The relative importance of health, income and social relations for subjective well-being: An integrative analysis
Introduction
In recent years, measures of subjective well-being (SWB) has gained importance as an indicator of economic and social progress (Kahneman et al., 2004, Stiglitz et al., 2009). This is largely because, in addition to material thing, human well-being is determined by many aspects of people's life circumstances such as health, social networks, quality of institutions, or leisure activities. As argued by Diener (1984), SWB is best understood as encompassing three separate aspects, such as life satisfaction, positive affect, and the absence of negative affect. Here we consider the satisfaction with life scale (SWLS), which is a widely used measure of SWB (Stiglitz et al., 2009). It involves an evaluative judgement of how one's quality of life is doing in general (Diener et al., 1985), which requires making an effort and remembering past experiences. It is the most stable dimension of SWB over an individual's life course (Diener, 1984) and robust to the effects of social desirability bias and stable across countries (Pacek and Radcliff, 2008).
SWB is also a population outcome measure beyond morbidity, mortality, and economic status that tells how people perceive the circumstances of their life from their own perspective (Diener and Seligman, 2004). A variety of evidence points to a robust correlation between SWB and alternative measures of personal well-being, such as independently ascertained friends' reports and with health and sleep quality (Diener et al., 2006, Kahneman and Krueger, 2006). SWB-measures provide valid and reliable information on how well people - and the wider societies - are doing, thereby assessing quality of life in addition to economic and social indicators (Diener and Suh, 1997). Thus, SWB data can be used to shape and appraise policy.
Several studies have concluded that health is positively associated with subjective well-being (Binder and Coad, 2011, Cubí-Mollá et al., 2014, Deaton, 2008, Graham, 2008, Okun and George, 1984). In a seminal study by Campbell et al. (1976), health was rated by respondents as the most important factor in happiness. The degree of the association between health and SWB varies as a function of whether health is rated by experts or by self-assessment. Objective measures of health, such as a physician's observations and diagnoses, are less correlated with SWB than subjective measures of health, such as a self-report of overall health status (Diener et al., 1999, Larson, 1978, Okun and George, 1984). However, regardless of how health is measured, health and SWB are significantly associated.
Similarly, numerous studies have been conducted on the effect of income on SWB (Diener and Seligman, 2004, Easterlin, 1995, Ferrer-i-Carbonell, 2005, Rojas, 2011), concluding that the relationship is generally positive but diminishing. In his seminal paper, Easterlin (1995) suggested: “raising the incomes of all, does not increase the happiness of all, because the positive effect of higher income on subjective well-being is offset by the negative effect of higher living level norms brought about by the growth in incomes generally” (p. 36). People either adapt to their circumstances (Diener et al., 1999, Menzel et al., 2002), and hence end up no more satisfied than they were before, or they raise their financial aspirations (Easterlin, 1995), which will make them feel less satisfied with their increase in income.
There is growing evidence that social relationships are crucial for people's health and well-being (Binder and Coad, 2011, Diener and Biswas-Diener, 2011, Lin, 1999). Individual-level social capital can be defined as the social skills and networks that enable an individual to access and/or mobilize resources embodied in social structure in purposive actions (Lin, 1999), which, of course enhance individuals' SWB. It has been argued that social relationships have the power to influence identity and recognition that are essential for the maintenance of mental health and entitlement to social resources (Lin, 1999), which in turn are associated with well-being. Furthermore, research in this area suggest that close supportive relationships are considered a necessary condition for SWB (Diener and Biswas-Diener, 2011, Helliwell and Putnam, 2004). Although social context and individual level effects play a role, studies suggest strong and stable effect of social relationships on SWB (Gleibs et al., 2013, Helliwell and Putnam, 2004).
