Perspectives On Wellness

Measuring Whole-Person Health

The new dimensions and new vitality of well-being

by Christopher DeRosa

Mr. DeRosa is the President of Cigna’s National Accounts Segment and Broker Exchanges. In this role, he ensures the creation of value for Cigna’s largest employer customers and their families. Visit

The pandemic, without a doubt, elevated the importance of health and well-being like never before. The fragility of our physical health crystalized. Stress, burnout, and loneliness were amplified. Mental health issues were exacerbated. Beyond this, the impacts of social determinants of health – such as education, income, location, and access to health care – became more pronounced.

As we move forward in the New Year, however, we need to recognize that well-being transcends physical and mental health. Our overall health and well-being are dynamic and multi-dimensional, encompassing elements that impact our ability to pursue life with health, strength, and energy – our vitality.

At Cigna, we set out to build a new, more substantive health measure – one that not only accounts for the intrinsic connection between body and mind, but also incorporates the complexities of well-being that go beyond physical and mental health.

I’m proud to introduce vitality as the next generation measure of health. Vitality is both a driver and an outcome of health and work/life engagement. It’s essential to individuals and a catalyst for business and community growth.

The Evernorth Vitality Index

To develop and scientifically validate a proprietary measure of whole-person health, we partnered with the world’s foremost authority on the science of vitality – psychologist Dr. Richard Ryan.

Measuring vitality gives us the ability to dive deeper into health and well-being and into vitality’s multiple, interdependent, dynamic dimensions. Importantly, vitality also accounts for how people feel about their ability to make their own choices and to be in control of their life across those dimensions. This sense of control – or autonomy, competency, and relatedness – is crucial to one’s vitality.

The Evernorth Vitality Index analyzes these dynamic influences and calculates the data as a single, comprehensive measure of whole-person health.

The Eight Dimensions of Vitality

Each dimension of vitality influences our overall health and well-being.

1.) Physical: Taking care of one’s body to stay healthy, now and in the future.

2.) Emotional: Taking care of the mind, promoting emotional and psychological well-being.

3.) Occupational: Balancing work in a way that promotes health and a sense of personal satisfaction.

4.) Social: Maintaining positive relationships and having a sense of connectedness and belonging.

5.) Spiritual: Ability to manage everyday stresses, be productive, and contribute at home, at work, and in the community.

6.) Financial: Reaching financial security in the present and in the future.

7.) Environmental: Maintaining and influencing one’s surroundings and environment to manage and promote health.

8.) Intellectual: Engaging in activities that expand knowledge and skills and contribute to one’s full potential.

The Vitality of U.S. Adults

In May of 2022, we gave the benchmark vitality survey to more than 10,000 Americans, ages 18-75, to better understand the state of vitality among U.S. adults.

Our research revealed that less than one in five have high levels of vitality, yet lower levels of vitality threatens people’s ability to engage and contribute – impacting families, communities, work, and beyond. The average vitality score among the general population is 67.4 out of 100. Unfortunately, 82% of those we surveyed fall in the low and medium vitality categories, including 15% who are experiencing low vitality.

A few key trends stood out: People with higher vitality experience a wide range of benefits, from better mental and physical health to higher levels of job satisfaction and performance. Higher vitality is linked to a more motivated, productive workforce. On the flipside, low vitality contributes to poor work quality, higher turnover, and workplace dissatisfaction.

This in-depth research on vitality and its eight interconnected dimensions gives us a clear blueprint of focus areas for employers and their advisors.

Employee Health and Vitality

Understanding vitality and the factors that impact it gives employers a path to more deeply discerning the unique needs of their people, to make meaningful investments in workforce health, and to grow their business.

The Evernorth Vitality Index research confirms that vitality levels are tied to key workforce engagement measures. A large majority (95%) of employees with high vitality say they have health insurance, and more than half (51%) have access to health insurance through their employer.

We set out to build a new, more substantive health measure – one that not only accounts for the intrinsic connection between body and mind, but also incorporates the complexities of well-being that go beyond physical and mental health...

