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Am J Health Promot. 2018 Nov;32(8):1800-1813. doi: 10.1177/0890117118791993. Epub 2018 Aug 5.

Collective Well-Being to Improve Population Health Outcomes: An Actionable Conceptual Model and Review of the Literature.

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1 Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
2 Division of Critical Care Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
3 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
4 Sarah Cannon, Nashville, TN, USA.
5 Tivity Health, Inc, Franklin, TN, USA.



To propose collective well-being as a holistic measure of the overall "health" of a community. To define collective well-being as a group-level construct measured across 5 domains (vitality, opportunity, connectedness, contribution, and inspiration) and introduce an actionable model that demonstrates how community characteristics affect collective well-being. To review the literature describing each domain's association with health outcomes and community characteristics' associations with collective well-being.


We came to consensus on topics describing each component of our conceptual model. Because "well-being" is not indexed in MEDLINE, we performed topic-specific database searches and examined bibliographies of papers retrieved. We excluded articles that were limited to narrow subtopics or studies within small subpopulations. Preference was given to quasi-experimental or randomized studies, systematic reviews, or meta-analyses. Consensus was reached on inclusion or exclusion of all articles.


Reviewed literature supported each of the proposed domains as important aspects of collective well-being and as determinants of individual or community health. Evidence suggests a broad range of community characteristics support collective well-being.


The health and quality of life of a community may be improved by focusing efforts on community characteristics that support key aspects of well-being. Future work should develop a unified measure of collective well-being to evaluate the relative impact of specific efforts on the collective well-being of communities.


built environment; collective well-being; community health; conceptual model; narrative review; population health; social determinants; social environment; well-being


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