Quality of life

Quality of life (QOL) is the general well-being of individuals and societies. QOL has a wide range of contexts, including the fields of international development, healthcare, politics and employment. It is important not to mix up the concept of QOL with a more recent growing area of health related QOL (HRQOL[1]). When we look at HRQOL we in effect look at QOL and its relationship with health.

Quality of life should not be confused with the concept of standard of living, which is based primarily on income.

Overview

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.[2][3]

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.[4]

One approach, called engaged theory, outlined in the journal of Applied Research in the Quality of Life, posits four domains in assessing quality of life: ecology, economics, politics and culture.[5] In the domain of culture, for example, it includes the following subdomains of quality of life:

Also frequently related are concepts such as freedom, human rights, and happiness. However, since happiness is subjective and difficult 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.[2][6] Also sometimes considered related is the concept of human security, though the latter may be considered at a more basic level and for all people.

Quantitative measurement

Unlike per capita GDP or standard of living, both of which can be measured in financial terms, it is harder to make objective or long-term measurements of the quality of life experienced by nations or other groups of people. Researchers have begun in recent times to distinguish two aspects of personal well-being: Emotional well-being, in which respondents are asked about the quality of their everyday emotional experiences—the frequency and intensity of their experiences of, for example, joy, stress, sadness, anger, and affection— and life evaluation, in which respondents are asked to think about their life in general and evaluate it against a scale.[7] Such and other systems and scales of measurement have been in use for some time. Research has attempted to examine the relationship between quality of life and productivity.[8]

Human Development Index

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.

World Happiness Report

Also developed by the United Nations and published recently along with the HDI, this report combines both objective and subjective measures to rank countries by happiness, which is deemed as the ultimate outcome of a high quality of life. It uses surveys from Gallup, real GDP per capita, healthy life expectancy, having someone to count on, perceived freedom to make life choices, freedom from corruption, and generosity to derive the final score.

Other measures

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 focusing 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.[9]

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 2012 list is instead topped by Costa Rica, Vietnam and Colombia.[10]

Gallup researchers trying to find the world's happiest countries found Denmark to be at the top of the list.[11] uSwitch publishes an annual quality of life index for European countries. France has topped the list for the last three years.[12]

A 2010 study by two Princeton University professors looked at 1,000 randomly selected U.S. residents over an extended period. It concludes that their life evaluations - that is, their considered evaluations of their life against a stated scale of one to ten - rise steadily with income. On the other hand, their reported quality of emotional daily experiences (their reported experiences of joy, affection, stress, sadness, or anger) levels off after a certain income level (approximately $75,000 per year); income above $75,000 does not lead to more experiences of happiness nor to further relief of unhappiness or stress. Below this income level, respondents reported decreasing happiness and increasing sadness and stress, implying the pain of life’s misfortunes, including disease, divorce, and being alone, is exacerbated by poverty.[13]

Gross national happiness and other subjective measures of happiness are being used by the governments of Bhutan[14] and the United Kingdom.[15] The World Happiness report, issued by Columbia University[16] is a meta-analysis of happiness globally and provides an overview of countries and grassroots activists using GNH. The OECD[17] issued a guide for the use of subjective well-being metrics in 2013.[18] In the U.S., cities and communities are using a GNH metric at a grassroots level.[19]

The Social Progress Index measures the extent to which countries provide for the social and environmental needs of their citizens. Fifty-two indicators in the areas of basic human needs, foundations of wellbeing, and opportunity show the relative performance of nations. The index uses outcome measures when there is sufficient data available or the closest possible proxies.

Livability

The term quality of life is also used by politicians and economists to measure the livability of a given city or nation. Two widely known measures of livability are the Economist Intelligence Unit's Where-to-be-born Index and Mercer's Quality of Living Reports. These two measures calculate the livability 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 individual quality of life. Livability has a long history and tradition in urban design, and neighborhoods design standards such as LEED-ND are often used in an attempt to influence livability.[20]

Crimes

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 litter, graffiti, or public urination by homeless individuals) 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 broken 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 refuse to tolerate even minor crimes; proponents argue that this will 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.

Popsicle index

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 home.[21][22][23]

In healthcare

Within the field of healthcare, quality of life is often regarded in terms of how a certain ailment affects a patient on an individual level. This may be a debilitating weakness 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; or 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 not connected to one's environment, and whether one achieves one's personal goals, hopes, and aspirations.[24][25]

Research shows that quality of life ratings are associated with clinical outcomes in nursing homes. Some, but not all dimensions of quality of life among nursing home residents were shown to be prospectively associated with clinical outcomes.[26] In another study, scholars showed that caretakers' proxy ratings were associated with residents' own ratings though not perfectly so[27]

In international development

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 as a whole.

Organisations such as the World Bank, for example, declare a goal of "working for a world free of poverty",[28] with poverty defined as a lack of basic human needs, such as food, water, shelter, freedom, access to education, healthcare, or employment.[29] 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 significantly different.

