(Redirected from Measuring well-being)
The 'well-being' or 'quality of life' of a population is an important concern in
economics and
political science. It is measured by many social and economic factors. A large part is
standard of living, the amount of money and access to goods and services that a person has; these numbers are fairly easily measured. Others like
freedom,
happiness,
art,
environmental health, and
innovation are far harder to measure. This has created an inevitable imbalance as programs and policies are created to fit the easily available economic numbers while ignoring the other measures, that are very difficult to plan for or assess.
Debate on quality of life is millennia-old, with
Aristotle giving it much thought in his ''
Nicomachean Ethics'' and eventually settling on the notion of
eudaimonia, a
Greek term often
translated as
happiness, as central. The neologism 'liveability' (or 'livability'), from the adjective ''liv(e)able'', is an abstract noun now often applied to the built environment or a town or city, meaning its contribution to the quality of life of inhabitants.
Understanding quality of life is today particularly important in
health care, where monetary measures do not readily apply. Decisions on what research or treatments to invest the most in are closely related to their effect on a patient's quality of life.
Organisational wellbeing looks at related factors from a corporate perspective, although this agenda is also informed by the employers' duty-of-care and external drivers such as the UK Health and Safety Executive's Management Standards for Stress (http://www.hse.gov.uk/stress/index.htm). Organisational wellbeing looks at wellbeing issues that affect a company's staff and manages them to dirve change and improve performance.
Measuring health-related quality of life (HRQoL)
The measures often used in the study of health care are '
quality-adjusted life years' (QALYs) and the related '
disability-adjusted life years' (DALYs); both equal 1 for each year of full-health life, and less than 1 for various degrees of illness or disability. Thus the cost-effectiveness of a treatment can be assessed by the cost per QALY or DALY it produces; for example, a cancer treatment which costs $1 million and on average gives the patient 2 extra years of full health costs $500,000 per QALY. Assessing treatments in this way avoids the much greater problems associated with putting a monetary
value on life, as required in other areas of economics; saying that a treatment ''costs'' $5000 per QALY (i.e. per year of life) does not say or assume anything about the monetary ''value'' of a year of life or about the real quality of that life.
Another method of measuring quality of life is by subtracting the ''"standard of living"'', according to the technical definition of the term. For example, people in rural areas and small towns are generally reluctant to move to cities, even if it would mean a substantial increase in their standard of living. One can thus see that the quality of life of living in a rural area is of enough value to offset a higher standard of living. Similarly people must be paid more to accept jobs that will lower their quality of life, night jobs, ones with extensive travel all pay more and the difference in salaries can also give a measure of the value of quality of life.
There is a growing field of research concerned with developing, evaluating and applying quality of life measures within health related research (e.g. within randomised controlled trials), especially
Health Services Research. Many of these focus on the measurement of health related quality of life (HRQoL), rather than a more global conceptualisation of quality of life. They also focus on measuring HRQoL from the perspective of the patient and thus take the form of self completed questionnaires.
The International Society for Quality of Life was founded in response to this research and is a useful source of information on this topic.
A number of groups and agencies around the world have tried to develop ways of assessing quality of life:
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The Economist:
Quality-of-life index
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Mercer Human Resource Consulting:
Quality of Living Survey
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Vanderford-Riley well being schedule
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Physical quality-of-life index
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UN Human Development Index
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Genuine Progress Indicator
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Gross National Happiness
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New Economics Foundation
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Health Utilities Index surveys
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EuroQOL (EQ-5D) survey
Application in politics
United Kingdom
David Cameron, the leader of the
Conservative Party (UK), has put Quality of Life issues at the heart of his policy agenda. Linking environmental issues (e.g. climate change) with policies on waste, transport, energy, water, planning and rural affairs. He has established a Quality of Life Policy Group [(http://www.qualityoflifechallenge.com)] to examine all these areas. There is, however, some scepticism surrounding this rhetoric with the commitment to "quality of life" being viewed in some, especially traditional Tory, circles as a pre-emptive apology for low economic growth expected to be brought on by Cameron's plans to continue the tax-and-spend legacy of
Labour, which is at odds to traditional Tory economic policy.
