Skip to main content
SpringerLink
Log in

Social Indicators Research and Health-Related Quality of Life Research

  • Published:
Social Indicators Research Aims and scope Submit manuscript

Abstract

The aim of this essay is to build a bridgebetween two intersecting areas of research,social indicators research on the one hand andhealth-related quality of life research on theother. The first substantive section of thepaper introduces key concepts and definitionsin the social indicators research tradition,e.g., social indicators, positive, negative,input and output indicators, social reports andquality of life. After that, there is asection reviewing some historical origins andmotives of social indicators researchers,beginning roughly with Jeremy Bentham's`felicific calculus' and ending with the searchfor a comprehensive accounting scheme capableof measuring the quality of human existencewith social, economic and environmentalindicators.Results of eleven surveys are reviewed whichwere undertaken to explain happiness on thebasis of levels of satisfaction thatrespondents got from a dozen specific domainsof their lives, e.g., satisfaction with theirjobs, family relations and health. On average,for the eleven samples, we were able to explain38% of the variance in reported happiness fromsome subset of the predictor variables. Satisfaction with one's own health was never the strongest predictor of happiness inany sample. In five of the eleven samples,satisfaction with one's own health failed toenter the final explanatory regression equationfor lack of statistical significance. Theresults in this section of the essay show thatdifferent groups of people with different lifecircumstances, resources and constraints usedifferent mixtures of ingredients to determinetheir happiness.After examining some research revealing therelative importance of people's satisfaction with their health to theiroverall happiness, I consider some studiesrevealing the importance of people's self-reported health to their overallhappiness. Self-reported health is measuredprimarily by the eight dimensions of SF-36.When a variety of additional potentialpredictors are entered into our regressionequation, 44% of the variance in happinessscores is explained, but only one of the eightdimensions of SF-36 remains, namely, MentalHealth. The latter accounts for a mere four%age points out of the total 44. Thus,self-reported health has relatively little tocontribute toward respondents' reportedhappiness, and its measured contribution issignificantly affected by the number and kindsof potential predictors employed.Two approaches to explaining people'ssatisfaction with their own health areconsidered. First, using the same set ofhealth-related potential predictors of overallhappiness, we are able to explain 56% of thevariance in respondents' satisfaction withtheir own health. Then, using MultipleDiscrepancies Theory, we are able to explainabout 51% of the variation in satisfactionwith one's own health scores for 8,076undergraduates, with highs of 76% for a sampleof Finnish females and 72% for Korean males.Accordingly, it is reasonable to conclude thatif one's aim is to explain people'ssatisfaction with their own health, thepotential predictors assembled in MDT canprovide quite a bit and sometimes even moreexplanatory power than a reasonably broad setof measures of self-reported health.In the penultimate section of the essay it isargued that there are good reasons forcarefully distinguishing ideas of health andquality of life, and for not interpreting SF-36and SIP scores as measures of the quality oflife. It is suggested that we might all bebetter off if the term `health-related qualityof life' is simply abandoned. However, sincethis is unlikely to happen, it is stronglyrecommended that researchers be much morecareful with their usage of the phrase andtheir interpretation of purported measures ofwhatever the phrase is supposed to designate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Allardt, E.: 1975, Att ha, alska, attvara. Om valfard i Norden [Having, Loving, Being. On Welfare in the Nordic Countries] (Borgholm, Argos).

    Google Scholar 

  • Andorka, R. and István Harcsa: 1990, 'Modernization in Hungary in the long and short run measured by social indicators', Social Indicators Research 23, pp. 1-153.

    Google Scholar 

  • Andresen, E. M., B. S. Fouts, J. C. Romeis and C. A. Brownson: 1999, 'Performance of health-related quality-of-life instruments in a spinal cord injured population', Archives of Physical Medicine and Rehabilitation 80, pp. 877-884.

    Google Scholar 

  • Andresen, E. M., B. M. Rothenberg and R. M. Kaplan: 1998, 'Performance of a self-administered mailed version of the Quality of Well-Being (QWB-SA) questionnaire among older adults', Medical Care 36(9), pp. 1349-1360.