Improving quality of life involves action not only by NGOs, but also by governments. Global health has the potential to achieve greater political presence if governments were to incorporate aspects of human security into foreign policy. Stressing individuals’ basic rights to health, food, shelter, and freedom addresses prominent inter-sectoral problems negatively impacting today’s society and may lead to greater action and resources. Integration of global health concerns into foreign policy may be hampered by approaches that are shaped by the overarching roles of defense and diplomacy.[30]

See also

Indices

See also

Journals

References

  1. ↑ Bottomley, Andrew (04/01/2002). "The Cancer Patient and Quality of Life". The Oncologist 7 (2): 120–125. doi:10.1634/theoncologist.7-2-120. ISSN 1083-7159. PMID 11961195. Retrieved 2015-05-07. Check date values in: |date= (help)
  2. 1 2 Gregory, Derek; Johnston, Ron; Pratt, Geraldine; Watts, Michael; et al., eds. (June 2009). "Quality of Life". Dictionary of Human Geography (5th ed.). Oxford: Wiley-Blackwell. ISBN 978-1-4051-3287-9.
  3. ↑ Martha Nussbaum and Amartya Sen, ed. (1993). The Quality of Life, Oxford: Clarendon Press. Description and chapter-preview links.
  4. ↑ Costanza, R. et al. (2008) "An Integrative Approach to Quality of Life Measurement, Research, and Policy". S.A.P.I.EN.S. 1 (1)
  5. ↑ Magee, Liam; James, Paul; Scerri, Andy (2012). "Measuring Social Sustainability: A Community-Centred Approach". Applied Research in the Quality of Life 7 (3): 239–61.
  6. ↑ Layard, Richard (6 April 2006). Happiness: Lessons from a New Science. London: Penguin. ISBN 978-0-14-101690-0.
  7. ↑ Kahneman, D.; Deaton, A. (2010). "High income improves evaluation of life but not emotional well-being". Proceedings of the National Academy of Sciences 107 (38): 16489–16493. doi:10.1073/pnas.1011492107. PMC 2944762. PMID 20823223.
  8. ↑ Federal Reserve Bank of Kansas City, The Increasing Importance of Quality of Life, October 2008
  9. ↑ Morris, Morris David (January 1980). "The Physical Quality of Life Index (PQLI)". Development Digest 1: 95–109.
  10. ↑ "The Happy Planet Index 2.0". New Economics Foundation. 2012. Retrieved September 2, 2012.
  11. ↑ Levy, Francesca (July 14, 2010). "Table: The World's Happiest Countries". Forbes. Archived from the original on January 23, 2013.
  12. ↑ King, Mark (September 29, 2011). "Table: UK has 'worst quality of life in Europe'". The Guardian.
  13. ↑ "Higher income improves life rating but not emotional well-being". PhysOrg.com. 7 September 2010. Retrieved 20 September 2010.
  14. ↑ http://www.gnhc.gov.bt/
  15. ↑ http://www.ons.gov.uk/ons/interactive/well-being-wheel-of-measures/index.html
  16. ↑ http://www.earth.columbia.edu/sitefiles/file/Sachs%20Writing/2012/World%20Happiness%20Report.pdf
  17. ↑ http://www.oecd.org/
  18. ↑ http://www.oecd.org/statistics/Guidelines%20on%20Measuring%20Subjective%20Well-being.pdf
  19. ↑ http://www.happycounts.org/happiness-initiatives/
  20. ↑ Boeing; et al. (2014). "LEED-ND and Livability Revisited". Berkeley Planning Journal 27: 31–55. Retrieved 2015-03-04.
  21. ↑ Fitts, Catherine Austin. "Understanding the Popsicle Index". SolariF. Retrieved 2009-06-10.
  22. ↑ "To lick crime, pass the Popsicle test". The Virginian-Pilot. July 9, 2005. Retrieved 2009-06-10.
  23. ↑ Darling, John (January 2006). "Money in a Popsicle-Friendly World". Sentient Times. Retrieved 2009-06-10.
  24. ↑ "Quality of Life: How Good is Life for You?". University of Toronto Quality of Life Research Unit. Retrieved October 14, 2009.
  25. ↑ About QLC : Quality of Life Care
  26. ↑ Degenholtz, Howard B., Jules Rosen, Nicholas Castle, Vikas Mittal, & Darren Liu (2008) "The association between changes in health status and nursing home resident quality of life." The Gerontologist, 48(5), 584-592 (2008). Available at SSRN: http://ssrn.com/abstract=2340702
  27. ↑ Mittal, Vikas and Rosen, Jules and Govind, Rahul and Degenholtz, Howard B. and Shingala, Sunil and Hulland, Shelly and Rhee, Yong-Joo and Kastango, Kari B. and Mulsant, Benoit H. and Castle, Nicholas and Rubin, Fred H. and Nace, David, Perception Gap in Quality-of-Life Ratings: An Empirical Investigation of Nursing Home Residents and Caregivers (2007). The Gerontologist, April 2007; 47, 2; p. 159. Available at SSRN: http://ssrn.com/abstract=2342300
  28. ↑ "The World Bank" (PDF). The World Bank. 2009. Retrieved 2010-11-02.
  29. ↑ "Poverty - Overview". The World Bank. 2009. Retrieved October 20, 2009.
  30. ↑ Spiegel and Huish. Canadian Foreign Aid for Global Health: Human Security Opportunity Lost.

Further reading

External links

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