ANALYSISQuality of life: An approach integrating opportunities, human needs, and subjective well-being
Introduction
The understanding, measurement, and improvement of human experience have been major goals of individuals, researchers, communities and governments. The overall assessment of human experience has been commonly expressed by the term quality of life (QOL) across multiple disciplines including psychology, medicine, economics, environmental science, and sociology. A search of the Institute for Scientific Information (ISI) database from 1982 to 2005 reveals over 55,000 citations utilizing the term “quality of life.” QOL as a general term is meant to represent either how well human needs are met or the extent to which individuals or groups perceive satisfaction or dissatisfaction in various life domains. Understanding QOL has tremendous potential implications because improving QOL is a major policy and lifestyle goal (Schuessler and Fisher, 1985). Recent research on QOL has focused on two basic methodologies of measurement. One method utilizes quantifiable social or economic indicators to reflect the extent to which human needs are met. The other looks to self reported levels of happiness, pleasure, fulfillment, and the like, and has been termed “subjective well-being” (SWB — see Diener and Lucas, 1999, Easterlin, 2003).
The so-called “objective” measurements of QOL generally center on social, economic, and health indicators (Cummins et al., 2003), utilizing tools such as the UN's Human Development Index (HDI) and GDP/capita (Vemuri and Costanza, in press). In the field of medicine, Health Related QOL (HRQOL) research has resulted in the development of numerous individual instruments, each intended to measure HRQOL for specific subsets of populations based, for example, on age, disease status, and condition. While these measurements may provide a snapshot of how well some physical and social needs are met they are narrow, opportunity-biased, and cannot incorporate many issues that contribute to QOL such as identity and psychological security. It is also clear that these so-called “objective” measures are actually proxies for experience identified through ”subjective” associations of decision-makers; hence the distinction between objective and subjective indicators is somewhat illusory.
More “subjective” measurement tools typically focus on personal reports of life experience that complement social, economic, and health indicators, such as the degree to which a perceived need is being met and the importance of that ‘perceived need’ to one's overall QOL. Haas (1999) argues QOL is “primarily a subjective sense of well-being.” In the literature, SWB has often been used as a proxy for QOL (Haas, 1999, Easterlin, 2003). However, in addition to some methodological flaws, subjective assessments of well-being have trouble delineating preference adaptation and the fact that people judge their well-being in comparison with peer groups rather than in absolute terms (e.g., see Schwarz and Strack, 1999).
While both methods have offered insight into the QOL issue, there are a number of limitations to using each of these approaches separately. Further, individual scientific disciplines have emphasized various aspects of QOL that are most pertinent to their respective disciplines, with no single QOL instrument flexible enough to be used across disciplines, cultures, and time. In this paper we address the limitations of current QOL concepts and measurement methodologies by integrating these two basic approaches. We suggest that overall human QOL is a function of both the level of human needs met and the extent to which individuals or groups are satisfied with this level. By integrating “objective” and “subjective” assessments of QOL it is possible to get a more complete and useful picture of QOL at multiple spatial and temporal scales. Our more comprehensive approach fills the gaps inherent in the other concepts and measurement tools. At the same time our work has pointed to important directions for QOL research, as well as elaborating the policy implications of a more accurate metric of QOL. We start with a definition of QOL that integrates the objective and subjective elements.
Section snippets
An integrative definition of quality of life
When we evaluate the state of human affairs or propose policies to improve them, we typically proceed from assumptions about the characteristics of a good life and strategies for achieving them. We might suppose, for example, that access to particular resources is a part of a good life and, therefore, that increasing economic production per-capita is an appropriate goal. Unfortunately, our underlying assumptions are rarely tested and established. We therefore need a more basic approach to
Human needs and quality of life
In this section we propose a list of human needs to be used as the basis for generating a set of indicators for both QOL and SWB. We decided to use the term “needs” rather than “domains” because we found the needs language to be clearer and more useful. The needs were derived primarily from an integration of Max-Neef's (1992) “Matrix of Human Needs” and Nussbaum and Glover's (1995) “Basic Human Functional Capabilities.” We took the spirit of Nussbaum and Glover, but the practical matrix of
Opportunities
The ability of humans to satisfy their basic needs come from the opportunities available and constructed from social, built, human and natural capital (and time). Policy and culture help to allocate the four types of capital as a means for providing these opportunities. Here we define:
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social capital as those networks and norms that facilitate cooperative action (Putnam, 1995)
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human capital as the knowledge and information stored in our brains, as well as our labor
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built capital as manufactured
Weighting of human needs and subjective well-being
Building on the work of Danna and Griffin (1999), Lewin (1951), Meadow (1988), and others, Sirgy (2002) argues that human beings structure or organize their cognitive and affective experiences (and their memories of them) by life domains (e.g., work, family, friends, health, etc.). Sirgy (p. 34) notes that these life domains tend to be organized and structured around a focal set of human needs. Thus we argue that the domains can be construed as categories of experience through which we address
Scale and measurement issues
The analysis of human needs is complicated by the different spatial and temporal scales of analysis at which human needs may be understood. One obvious level, of course, is the individual. In order to gauge QOL on the basis of human needs, measures of individual needs must be obtained. Despite the fact that we are interested in objective measures of human needs (e.g., caloric intake), often the most efficient way to operationally define such needs is through self-report. For some indicators,
Research agenda
By combining so called subjective and objective measures into a single QOL concept we get a more realistic picture of the important inputs and variables for improving QOL. Our general tool provides a framework for further research. At the same time, this work has generated a series of specific questions to focus this future research.
One of the major issues with any measurement tool is the scaling issue. In this case, the question of how a QOL indicator deals with multiple spatial (cultural,
Policy implications
The kingdom of Bhutan has recently declared that “gross national happiness” is their explicit policy goal (Bond, 2003). In fact, several authors (including most recently Layard, 2005) have recommend that our primary social policy goal should be the increase in QOL for this and future generations. We agree with Layard and recommend a refocusing of social policy around the goal of long-term, sustainable QOL improvement. As we have discussed, QOL improves according to our abilities to meet human
Acknowledgements
This paper was the result of a conference of University of Vermont researchers representing multiple social and natural science and humanities disciplines including but not limited to sociology, economics, psychology, philosophy, engineering, medicine, and anthropology. The title of the conference was: “Quality of Life: What is it, how do we measure it, and how do we enhance it?” The goals of the conference were to gather members of the various research disciplines related to QOL in order to
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