The term quality of life is used to evaluate the general well-being of individuals and societies. The term is used in a wide range of contexts, including the fields of international development, healthcare, and political science. Quality of life should not be confused with the concept of standard of living, which is based primarily on income. Instead, standard indicators of the quality of life include not only wealth and employment, but also the built environment, physical and mental health, education, recreation and leisure time, and social belonging.[1]
According to ecological economist Robert Costanza:
While Quality of Life (QOL) has long been an explicit or implicit policy goal, adequate definition and measurement have been elusive. Diverse "objective" and "subjective" indicators across a range of disciplines and scales, and recent work on subjective well-being (SWB) surveys and the psychology of happiness have spurred renewed interest.[2]
Also frequently related are concepts such as freedom, human rights, and happiness. However, since happiness is subjective and hard to measure, other measures are generally given priority. It has also been shown that happiness, as much as it can be measured, does not necessarily increase correspondingly with the comfort that results from increasing income. As a result, standard of living should not be taken to be a measure of happiness.[1][3]
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Quality of life is an important concept in the field of international development, since it allows development to be analyzed on a measure broader than standard of living. Within development theory, however, there are varying ideas concerning what constitutes desirable change for a particular society, and the different ways that quality of life is defined by institutions therefore shapes how these organizations work for its improvement.
Organizations such as the World Bank, for example, declare a goal of "working for a world free of poverty",[4] with poverty defined as a lack of basic human needs, such as food, water, shelter, freedom, access to education, healthcare, or employment.[5] In other words, poverty is defined as a low quality of life. Using this definition, the World Bank works towards improving quality of life through neoliberal means, with the stated goal of lowering poverty and helping people afford a better quality of life.
Other organizations, however, may also work towards improved global quality of life using a slightly different definition and substantially different methods. Many NGOs do not focus at all on reducing poverty on a national or international scale, but rather attempt to improve quality of life for individuals or communities. One example would be sponsorship programs that provide material aid for specific individuals. Although many organizations of this type may still talk about fighting poverty, the methods are obviously significantly different.
Because of these differences in the theory and practice of development, there are also a wide range of quantitative measures that are used to describe quality of life.
Perhaps the most commonly used international measure of development is the Human Development Index (HDI), which combines measures of life expectancy, education, and standard of living, in an attempt to quantify the options available to individuals within a given society. The HDI is used by the United Nations Development Programme in their Human Development Report.
The Physical Quality of Life Index (PQLI) is a measure developed by sociologist Morris David Morris in the 1970s, based on basic literacy, infant mortality, and life expectancy. Although not as complex as other measures, and now essentially replaced by the Human Development Index, the PQLI is notable for Morris's attempt to show a "less fatalistic pessimistic picture" by focussing on three areas where global quality of life was generally improving at the time, and ignoring Gross National Product and other possible indicators that were not improving.[6]
The Happy Planet Index, introduced in 2006, is unique among quality of life measures in that, in addition to standard determinants of well-being, it uses each country's ecological footprint as an indicator. As a result, European and North American nations do not dominate this measure. The 2009 list is instead topped by Costa Rica, the Dominican Republic, and Jamaica.[7]
Gallup researchers trying to find the world's happiest countries found Denmark to be top of the list.[1]
The term quality of life is also used by politicians and economists to measure the liveability of a given city or nation. Two widely known measures of liveability are the Economist Intelligence Unit's quality-of-life index and Mercer's Quality of Living Reports. These two measures calculate the liveability of countries and cities around the world, respectively, through a combination of subjective life-satisfaction surveys and objective determinants of quality of life such as divorce rates, safety, and infrastructure. Such measures relate more broadly to the population of a city, state, or country, not to the individual level.
Some crimes against property (e.g., graffiti and vandalism) and some "victimless crimes" have been referred to as "quality-of-life crimes." American sociologist James Q. Wilson encapsulated this argument as the Broken Window Theory, which asserts that relatively minor problems left unattended (such as public urination by homeless individuals, open alcohol containers and public alcohol consumption) send a subliminal message that disorder in general is being tolerated, and as a result, more serious crimes will end up being committed (the analogy being that a broken window left unrepaired shows an image of general dilapidation). Wilson's theories have been used to justify the implementation of zero tolerance policies by many prominent American mayors, most notably Oscar Goodman in Las Vegas, Richard Riordan in Los Angeles, Rudolph Giuliani in New York City and Gavin Newsom in San Francisco. Such policies do not tolerate even minor crimes, it is argued, in order to improve the quality of life of local residents. However, critics of zero tolerance policies believe that such policies neglect investigation on a case-by-case basis and may lead to unreasonably harsh penalties for crimes.
The Popsicle Index is a quality of life measurement coined by Catherine Austin Fitts as the percentage of people in a community who believe that a child in their community can safely leave their home, walk to the nearest possible location to buy a popsicle, and walk back to their homes.[8][9][10]
Within the field of healthcare, quality of life is often regarded in terms of how it is negatively affected, on an individual level, a debilitating illness that is not life-threatening, life-threatening illness that is not terminal, terminal illness, the predictable, natural decline in the health of an elder, an unforeseen mental/physical decline of a loved one, chronic, end-stage disease processes. Researchers at the University of Toronto's Quality of Life Research Unit define quality of life as “The degree to which a person enjoys the important possibilities of his or her life” (UofT). Their Quality of Life Model is based on the categories “being”, “belonging”, and “becoming”, respectively who one is, how one is connected to one's environment, and whether one achieves one's personal goals, hopes, and aspirations.[11][12]