Whole person health across sociodemographic groups of adults in the United States
Gaston, S. A.; Payne, C.; Jackson, C. L.
Show abstract
Chronic disease accounts for most health care expenditures in the United States (US), highlighting the need for approaches that address health across interconnected spiritual, mental/emotional, behavioral, physical (including environmental), and social domains. Whole person health (WPH) is increasingly recognized as important for alleviating chronic disease burdens but has not been well-described across various sociodemographic groups of US adults. Using cross-sectional data from the 2025 National Health Interview Survey, we sought to describe the prevalence of WPH and its components among US adults overall and by age, sex, and race along with ethnicity. Participants responded to the nine-item Whole Person Health Index (WPHI), which we used to assess continuous scores (range: 9-45, where higher scores indicated improved health) and ''optimal'' (excellent/very good vs. good/fair/poor) overall and domain-specific WPH. Using survey procedures, we estimated medians (IQR) and prevalence (95% CI) and compared subgroups using multiple comparison correction. Among 23,884 NHIS participants aged 18 years and older (mean age (SE)=48 (0.2) years), representing approximately 261,620,640 US adults, the median WPHI score was 33 (28-37) and slightly over half (57% [56%-58%]) of adults were classified as having ''optimal'' overall WPH. Optimal social/family connections (72% [72%-73%]) were frequently reported; ''optimal'' sleep was infrequently reported (36% [35%-37%]). WPH and its components were generally highest among younger adults. Men and women differed in WPH domains but not in overall WPH. Non-Hispanic (NH) American Indian/Native Alaskan and NH-Black adults generally had lowest prevalence of optimal WPH and its components, which was often higher among Hispanic/Latino adults and highest among NH-Asian and White adults. These results showing variation in WPH in the US may inform future investigations of WPH, related predictors and health outcomes, and health disparities.
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