Numerous definitions and survey measures of well-being and flourishing have been proposed (Hone et al., 2014; Su et al., 2014). Their core foundation is happiness, life satisfaction, and positive affect. A sense of meaning and/or purpose and other aspects of eudaimonic well-being [i.e., fulfillment of human potential and a meaningful life resulting from self-truth and self-responsibility (Norton, 1976; Ryan and Deci, 2001)] are also frequently included in composite well-being (flourishing) measures (Ryff and Keyes, 1995; Ryff and Singer, 2008). A comparison of four prominent measures of “flourishing” conducted by Hone et al. (2014); for a review of measures of “psychological well-being” and “thriving,” see Su et al. (2014), involving the conceptualizations and operationalizations of Keyes (2002, 2007), Diener et al. (2010), Huppert and So (2013), and Seligman (2011), revealed that all approaches included items referring to positive relationships, positive affect or engagement, and purpose or meaning (two instruments included both). Three out of four included self-acceptance and/or self-esteem, as well as competence or accomplishment. Two covered optimism and social contribution. Only one of the four measures included social integration, social growth, social acceptance, social coherence, environmental mastery, personal growth, autonomy, emotional stability, vitality, and resilience. Despite their important role for complete well-being, measures of well-being/flourishing usually neglect financial issues (Bialowolski et al., 2021). They also rarely focus on physical health. Character strengths are marginally present only in Seligman's (2011) accomplishment domain of the PERMA model of flourishing (P stands for positive emotion; E for engagement; R for relationships; M for meaning; and A for accomplishments). Even the 58-item, 18-domain “Comprehensive Inventory of Thriving” (Su et al., 2014) omits physical health and finances and only indirectly assesses character. With such a diversity, it is no wonder that findings generated by aggregated scales are inconsistent and difficult to reconcile, and a consensus in the field is needed (Hone et al., 2014).

Consequently, there seems to be a space for expanding the scope of well-being measurement. In particular, as argued by VanderWeele (2017), if the intention is to assess complete human well-being or human flourishing with a composite measure, features beyond psychological well-being should be considered. In this vein, a concept of complete well-being, which originates from the theoretical model of human flourishing understood as a state in which all aspects of a human life are good, has been proposed (VanderWeele, 2017; VanderWeele et al., 2019). This conceptual framework includes not only commonly agreed domains of flourishing (e.g., happiness, life satisfaction, affect, meaning and purpose, and social relationships) but also those that are often neglected in other measures. Regarding the latter, first, the framework assumes that domains such as physical health as well as character and virtue should become an inherent part of the composite measure. These domains, despite being analyzed as outcomes (e.g., physical health) or contributors (e.g., character strengths) to well-being, are seldom included as components of well-being measures. Second, it is also recognized that financial and material resources are necessary in order to achieve or sustain complete well-being over time, and thus an inclusion of a financial security domain in the assessment is proposed.

In order to overcome the current issues in measurement of well-being (Diener and Seligman, 2004; Lee et al., 2021b), the Well-Being Assessment (WBA) was proposed by the Human Flourishing Program and the Sustainability and Health Initiative for NetPositive Enterprise (SHINE) at Harvard University. The aim was to develop a measure of complete well-being that produces reliable and valid scores on each of its domains. The measure comprises six theoretically coherent and interrelated, yet distinct, domains of well-being: emotional health, physical health, social connectedness, meaning and purpose, character strengths, and financial security (see VanderWeele, 2017 for the rationale for these domains). Consequently, the concept of complete well-being, or human flourishing applied in this study, is in line with the World Health Organization definition of health¹ that not only considers the health of body and mind but also embraces the wholeness of the person.

The WBA's logic follows the top-down (dispositional) hypotheses of well-being (Diener, 1984; Diener et al., 1999) that assume that because each person tends to evaluate her or his experiences in a positively or negatively oriented way (Judge and Hulin, 1993), well-being is reflected in its domains. Therefore, the WBA was conceptualized according to the logic of reflective measurement (Bagozzi, 2007; Howell et al., 2007) and developed focusing simultaneously on ensuring satisfactory psychometric properties of each of the WBA domains (as they may perhaps be used as independent measures in future research) as well as of the WBA itself (Furr, 2011).

The conceptualization of WBA in the present study originates from VanderWeele's (2017) definition of human flourishing and his Secure Flourishing Index (SFI). He defines flourishing in terms of complete human well-being and distinguishes its six domains: (1) life satisfaction and happiness, (2) meaning and purpose in life, (3) mental and physical health, (4) satisfactory relationships, (5) character and virtue, and (6) financial and material stability. By offering an expanded list of items covering in greater detail on the six domains of the SFI, the WBA provides more depth and nuance about crucial aspects of flourishing that are “ends” in themselves and that represent a nearly universal consensus of the meaning of complete well-being (Lee et al., 2021a). However, in this study, the composition of SFI was refined and the labeling of well-being domains was reworded as suggested by a group of well-being experts involved in this study. Thus, the instrument appeared to be of greater practical utility in a workplace setting focused on the well-being of employees. First, the number of items was expanded from 12 to 45 (initially; in the following steps, this number was reduced to 40) to gain an understanding of a broader range of aspects present in each of the domains of the SFI. Second, although the SFI combines mental and physical health in a single domain, recent empirical research suggested separating mental and physical health domains, whereas mental health and happiness/life satisfaction domains could be combined (Lee et al., 2021a). Consequently, the WBA was developed to comprise the following six domains.