North America
The term has often been used, since the
1980s and esp.
1990s, in connection with the presence or absence of so-called
victimless crimes, its users in this sense citing the incidence of these to gauge the inherent level of disorder in a society at a particular time. Users of the term in this application — who tend to be political and/or
social conservatives — often refer to victimless crimes by the alternate name of "quality-of-life crimes." In conjunction with this, American
sociologist James Q. Wilson has articulated what he calls the
Broken Window Theory, which asserts that relatively minor problems left unattended (such as 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 unrepaired exudes an image of general dilapidation). Wilson's theories have been expounded 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. Their cities have instituted so-called
zero tolerance policies, i.e. that do not tolerate even minor crimes.
One attempt to take quality of life more into account in government decisions is the notion of a
seventh generation standard, which argues that the effect of any decision today should be judged by its effect in six generations. These measures are often associated in the
United States with the proposed
Seventh Generation Amendment proposal to the
U.S. Constitution, and in Canada with the
Canada Well-Being Measurement Act co-authored by
Mike Nickerson of the Green Party of Ontario and
Joe Jordan, a former
Liberal Party of Canada Member of Parliament. This strategy still would be very difficult to implement as predicting the future is never easy. Decision makers seven generations ago in the early mid-nineteenth century would have great difficulty comprehending today's realities.
Several
First Nations in both Canada and U.S. seem to have independently originated this standard, prior to European contact, which seems to represent the age ratio between the longest-lived elders and newborns expressed in terms of generations, i.e. humans live at most 100-115 years, and reproduce in most tribal cultures at about 15-17 years old, a ratio of about seven to one. So, according to the standard, any child born as a decision was being made would be able to assess its impact over their entire life as an elder.
Although laws to require standards for measuring well-being have not yet been adopted, they are growing in popularity in the
labor movement, forced attention to these matters to the
NAFTA level and have begun to challenge assumptions of economics regarding
inflation and
money supply.
Early studies by JCMOPS In Dt 365 found that adopting the U.S. dollar (i.e. in both
Canada and
Mexico) have been drastically complicated by proposals to agree, as a prerequisite, on measuring well-being, which is still a very new subject. In part to stall or block
currency union, the
Canadian Labour Congress,
Green Party of the United States,
Green Party of Ontario and
Green Party of Canada have all backed well-being measures very strongly. However, there is broad agreement among
green economists that a common standard for measuring well-being, and possibly also
Bioregional Democracy measures, would be required in order to ensure
biosecurity after a currency union.
See also
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Standard of living
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Canadian Index of Wellbeing
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Subjective life satisfaction
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Civil protection
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Copenhagen Consensus
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Gross domestic product
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Simple living
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Meaning of life
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Social security
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Auxology
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Sustainability
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Community
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Appropriate Technology
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Activism
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Patient-reported outcome
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Great Transition
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Health Services Research
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Human Development Index
External links
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United Nation's 2006 Quality of Life Survey
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Stanford Encyclopedia of Philosophy entry on Well-being
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The Economist's 2005 Quality of Life Survey - Requires Subscription
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Mercer International's Quality of Living Survey 2006 (Cities)
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Ecosystems and Human Well-being (PDF) by the Millennium Ecosystem Assessment (MA, 2005)
★ ''The Role of Well-being in a Great Transition'', in
GTI Paper Series, provides an overview of theories of Well-being and examines how a focus on quality of life could change the trajectory of global development,
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''Human Services'' Barnstable, MA. On line, papers, CD, etc.
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Article: Get Happy from
Intelligent Giving
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CEA Registry Website
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ProQolid (Patient-Reported Outcome & Quality of Life Instruments Database)
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Mapi Research Trust ("Non-profit organization advancing the art & the use of scientific approaches to Patient-Reported Outcome (PRO) measures")
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Global Social Change reports includes reports about global quality of life.
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Measuring quality of life using free and public domain data Paper in Social Research Update, a peer reviewed journal.