1. Lincoln, Neb.
2. Boulder, Colo.
3. Provo-Orem, Utah
4. Fort Collins-Loveland, Colo.
A national, yearlong survey that ranks states based on residents' well-being puts Tennessee near the bottom of the list, which is viewed as bad news for business owners.
In addition to Tennessee's low rank, the Chattanoga region scored poorly in the survey, earning the 178th spot of 189 cities polled.
Sliding into the 47th spot, Tennessee beats only Mississippi, Kentucky and West Virginia - which means Tennesseans tend to fare worse than the majority of the country when it comes to physical health, work environment, emotional health and healthy behaviors, the Gallup and Healthways 2012 Well-Being Index shows.
And unhappy or unhealthy people make poor employees. A growing number of Tennessee companies are looking for ways to improve employee health -- aiming to decrease health insurance costs, improve productivity and boost the bottom line.
Poor productivity associated with poor health sets the U.S. economy back by about $227 billion every year, according to the Integrated Benefits Institute, a nonprofit that specializes in health and productivity research.
That estimate includes the cost of employee absence because of illness as well as "presenteeism." That's when an employee comes to work sick or tired and doesn't perform well.
"They've shown up, but they're not engaged or at the top of their game where you need them to be," said Mary Danielson, a BlueCross BlueShield of Tennessee spokeswoman. "When you feel better physically, you'll put out a better work output."
BlueCross BlueShield offers a wellness program to all fully-insured groups, and the number of employers who implement work-based wellness plans has increased over the last decade, she said.
At Southern Champion Tray, management is in the middle of a year-long push to equip their 500 employees to be healthier: they're doubling the size of the business' on-site wellness center, offering on-site WeightWatchers classes and planning to hire a trainer or nutritionist.
"We're trying to provide the tools for people to get healthy for themselves and their families," said T.W. Francescon Jr., human resources director. "We feel like it's the right thing to do. We've had a wellness center for 30 years, before wellness was really trendy."
Starting this December, employees who are tobacco-free and meet the target levels for Body Mass Index, cholesterol, blood pressure can claim a new discount on their health insurance. Healthy employees will have the chance to save between 15 and 40 percent of their monthly premium.
"That's going to help the company too, because the company pays a part of the insurance premiums. But it should be a win-win-win," Francescon said. "Us and our families are healthier, hopefully we're paying less on our premiums and health care, and hopefully the bottom line is impacted, which helps us all because we're all in this together as a company."
Britt Watson, wellness director at the downtown Chattanooga YMCA, said he's not surprised by the city's poor rank.
"One of the trends I've seen in the last few years is that the girth of people is expanding," he said. "And we're seeing it in the children more, too."
But Watson added, he thinks Chattanooga's growing focus on outdoor activities is a good sign.
"I do see Chattanooga heading in the right direction," he said. "I could see that trend reversing itself."
Mayor-elect Andy Berke said Chattanooga's low scores are consistent with regional rankings.
"I've been a state legislator for several years and worked on these health issues," he said. "Our city numbers fit in with where we are as a state, and also generally, the South as a region."
He added that it's important to encourage area residents to improve their healthiness. The city voted to invest $4.1 million in a new wellness center for city employees in January 2012, which will include a pharmacy, fitness center and doctors' offices.
"The city wants its workers to be healthy and productive," Berke said. "We also know that minimizing our costs requires a healthy workforce. Every employer wants to reduce lost work time, health insurance and benefits costs, and in addition it's the right thing to do to help people have a healthy and active life."