    Google Scholar 

  • Andrews, F. M.: 1974, 'Social indicators of perceived life quality', Social Indicators Research 1, pp. 279-299.

    Google Scholar 

  • Andrews, F. M. and S. B. Withey: 1976, Social Indicators of Well-Being (Plenum Press, New York).

    Google Scholar 

  • Argyle, M.: 1987, The Psychology of Happiness (Routledge, London).

    Google Scholar 

  • Bardsley, M. J., S. Astell, A. McCallum and P. D. Home: 1993, 'The performance of three measures of health status in an outpatient diabetes population', Diabetic Medicine 10, pp. 619-626.

    Google Scholar 

  • Bentham, J.: 1789, An Introduction to the Principles of Morals and Legislation (London).

  • Bergner, M.: 1993, 'Development, testing and use of the Sickness Impact Profile', in S. R. Walker and R. M. Rosser (eds.), Quality of Life Assessment: Key Issues in the 1990s (Kluwer Academic Publishers, Dordrecht), pp. 95-110.

    Google Scholar 

  • Bergner, M., R. A. Bobbitt, W. B. Carter and B. S. Gilson: 1981, 'The Sickness Impact Profile: development and final revision of a health status measure', Medical Care 19(8), pp. 787-805.

    Google Scholar 

  • Birnbacher, D.: 1999, 'Quality of life — evaluation or description', Ethical Theory and Moral Practice 2(1), pp. 25-36.

    Google Scholar 

  • Bradburn, N. M. and D. Caplovitz: 1965, Reports of Happiness (Aldine, Chicago).

    Google Scholar 

  • Braybrooke, D.: 1967, 'Skepticism of wants, and certain subversive effects of corporations on American values', in S. Hook (ed.), Human Values and Economic Policy (New York University Press, New York), pp. 224-239.

    Google Scholar 

  • Bruin, A. F. de, L. P. de Witte, F. Stevens and J. P. M. Diederiks: 1992, 'Sickness Impact Profile: The state of the art of a generic functional status measure', Social Science and Medicine 35(8), pp. 1003-1014.

    Google Scholar 

  • Brunk, C.: 1987, 'Professionalism and responsibility in the technological society', in D. C. Poff and W. J. Waluchow (eds.), Business Ethics in Canada (Prentice-Hall Canada, Toronto), pp. 60-75.

    Google Scholar 

  • Bunge, M.: 1961, 'The weight of simplicity in the construction and assaying of scientific theories', Philosophy of Science 28, pp. 120-149.

    Google Scholar 

  • Cella, D. F. et al.: 1993, 'The functional assessment of cancer therapy scale: Development and validation of the general measure', Journal of Clinical Oncology 11(3), pp. 570-579.

    Google Scholar 

  • Churchill, D. N., J. Morgan and G. W. Torrance: 1984, 'Quality of life in end-state renal disease', Peritoneal Dialysis Bulletin 4, pp. 20-23.

    Google Scholar 

  • Dewey, J.: 1939, Theory of Valuation (University of Chicago Press, Chicago).

    Google Scholar 

  • Diabetes Control and Complications Trial: 1988, 'Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial', Diabetes Care 11(9), pp. 725-732.

    Google Scholar 

  • Diener, E. and R. E. Lucas: 1999, 'Personality and subjective well-being', in D. Kahneman, E. Diener and N. Schwarz (eds.), Well-Being: The Foundations of Hedonic Psychology (Russell Sage Foundation, New York), pp. 213-229.

    Google Scholar 

  • Diener, E. and R. E. Lucas: 2000, 'Explaining differences in societal levels of happiness: Relative standards, need fulfillment, culture and evaluation theory', Journal of Happiness Studies 1, pp. 41-78.

    Google Scholar 

  • Eiser, C. and J. E. Tooke: 1993, 'Quality-of-life evaluation in diabetes', PharmacoEconomics 4(2), pp. 85-91.

    Google Scholar 

  • Fairbank, J. C. T. et al.: 1980, 'The Oswestry Low Back Pain Disability questionnaire', Physiotherapy 66, pp. 271-273.