We aimed to develop a robust multidimensional measure of complete well-being based on the conceptual model of human flourishing developed by VanderWeele (2017) and VanderWeele et al. (2019), the WHO definition of health, and a broader review of the well-being and health literature. By defining well-being within the framework of complete well-being, or human flourishing, understood as “a state in which all aspects of a person's life are good” (VanderWeele, 2017, p. 8149), our approach extends the well-being measurement literature by including domains beyond psychological well-being.

Findings of the current study indicated that the six-factor model underlying the WBA is broadly supported by the CFA and ESEM. Consequently, the WBA six-domain comprehensive instrument that we proposed can be used to assess holistic well-being in terms of its six domains: emotional health, physical health, meaning and purpose, character strengths, social connectedness, and financial security. Although each of these domains is distinct, all of them are nearly universally desired, and all but financial security constitute ends in themselves (VanderWeele, 2017; Weziak-Bialowolska et al., 2019). The six WBA domains showed good reliability, test–retest correlation, convergent/discriminant validity in relation to stability over time and relevant health measures, and a good fit to the data that was invariant over time, and across gender, age, education, and marital status.

The results of the current study support the conclusions of Hone et al. (2014) that flourishing measures are built on a foundation of positive social relationships, positive affect, and purpose or meaning in life. Our results add to the literature by providing evidence that the character domain can be incorporated in the well-being measurement. So far, this domain was either included indirectly in flourishing instruments (see for example Su et al., 2014) or measured as an unrelated phenomenon (see for example McGrath, 2015; Blanchard et al., 2019). However, the importance of character strengths and virtues for human flourishing has been long argued by philosophers (Pieper, 1966; Aristotle and Brown, 2009; Baril, 2016) and, more recently, also by psychologists (Graziosi et al., 2020; Niemiec, 2020; Weziak-Bialowolska et al., 2021). Additionally, this study corroborates that, although measures of mental state are covered by instruments of psychological well-being (Ryff and Keyes, 1995) and measures of flourishing are covered by instruments of psychological and social well-being (Diener et al., 2010), a more holistic conceptualization of flourishing goes beyond these areas of human functioning. In particular, this study provides evidence that physical health is just as essential quality for personal well-being as is emotional well-being, confirming theoretical arguments of VanderWeele et al. (2019) and prior findings of Weziak-Bialowolska et al. (2019). This is also reflected in research on the importance of the individual well-being domains, which found physical health to be the top-ranked domain (Lee et al., 2021a). Finally, the results of this study also indicate that, if the aim is to measure complete human well-being, qualities allowing for the persistence of well-being should be included in measurement. Theoretical arguments imply that financial conditions belong to such qualities (VanderWeele, 2017) and empirical evidence on the good fit of the six-factor model underlying the WBA with financial security domain included provides further confirmation.

Despite these positive findings, our study also has some limitations. We note, first, that although our approach to examine the factor structure of the WBA is in line with growing body of research on ESEM (Marsh et al., 2012, 2019, 2020; Tóth-Király et al., 2017), we also observed some reluctance with respect to this approach in the research community. Nonetheless, we followed the ESEM logic because it has been theoretically and empirically documented that it results in a more realistic representation of covariance structure than its traditional counterpart—CFA (Asparouhov and Muthén, 2009; Marsh et al., 2009).

Second, two non-zero cross-loadings were observed that could have challenged the theoretical model. Although the cross-loadings were present, they did not undermine the meaning of the WBA domains. However, two of them (referring to one item of the meaning and purpose domain: “Overall, to what extent do you feel the things you do in your life are worthwhile?” And one item of the social well-being domain: “How often do you feel lonely?”) had a substantial presence in the emotional health domain, which seemed plausible. The former item is a well-known indicator of eudaimonic psychological well-being (Ryff and Singer, 2008) that reflects the experience of existence and refers to overall relatedness and sense of one's experiences (King et al., 2006). Additionally, in prior factor analytical approaches, it has been already evidenced to be grouped together with other indicators of emotional well-being (Weziak-Bialowolska et al., 2019). The latter item, instead, can be understood as an indicator of not only social but also emotional isolation (Weiss, 1973; Perlman and Peplau, 1981; Beutel et al., 2017). Consequently, the overall pattern of loadings and cross-loadings reflected the theoretical structure that comprises the six distinct domains of the WBA.