Overall, people who are employed are more likely to consider themselves in excellent health than people who are not employed (20% vs. 9%). Significantly more workers report experiencing excellent mental health than non-workers (23% vs. 10%) and excellent physical health (17% vs. 8%). Additionally, 77% of workers have a primary care provider, and 69% have had an annual physical within the past year.

The research indicates those who are employed are more likely to eat well (44%), exercise (78%), and have better sleep quality (15%). They are also less likely to experience chronic pain (25% vs. 46%). Workers with chronic conditions believe more strongly that they can manage their health compared to non-workers with chronic conditions (48% vs. 28%).
People who are employed often exhibit a level of competence in other areas of their life as well. They are significantly more likely to feel confident in their ability to complete difficult tasks compared with those who are not employed (53% vs. 41%). And more workers than non-workers say they are able to adapt when changes occur and that they tend to bounce back after illness, injury, and other hardships, which speaks to their resilience.

Workplace Culture, Relationships, and Vitality

Vitality helps quantify the correlation between work culture and employee wellness. Through our study, we learned that workers tend to have higher vitality levels when they feel their employers prioritize their wellness, enable them to maintain strong work-life balance, and communicate clearly. Workers with high vitality are more likely to agree that their employer provides adequate opportunities to care for personal health (71%) and shows focus on wellness in actions and communications (62%). While many workers feel supported by their employers, sizable minorities do not, and 29% of all workers say that work causes their personal life to suffer.

Internal communication is key to demonstrating employers’ priorities and enabling a sense of autonomy for employees. Workers with high vitality are distinguished by a near-universal sense that they are kept informed about what is going on in the company (93% vs. 52% of low-vitality workers).

Interestingly, we found that many workers with high vitality are at a transitional period in their lives. They are more likely to be in the 35-44 age bracket, representing a large share of working parents and professionals who may be experiencing positive life shifts, such as engagements, pregnancy, and new parenthood. We found that 92% of high-vitality workers make time for relationships, suggesting that families and relationships lead to positive social well-being.

This group also illustrates that thriving at work is possible within a supportive work culture, with 72% saying that their work environment enables their family and personal commitments, compared with just 13% of low-vitality workers. Having personal relationships with people work also influences overall vitality. We found that 79% of high-vitality workers overwhelmingly “feel connected with people” at work, compared to 36% of medium-vitality workers and 12% of low-vitality workers.

Additionally, high-vitality workers report strong relationships with their managers and are more likely to feel they can easily express their opinions or feelings about their job conditions, agree that their manager tries to understand how they see things, and feel encouraged to ask questions.

Employees With High Vitality Demonstrate Strong Performance and Are More Satisfied at Work

Vitality is crucial for employees to feel engaged with and satisfied by their work, which often leads to strong worker performance. Workers with high vitality overwhelmingly feel confident they can do things well at work; 31% have taken on additional responsibilities in the past year, compared to 23% of low-vitality workers.

Rewards, recognition, and compensation at work also influence a worker’s vitality levels. The large majority of high-vitality workers (69%) say they receive appropriate recognition and rewards, compared to 21% of their low-vitality peers, and 38% of high-vitality workers received a promotion last year.

Employees with high vitality are almost universally satisfied with their jobs (97%) and report greater chances for advancement (92%). Nearly two out three high-vitality workers have been in their current job for more than a year, and 88% would like to be working for the same employer in three years. Only 11% of high-vitality workers applied for a new job in the past year.

These results clearly demonstrate that higher levels of vitality among employees contribute to better work quality, greater employee motivation and satisfaction, and strong retention – all critical to a business’s bottom line.

The Takeaway

Vitality is a catalyst for growth that can help people achieve the healthiest versions of themselves, causing a ripple effect that can power healthier, more engaged families, workplaces, and communities. By better understanding vitality and the factors that impact it, you can help your employer clients fuel a healthier workforce and drive business and economic growth. Beyond your book of business, you can inspire the personal, business, and economic growth that are hallmarks of a healthy society.


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