    Google Scholar 

  • Ferriss, A.: 1990, 'Whatever happened, indeed!', Journal of Public Policy 9, pp. 401-405.

    Google Scholar 

  • Fletcher, A. E., B. M. Hunt and C. J. Bulpitt: 1987, 'Evaluation of quality of life in clinical trials of cardiovascular disease', Journal of Chronic Diseases 40(6), pp. 557-566.

    Google Scholar 

  • Fox, K. A.: 1985, Social System Accounts: Linking Social and Economic Indicators Through Tangible Behavior Settings (D. Reidel, Dordrecht).

    Google Scholar 

  • Guyatt, G. H., M. Townsend, L. B. Berman and S. O. Pugsley: 1987, 'Quality of life in patients with chronic airflow limitation', British Journal of Diseases of the Chest 81, pp. 45-54.

    Google Scholar 

  • Guyatt, G. H., S. J. O. Veldhuyzen Van Zanten, D. H. Feeny and D. L. Patrick: 1989, 'Measuring quality of life in clinical trials: A taxonomy and review', Canadian Medical Association Journal 140, pp. 1441-1448.

    Google Scholar 

  • Hagerty, M. R. et al.: 2001, 'Quality of life indexes for national policy: Review and agenda for research', Social Indicators Research 55, pp. 1-96.

    Google Scholar 

  • Hanestad, B. R.: 1990, 'Errors of measurement affecting the reliability and validity of data acquired from self-assessed quality of life', Scandanavian Journal of Caring Sciences 4(1), pp. 29-34.

    Google Scholar 

  • Hörnquist, J. O.: 1989, 'Quality of life: Concept and assessment', Scandanavian Journal of Social Medicine 18, pp. 69-79.

    Google Scholar 

  • Idler, E. L. and Y. Benyamini: 1997, 'Self-rated health and mortality: A review of twenty-seven community studies', Journal of Health and Social Behavior 38, pp. 21-37.

    Google Scholar 

  • Ingersoll, G. M. and D. G. Marrero: 1991, 'A modified quality-of-life measure for youths: Psychometric properties', The Diabetes Educator 17(2), pp. 114-118.

    Google Scholar 

  • Jacobson, A. M., M. de Groot and J. A. Samson: 1994, 'The evaluation of two measures of quality of life in patients with type I and type II diabetes', Diabetes Care 17(4), pp. 267-274.

    Google Scholar 

  • James, W.: 1909, The Meaning of Truth: A Sequel to Pragmatism (Longmans, Green and Co., New York).

    Google Scholar 

  • James, W.: 1977 (originally published 1891), 'The moral philosopher and the moral life', in J. J. McDermott (ed.), The Writings of William James: A Comprehensive Edition (University of Chicago Press, Chicago), pp. 610-629.

    Google Scholar 

  • Juster, F. T. and K. C. Land: 1981, Social Accounting Systems: Essays on the State of the Art (Academic Press, New York).

    Google Scholar 

  • Karl, B. D.: 1974, Charles E. Merriam and the Study of Politics (University of Chicago Press, Chicago).

    Google Scholar 

  • Land, K.: 1983, 'Social indicators', Annual Review of Sociology 9, pp. 1-26.

    Google Scholar 

  • League For Social Reconstruction Research Committee: 1935, Social Planning for Canada (Thomas Nelson, Toronto).

    Google Scholar 

  • Lewis, C. I.: 1946, Analysis of Knowledge and Valuation (Open Court, LaSalle).

    Google Scholar 

  • MacRae, D.: 1985, Policy Indicators: Links between Social Science and Public Debate (University of North Carolina Press, Chapel Hill).

    Google Scholar 

  • McDowell, I. and C. Newell: 1996, Measuring Health: A Guide to Rating Scales and Questionnaires (Oxford University Press, New York).

    Google Scholar 

  • McDowell, I. and E. Praught: 1982, 'On the measurement of happiness: an examination of the Bradburn scale in the Canada Health Survey', American Journal of Epidemiology 116(6), pp. 949-958.

