A Deeper Look at the Evernorth Vitality Index: A Next Generation Measure of Whole Person Health


Over the last few years, the impact of diminished health on personal, professional, and social lives crystalized the need for a more substantive approach to health – one that values, promotes, and prioritizes good health while also treating sickness and disease. Evernorth’s relentless focus on improving health care led us to the world’s leading expert on the science of vitality, psychologist Dr. Richard Ryan.

Dr. Ryan pioneered the measurement of vitality in 1997 with the Subjective Vitality Scales (SVS), a six-item survey tool used to gauge vitality levels across populations. His research, and the work of others, links subjective vitality levels to positive mental and physical health outcomes, better work outcomes, a positive disposition, and a stronger sense of self-worth and purpose. Subjective vitality stands out as a measure of health because it is an inner resource readily available to everyone, and it is supported by more than 25 years of academic research.

Vitality is not a fixed state of being; rather, it conveys an active approach to living that can be improved or depleted. Individuals, employers, and health care providers have the power to influence vitality and make a direct impact on health and productivity. Until now, however, payers, providers, and plan sponsors have done little to help people understand how to access and improve this critical resource within themselves. Increasing the understanding of vitality through the expansive lens of whole person health will open doors to small and large improvements to well-being at individual and population levels.

To fill this critical gap, we partnered with Dr. Ryan to develop the Evernorth Vitality Index (EVI), a first-of-its-kind measure that builds upon decades of academic theory and other data, and commissioned a study by Morning Consult to better understand the levels of vitality in the United States.

What Makes the Evernorth Vitality Index Valuable?

Our approach to vitality extends beyond individual energy and represents a comprehensive view of one’s capacity to live with health, strength, and energy. To demonstrate and measure the impact of vitality, we developed a differentiated tool that quantifies the multiple, interrelated dimensions of health as well as an individual’s ability to manage those dimensions. This tool combines the leading academic scale, the SVS, with newly developed subscales, and is anchored in Self-Determination Theory (SDT). The SDT presents three basic human needs that, when fulfilled, motivate, engage, and drive optimal wellness: autonomy, competence, and relatedness.

The EVI does more than measure current health and behaviors. It delves deeper to look at individuals’ impressions of their own agency across the dimensions of health. This means that even individuals experiencing chronic health conditions or financial hardship can experience vitality, and improving their vitality would likely help manage those situations. It also means that physically healthier individuals or those with strong social connectivity can experience lower vitality. They too can benefit from actions designed to increase their vitality. The EVI also allows for the identification of opportunities across the dimensions of health for enhancing vitality and enables better understanding of how individuals living with disease or suboptimal personal, financial, or environmental conditions can live a happy and healthy life.

How We Plan To Use the Evernorth Vitality Index

Just as unequal challenges and circumstances result in well-documented disparities in physical health, there are notable disparities in EVI levels. We acknowledge the disparities that exist today, and seeing them reflected in the EVI data is confirmation of the efficacy of this measure across demographics and other social determinants of health.

As a next-generation measure of whole person health, the EVI’s applications are profound and far-reaching. It can be utilized to track vitality levels over time and to provide a path to understand and influence what enhances vitality for an individual or a population.

Current research provides a wealth of evidence that the EVI can serve as an effective measure for workforce health. In the future, applying the EVI in an employer population will complement and enhance other performance metrics while informing workplace strategies, from education and resources to employee engagement to health and well-being programs and benefits. Our organization will continue to deploy the EVI to better understand changes in vitality over time.

EVI Output and Reporting

Cigna Corp. commissioned Morning Consult to survey more than 10,000 U.S. adults using the 10-item Evernorth Vitality Index. We benchmarked the data across key demographics, health status, residential and work environments, and more.

The EVI produces a score on a scale from 0 to 100, which should be viewed as an indicator of well-being that can fluctuate along with an individual’s satisfaction with how their basic needs are met. The values fall into three categories, low, medium and high: Low vitality refers to individual scores from 0 to 49, medium vitality is 50-85, and high vitality is 86-100.