Despite an increasing interest into the partial effects of health, income and social relationships on SWB, empirical studies on the associations between these integrated factors on SWB are sparse. Most studies examined the link between individuals' subjective health ratings and SWB and found this link to be positive and strong (Dolan et al., 2008, Graham, 2008). Few studies extend to more detailed health measures such as provided by using health state utility (HSU) instruments. For example, Graham et al. (2011) conducted a cross-sectional study for a number of Latin American countries, where EQ-5D measure of health problems was related to health satisfaction and life satisfaction. The present study utilizes several measures of health including objective diagnosis indicators in alternative models to test for the stability of results on the relative importance of health on SWB. Moreover, the measure of social relationships used in this paper is unique in that it provides a composite score, which combines the extent and quality of both primary ties (close friends and families) and secondary ties with the public (social inclusion and isolation).
We apply the Shapley value regression based techniques to determine the relative importance of each variable for SWB. While variance decomposition techniques are common in research related to poverty and income inequalities, few applications exist in SWB studies. Graham and Nikolova (2015) discussed the relative importance of objective vs. subjective perceived opportunities for different SWB dimensions using variance decomposition techniques. Sundmacher et al. (2011) applied similar approach to assess the contribution of material, cultural-behavioural, capability and psychosocial factors to variations in health. They both used a variance decomposition technique proposed by Fields (2003) that allows for a negative value, which creates difficulty in interpretation. The Shapley value regression applied in this paper is calculated across all possible combinations of predictors, and is always positive unlike other net effect measures (Conklin et al., 2004).
We used quantile regression model (QRM) to test whether our predictors are more important for individuals with lower SWB than higher SWB. QRM was introduced in a SWB study by Hohl (2009) using the relationship between income and life satisfaction as an example. Binder and Coad (2011) extended this method to a wider investigation of happiness using health, income and social factors. They used an aggregated health measure (self-reported health and objective health) although objective health might be sufficiently captured by subjective health measures. Yuan and Golpelwar (2013) used a similar approach in testing SWB from the perspective of social quality. More recently, Binder and Coad (2015) examined the relationship between unemployment and SWB, and Graham and Nikolova (2015) assessed the capability-SWB relationship using QRM. The current paper further investigates the wider interrelationships by considering several measures of health and using a composite measure of social relationships.
Based on a comprehensive cross-sectional data set (N = 7933) from six developed countries that combine a healthy group and seven disease groups, this paper aims to answer the following two questions: i) What is the relative importance of health, income and social relationships for SWB?, and; ii) Will the (relative) importance of these three key predictors differ depending on the level of the SWB distributions?
Section snippets
Data
Data was obtained from the multi-instrument comparison (MIC) study, which is based on a 2012 online survey carried out in Australia, Canada, Germany, Norway, UK and the US by a global panel company, CINT Pty Ltd (Richardson et al., 2012). The data include a representative ‘healthy group’ (N = 1760) and seven major disease groups (N = 6173), which give a total sample size of 7933. The survey was approved by the Monash University Human Research Ethics Committee (MUHREC), Melbourne, Australia,
Results
Table 3 reports the regression results of unstandardized and standardized coefficients for each of the three HRQoL-measures. Results from OLS1 includes measures for the three key variables (HRQoL, income, social relationships), but adjusting for variables that are standard to include in this literature: gender, age, unemployment, education, marital status. Results from OLS2 in addition includes dummies for diagnosis and countries. The larger the difference across the three HRQoL-measures after
Discussion
This study examines the relative importance of health, income and social relationship as determinants of SWB. The standardized coefficients and variance decomposition results suggest that measure of health, particularly self-rated measure, have the strongest associations with SWB. For instance, the Shapley value decomposition reveal that the proportion of variation in SWB associated uniquely with VAS is 15.8% after controlling for all other variables including disease and country dummies.
Conclusions
Subjective well-being (SWB) is more than having a good financial standing and the absence of disease. It is an asset that allows people to realize their aspirations, and enhance their social ties. This study provides empirical evidence that health, income and social relationships are positively associated with SWB even after controlling for individual, household and national-level control variables. The study reveals that the aggregate measure of social relationship is the most important
Acknowledgements
We are grateful to John Brazier and two anonymous referees for their very constructive comments. Data collection was funded by grants from The Australian National Health and Medical Research Council (grant number 1006334), while the Norwegian arm was funded by the University of Tromsø. The Research Council of Norway, grant number 221452, funded the preparation of this manuscript.