Third, despite using the less restrictive framework of ESEM (compared with CFA), three pairs of correlated errors were included in the final measurement model. As suggested by the literature (Marsh et al., 2010b), this decision was made only after convincing arguments supporting a possible common cause for correlated error terms were identified. In the first two cases, they concerned pairs of negatively oriented items. It is worth noting that the 40-item WBA instrument includes only five negatively oriented items. Two of them are in the emotional health domain, two in the financial security domain, and one in the physical health domain. Those pairs in the emotional health and the financial security domains required correlated error terms, which might have been an artifact resulting from the method factor (Finkel, 1995; Marsh et al., 2013). In the remaining case, the correlated error term corresponded to the only two items in which a collective perspective was adopted (i.e., two items related to communal social well-being in the social connectedness domain) as opposed to the distinctly individual nature of the remaining 38 items. Although we believe that our explanations for the three correlated error terms are plausible and provide sufficient justification for the inclusion of these terms, we recognize that there might be some minor issues that might warrant a reexamination of these items. For instance, the reorientation of negatively oriented items through an adjustment of their wording (e.g., by using antonyms) may be considered. Finally, since the sample of U.S. working adults was used to establish psychometric properties of the WBA instrument, further research is needed to establish generalizability of the WBA instrument with a community sample and with other nationalities, especially from non-Western, culturally different populations.

With psychometric properties well-established, this new measure of well-being may be used more broadly. For example, the WBA can advance research and policies related to health and well-being. The instrument may be considered for use by scientists and practitioners in psychology and related social sciences, as well as clinicians, public health officials, and patients. These three latter groups often equate the absence of a disease with health, applying a deficit-reduction framework to health (VanderWeele et al., 2019) and disregarding other outcomes perceived by people as central for well-being (e.g., happiness and social connections). Adoption of more holistic measures of well-being that go beyond psychological well-being and consider a positive health approach may help to shift the focus of clinicians and public health officials from only the alleviation of health deficiencies toward health and well-being promotion. For patients facing serious treatment decisions (e.g., men wrestling with treatment decisions over relatively advanced stage bladder cancer, knowing that a cystectomy will maximize life expectancy but severely hamper quality of life and happiness), asking questions related to distinct domains of complete well-being can inform complex trade-offs (VanderWeele et al., 2019). Future research in groups of patients with specific diseases will strengthen the applicability of the WBA.

This 40-item instrument can be used to assess well-being in six domains: (1) emotional health (e.g., “How satisfied are you with life as a whole these days?”); (2) physical health (e.g., “How would you rate your physical health?”); (3) meaning and purpose (e.g., “I have values and beliefs that help me understand who I am.”); (4) character strengths (e.g., “I always act to promote good in all circumstances, even in difficult and challenging situations.”); (5) social connectedness (e.g., “My relationships are as satisfying as I would want them to be.”); and (6) financial security (e.g., “I am able to meet my normal monthly living expenses without any difficulty.”). The responses to each of the 40 items are measured on an 11-point Likert scale ranging from 0 to 10 (details in Table 1). A domain-specific score can be calculated for each domain by averaging the responses across all items included in the domain. Since some items are negatively oriented (denoted with r in Table 1), reverse coding is necessary to ensure that a higher score indicates greater well-being.

The overall WBA score can be calculated by simply averaging the composite scores across all six domains. Lack of weights in the WBA computation formula implies equal importance of all domains. This approach is supported by the empirical evidence on the comparable importance of each of the domains (Lee et al., 2021a).

Because it includes neglected domains of physical health, character, and virtue and the enabling domain of financial security, the WBA offers benefits for researchers interested in the assessment of complete well-being beyond measures that focus on emotional well-being only. We recommend using the full WBA instrument for an overall assessment of complete well-being for virtually all people because the domains are nearly universally valued (VanderWeele, 2017; Lee et al., 2021a). The WBA is also useful for identifying specific of domains of excellence for individuals and groups. However, if researchers are interested in particular domains of the WBA (e.g., character strengths) or are unable to include the entire 40-item WBA, we recommend using a subset of items corresponding to the domain of interest. Since our analyses provided support for satisfactory psychometric properties and robustness of not only the WBA instrument but also each of its domains, measures of single well-being domains can be represented as a single total score.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The studies involving human participants were reviewed and approved by Harvard T.H. Chan School of Public Health Institutional Review Board. The patients/participants provided their written informed consent to participate in this study.

DW-B contributed to the study concept, data analysis, and interpretation of the result, she also drafted and revised the manuscript. PB contributed to data analysis and interpretation of the result, he also revised the manuscript. ML and YC contributed to interpretation of the results and revised the manuscript. TV developed the study design and the study concept, contributed to interpretation of the results, revised the manuscript, and provided funding for the study. EM developed the study design and provided funding for the study. All authors approved the final version of the manuscript.

EM and TV report receiving grants and personal fees from Aetna Inc. EM reports receiving grants from the Levi Strauss Foundation; she also reports serving as director of SHINE at Harvard (Sustainability and Health Initiative for NetPositive Enterprise); support is made possible through SHINE from multiple companies. TV reports receiving grants from the John Templeton and personal fees from Flerish Inc. and Flourishing Metrics. The research findings represent the perspective of the authors and do not reflect the opinions or endorsement of any organization.