup survey that named the Evansville metro area as having the highest obesity rates in the country. That survey found the Evansville area had an obesity rate of 37.8 percent — the highest among 188 metro areas in the survey.
But Evansville did not even make it into the top 10 “most obese metros” list in 2011 or 2012, which makes Tharp skeptical.
“If that was an accurate ranking, then we should have at least been in the top 10 the next year, because obesity doesn’t change that quickly,” she said.
Evansville Mayor Lloyd Winnecke pointed out that the poll relies on self-reported data.
“It’s how people saw themselves on the day they were asked whatever questions were asked,” he said.
Winnecke also pointed out that his administration has established measures aimed directly at improving the city’s health status.
He cited Energize Evansville, a program that offers free monthly exercise sessions at local public parks and recreational facilities. The program has attracted an average of 25 to 30 people per session, Winnecke said.
Winnecke said that Evansville’s “most obese” Gallup ranking from 2010 inspired him to establish the fitness program.
The mayor also cited several health summits last year in which his office pulled together representatives from different health-related groups to share information and ideas about promoting physical activity.
This summer the city will roll out an initiative that has to do with public health, said Mayor’s Office spokeswoman Ella Johnson-Watson.
The Welborn Foundation’s Tharp said that, despite its shortcomings the Well-Being Index does help promote awareness.
“It highlights some very important health and well-being factors,” she said.
And that, Gallup’s Witters said, is the main goal of the index.
The hope, Witters said, is that communities will use the index as a catalyst for making healthy changes.
And those changes, Witters said, must be driven from the top. In other words, elected officials, business executives and community leaders must be working together to create a “culture of well-being.”
“You need consistent messaging, and you need everyone singing off the same song sheet.”
He cited Boulder, Colo., which was second in the 2012 Well-Being Index rankings and fifth in 2011.
That metro area, Witters said, spends public money on walking and bicycling paths, conducts development and redevelopment projects with walkers and cyclists in mind, even has businesses involved in promoting healthy foods and fitness.
“There is a palatable culture of well-being,” Witters said.
So is there hope for Evansville?
“Sure. All this stuff is changeable,” Witters said.
“It’s just having the will to say, ‘This is what we’re going to pursue now.’”