References (64)
- et al.
From Average Joe's happiness to Miserable Jane and Cheerful John: using quantile regressions to analyze the full subjective well-being distribution
J. Econ. Behav. Organ.
(2011) - et al.
The estimation of a preference-based measure of health from the SF-36
J. Health Econ.
(2002) - et al.
Customer satisfaction analysis: Identification of key drivers
Eur. J. Oper. Res.
(2004) - et al.
A Study of the Relationship between Health and Subjective Well-Being in Parkinson's Disease Patients
Value Health
(2014) - et al.
Do we really know what makes us happy? A review of the economic literature on the factors associated with subjective well-being
J. Econ. Psychol
(2008) Will raising the incomes of all increase the happiness of all?
J. Econ. Behav. Organ.
(1995)Income and well-being : an empirical analysis of the comparison income effect
J. Public Econ
(2005)- et al.
The relationship between happiness, health, and socio-economic factors: results based on Swedish microdata
J. Socio-Economics
(2001) - et al.
Bentham or Aristotle in the Development Process? An Empirical Investigation of Capabilities and Subjective Well-Being
World Dev.
(2015) How's life? Combining individual and national variables to explain subjective well-being
Econ. Model
(2003)
A psychometric evaluation of the Satisfaction with Life Scale in a Swedish nationwide sample of university students
Personal. Individ. Differ
The role of adaptation to disability and disease in health state valuation: a preliminary normative analysis
Soc. Sci. Med
The concept of life satisfaction across cultures: An IRT analysis
J. Res. Personal
Physician-Ratings and Self-Ratings of Health, Neuroticism and Subjective Well-Being among Men and Women
Personal. Individ. Differ
The anatomy of subjective well-being
J. Econ. Behav. Organ
Heterogeneity in the Relationship Between Unemployment and Subjective Wellbeing: A Quantile Approach
Econ.
The Quality of American Life: Perceptions, Evaluations, and Satisfactions
Unhappiness and Unemployment
Econ. J
Social relationships and health
Am. Psychol
Income, Health, and Well-Being around the World: Evidence from the Gallup World Poll
J. Econ. Perspect
Scale Development: Theory and Applications
An EQ-5D-5L value set for England
Subjective Well-Being
Psychol. Bull.
Will Money Increase Subjective Well-Being? A Literature. Review and Guide to Needed Research
Soc. Indic. Res.
Happiness: Unlocking the Mysteries of Psychological Wealth
The Satisfaction With Life Scale
J. Pers. Assess
International Differences in Well-Being
Beyond the hedonic treadmill: Revising the adaptation theory of well-being
Am. Psychol
Beyond Money: Toward an Economy of Well-Being
Psychol. Sci. Public Interest
Measuring quality of life: economic, social, and subjective indicators
Soc. Indic. Res.
Subjective well-being: Three decades of progress
Psychol. Bull.
Income and Happiness: Towards a Unified Theory
Econ. J.
Cited by (59)
The emergent role of explainable artificial intelligence in the materials sciences
2023, Cell Reports Physical ScienceAmplified disparities: The association between spousal education and own health
2023, Social Science and MedicinePerceived mental health impacts of the COVID-19 pandemic: The roles of social support and social engagement for working age adults in the United States
2022, Preventive MedicineCitation Excerpt :Therefore, we assess if social support and social engagement are, in fact, associated with lower risk of reporting worsening mental health as a result of the pandemic among a cross-sectional sample of rural and urban working age adults in the U.S. Numerous studies have shown that social support has direct and indirect benefits for mental health (Cohen et al., 2000; House et al., 1988; Lamu and Olsen, 2016; Teo et al., 2013). Social support is a multi-dimensional construct described as “support accessible to an individual through social ties to other individuals, groups, and the larger community” (Lin et al., 1979).
Profiles of subjective well-being among people living with HIV during the COVID-19 pandemic
2023, Quality of Life ResearchQuality of life in 13-year-olds depending on health status, residential neighbourhood deprivation and social capital – results from the Polish HBSC Study 2010–2018
2023, Annals of Agricultural and Environmental Medicine