During the darkest, dreariest days of the COVID-19 pandemic, humans worldwide became more aware of and interested in their personal well-being. Since 2020, the wellness market has grown twice as quickly as the international economy, with global spending having now reached $4.5 trillion.

In 2015, faculty in the Stanford Prevention Research Center (SPRC), already deeply interested in well-being, launched a longitudinal, five-country Stanford WELL for Life study, now commonly known as “WELL.” The study, now on the brink of publishing breakthrough research findings, uses novel methods to measure and understand multiple dimensions of well-being across cultures. Since its inception, WELL’s multidisciplinary team of experts has been building the science by studying over 31,000 participants from the U.S., China, Taiwan, Singapore, and Thailand.

“WELL’s unique value is its quest for science-driven answers about well-being in diverse populations and its commitment to engaging and improving well-being in communities through science-based intervention and implementation,” says Ann Hsing, PhD, professor of medicine and principal investigator of WELL. She notes that SPRC defines it as “a holistic synthesis of a person’s biological, psychological, and spiritual experiences, resulting from interplay between individuals and their social, economic, and physical environments, that promote living a fulfilling life.”

“This extends beyond physical health and the absence of disease,” Hsing says. “Everyone wants to live a fulfilling life. With scientifically valid information and practical tips, we believe that it is possible to empower individuals to improve their own well-being and that of their communities. With the help of our international team, Stanford WELL for Life is building the science and learning how to improve well-being in people around the world.”

with translation of science and implementation of interventions that may help lower the cancer burden in individuals and their communities,” she says.

After coming to Stanford, Hsing took on community engagement and leveraged opportunities to educate the public about cancer prevention through presentations at local churches and community centers about cancer epidemiology, risk factors, and early detection of cancer.

Through those engagements, Hsing realized that even great scientific discoveries will have little or no impact if the public does not understand what they mean.

“I learned how important it is for us scientists to share our knowledge with the community in a way that resonates with them. WELL is a perfect example of why implementation and meaningful engagement matter. Our goal is not only to conduct research, but also to ensure that knowledge generated by WELL benefits everyone worldwide. Well-being is multidimensional, encompassing physical, mental, and spiritual health — body, mind, and soul,” Hsing says.

“I realized that the concept and practice needed to be communicated in a simple and effective way to the general public to empower them and to make everyone a little bit better, thereby making our world a bit better. All of us want to live a satisfying life, so the potential impact of our research is enormous. This is why I took on the challenge of serving as WELL’s principal investigator,” she adds.

The Future

Where is WELL headed?

“WELL focused on psychology initially, as well-being is a subjective perception. As a molecular epidemiologist, my goal is to infuse molecular biology, environmental data, technology, and other biological disciplines into WELL to enhance its breadth and depth,” Hsing says.

“For example, we used a multidisciplinary approach and recently added biosensing digital technology and used heart rate variability to measure stress and sleep fragments. We have proposed a functional MRI pilot study to assess brain function and structure among people in our study who chronically and persistently have very low well-being.”

Since 2015, WELL has established a biobank of more than 300,000 specimens, including hair, nail, blood, urine, and stool samples. To build on 

this rich resource, WELL is funded to measure gut microbiome and metabolomics on over 2,000 individuals in China and to determine if these omics profiles correlate with well-being. Using a holistic approach, WELL will integrate self-reported data with objectively measured omic, biosensing, and imaging data to understand the biological basis of well-being. This will provide evidence-based data to guide the development of future intervention studies designed to promote well-being in individuals and communities.

WELL’s investigators collaborate widely with many faculty from the SPRC as well as from various departments and schools within and outside of Stanford. However, Hsing works most closely with two colleagues: Catherine Heaney, PhD, associate professor of psychology and of medicine, who conducts qualitative studies in various countries to develop WELL’s scale for well-being assessment and leads WELL Thailand; and Ying Lu, PhD, professor of biomedical data science, who serves as the principal biostatistician for WELL. Together, the trio developed the methodology and analyses of the study.

“WELL welcomes collaboration. I believe our rich data and resources provide a unique opportunity for partnerships to advance the science of well-being and healthy aging. I invite faculty, postdocs, and graduate students to reach out for potential collaboration at annhsing@stanford.edu. The Stanford WELL for Life study is an excellent example of achieving humanity through science. I feel extremely lucky and honored to lead such an important and exciting study,” Hsing concludes.