Feeling stressed at work? You’re not alone.

About seven out of 10 respondents in a recent Business Record survey said they feel more stressed than they did a year ago. And a national barometer of overall well-being indicates that Greater Des Moines isn’t faring as well as the rest of the nation in some key stress-related measures, among them healthy behavior and work environment.

Greater Des Moines ranks near the bottom of the pack among 188 U.S. cities in terms of healthy behavior and work environment, according to the Gallup-Healthways Well-Being Index. Greater Des Moines ranked 182nd in self-reported healthy behavior and 111th in work environment.

The bottom line, say health experts, is that poor health choices and stressful workplaces can lead to more chronic health conditions, leading to even greater strain on the nation’s health-care system and on health-care costs for businesses and individuals.

Before you stress out over this, however, read about an initiative that’s designed to help us all become healthier and a little less anxious.

New tool

In an online survey conducted by the Business Record in mid-November, a majority of those responding said they felt more stressed at work than they did a year ago, and more than half rated their stress level as “high” or “very high.” Among 182 respondents to the Business Record Daily poll, 69 percent agreed or strongly agreed that they felt more stressed at work than they did a year ago, and 55 percent indicated a stress level of 8 or higher on a 10-point scale, with 1 indicating low stress and 10 indicating high stress.

Though that survey was completely unscientific, some genuine research has shown definite connections between workplace stress and health. According to a 2007 report by the American Psychological Association, nearly 75 percent of Americans said their workplace was a significant source of stress. Another study found that employees with positive perceptions of their workplace were 30 percent less likely to develop heart disease than employees with negative feelings about their workplace.

“We know that the work environment, whether it’s the physical environment or the social environment, is a big determiner of stress,” said Dr. Lindsay Sears, a principal investigator at the Center for Health Research and Outcomes for Healthways Inc.

The Tennessee-based research firm recently partnered with Wellmark Blue Cross and Blue Shield to provide its Gallup-Healthways Well-Being Index as a tool to help the state improve residents’ overall health. During the next five years, 10 Iowa communities will participate in a pilot “Blue Zones” program to demonstrate methods for improving residents’ overall well-being. Healthways also has a corporate version of the program that it markets to businesses nationwide for employers to customize to their workplaces.

The Blue Zones demonstration project is part of the Healthiest State Initiative, a statewide initiative announced by Gov. Terry Branstad in August to make Iowa the healthiest state in the nation. Wellmark has pledged to provide up to $25 million to fund an information campaign for the initiative, which has the goal of moving the state’s cumulative Well-Being Index, currently at 19th among the 50 states, to No. 1. Wellmark estimates that reaching that goal could save the state as much as $16 billion in the next five years by reducing health-care costs and increasing productivity.

Though some Southern California cities have used the index in community-wide programs, Iowa is the first state to use the index as part of a statewide initiative, which is “quite possibly the first initiative of its kind, period,” said Bruce Middlebrooks, Healthways’ communications director.

The Gallup-Healthways index is based on 42 scientifically developed questions within six sub-indexes, which in addition to healthy behavior and work environment include emotional health, physical health, access to basic services and life evaluation, which Healthways defines as a measure of a person’s overall outlook on life. An index reading of 100 represents ideal well-being.

When the index is applied to metropolitan areas, Greater Des Moines ranked 78th out of 188 metro areas in overall well-being, with an index reading of 66.9 in 2010, a decrease of one point from 67.9 the previous year.

By comparison, the latest monthly results from the October 2011 survey showed a national well-being index of 65.6, down 0.9 point from a 66.5 index in October 2010. Two of the components of that score, the emotional health index and the healthy behavior index, reached their lowest October scores in four years, at 78.6 and 63, respectively.

Within our control

Iowa’s overall health status is “actually a little bit better than the national average,” said Dr. Michael Kitchell, an Ames physician and past president of the Iowa Medical Society. “In terms of obesity, we’re about midway in the pack. We are by no means the most obese.”

Iowa currently ranks as the 22nd most-obese state in the country, according to the U.S. Centers for Disease Control and Prevention (CDC); 39 percent of Iowans are overweight and 29 percent are obese. If the current trend continues, more than one in three Iowans will tip the scales in the obese column within the next few years.

The good news – and a key message of the Healthiest State Initiative – is that we can control 70 percent of the factors influencing our health. According to research by the Urban Institute and the CDC, health behavior and environment account for 50 and 20 percent of our health, respectively; 20 percent of health is affected by our genetic makeup and 10 percent by access to care.

Kitchell, who was among an estimated 290,000 Iowans who participated in a statewide 1-kilometer walk on Oct. 7 to kick off the Healthiest State Initiative, said he believes community-based efforts can make a difference by engaging people to become more healthy. He said he’s also supporting Ames’ effort to become one of the 10 pilot Blue Zones cities.

“I think we could do a little bit better job as physicians to get with it, because it’s really a community effort,” he said. “It’s a beginning of a journey, as far as I’m concerned. I want to live in a healthy community. I want to stay as healthy as I can, and I want my children to be healthy.”

To compile the Well-Being Index, Healthways surveys 1,000 U.S. adults daily by telephone, 350 days a year. The questions range from how many times a person ate a serving of fruit or vegetables in the past week to how happy they felt yesterday.

“It’s really all subjective,” Sears said. “It’s really trying to capture people’s daily experiences and how they affect their well-being. We ask people to report their own behaviors, thoughts, feelings and experiences in their day-to-day life.”

October’s healthy behavior index dropped because fewer Americans reported they were eating healthful foods and exercising: just 55.2 percent reported eating at least five servings of fruits and vegetables per day for at least four days in the previous week. The percentage who said they exercised 30 minutes or more at least three days in the previous week was 52.2 percent.

Fight or flight

The percentage of Americans who said they weren’t under a lot of stress has been declining. Among U.S. residents who were surveyed in October, 57.9 percent reported they were without stress “a lot of the day yesterday,” which was the second-lowest percentage in four years.

The pervasiveness of stress is evident from the way the word itself has crept into our everyday language, said Dr. Bill Jagiello, associate medical director for Wellmark.

“Not all stress is necessarily bad,” said Jagiello, who has practiced as a family physician for the past 30 years. “It can bring out the best in us and help us work better; a little bit of stress can actually be a good thing. The danger is when the amount of stress exceeds the ability to adjust. It leads to exhaustion and health consequences.”

The same physiological “fight or flight” response that helped our ancestors survive can lead to headaches, insomnia, high blood pressure or other health conditions if workplace stress isn’t managed correctly, he said. Additionally, “it’s not like a switch goes off when you walk out of the office,” he said. On top of the workday stress that people bring home, they may often face additional pressures from family finances or marital problems.

Poor health choices and stress often go hand in hand, as busier schedules lead to more time sitting at a desk, less exercise, more stops for high-calorie fast food and less personal interaction.

“More stress leads to poor choices, which leads to health consequences, whereas engaging in healthy behaviors leads to less stress,” Jagiello said.

However, there’s no single test to measure an individual’s stress level, he noted. “That’s where the Well-Being Index has value,” he said. “We can measure it as a community and track the change over time and ask, ‘Is our community getting better or worse?’”

Many lifestyle strategies can be gleaned from the habits of people in the world’s “Blue Zones,” those regions identified by researcher Dan Buettner as having the greatest pecentage of centenarians in the world. Those “Power Nine” are summarized on page 11.

“The beauty of Dan Buettner’s research is that it’s evidence-based,” Jagiello said. “He’s done the research and there is science behind what he’s done. The Blue Zones and the Power Nine will be a driver for the program in the state.”