    Google Scholar 

  • McSweeny, A. J. et al.: 1982, 'Life quality of patients with chronic obstructive pulmonary disease', Archives of Internal Medicine 142, pp. 473-478.

    Google Scholar 

  • Michalos, A. C.: 1967, 'Postulates of rational preference', Philosophy of Science 34, pp. 18-22.

    Google Scholar 

  • Michalos, A. C.: 1969, Principles of Logic (Prentice-Hall, Englewood Cliffs).

    Google Scholar 

  • Michalos, A. C.: 1970a, 'Decision making in committees', American Philosophical Quarterly 7, pp. 91-106.

    Google Scholar 

  • Michalos, A.C.: 1970b, 'Cost-benefit versus expected utility acceptance rules', Theory and Decision 1, pp. 61-88.

    Google Scholar 

  • Michalos, A. C.: 1970c, 'The impossibility of an ordinal measure of acceptability', Philosophical Forum 2, pp. 103-106.

    Google Scholar 

  • Michalos, A. C.: 1970d, 'The costs of decision making', Public Choice 9, pp. 39-51.

    Google Scholar 

  • Michalos, A. C.: 1979, 'The loyal agent's argument', in T. Beauchamp and N. Bowie (eds.), Ethical Theory and Business (Prentice-Hall, Englewood Cliffs), pp. 247-253. Reprinted in Michalos 1995.

    Google Scholar 

  • Michalos, A. C.: 1978, Foundations of Decision-Making (Canadian Library of Philosophy, Ottawa).

    Google Scholar 

  • Michalos, A. C.: 1980, North American Social Report, Vol. 1: Foundations, Population and Health (D. Reidel, Dordrecht).

    Google Scholar 

  • Michalos, A. C.: 1985, 'Multiple discrepancies theory (MDT)', Social Indicators Research 16, pp. 347-413.

    Google Scholar 

  • Michalos, A. C.: 1988, 'Integrated development planning using socio-economic and quality of life indicators', in Innovative Approaches to Development Planning (UNESCO, Paris), pp. 113-216.

    Google Scholar 

  • Michalos, A. C.: 1990, 'The impact of trust on business, international security and the quality of life', Journal of Business Ethics 9, pp. 619-638. Reprinted in Michalos 1995.

    Google Scholar 

  • Michalos, A. C.: 1991, Global Report on Student Well-Being, Vol. 1: Life Satisfaction and Happiness (Springer-Verlag, New York).

    Google Scholar 

  • Michalos, A. C.: 1991a, Global Report on Student Well-Being, Vol. 2: Family, Friends, Living Partner and Self-Esteem (Springer-Verlag, New York).

    Google Scholar 

  • Michalos, A. C.: 1992, 'Ethical considerations in evaluation', Canadian Journal of Program Evaluation 7, pp. 61-75. Reprinted in Michalos 1995.

    Google Scholar 

  • Michalos, A. C.: 1993, Global Report on Student Well-Being, Vol. 3: Employment, Finances, Housing and Transportation (Springer-Verlag, New York).

    Google Scholar 

  • Michalos, A. C.: 1993a, Global Report on Student Well-Being, Vol. 4: Religion, Education, Recreation and Health (Springer-Verlag, New York).

    Google Scholar 

  • Michalos, A. C.: 1995, A Pragmatic Approach to Business Ethics (SAGE Publications, Thousand Oaks).

    Google Scholar 

  • Michalos, A. C.: 1997, 'Combining social, economic and environmental indicators to measure sustainable human well-being', Social Indicators Research 40, pp. 221-258.

    Google Scholar 

  • Michalos, A. C.: 1999, 'Reflections on twenty-five years of quality-of-life research', Feminist Economics 5(2), pp. 119-123.

    Google Scholar 

  • Michalos, A. C.: 2001, 'Ethics counselors as a new priesthood', Journal of Business Ethics 29, pp. 3-17.

    Google Scholar 

  • Michalos, A. C., A. Hubley, B. D. Zumbo and D. Hemingway: 2001, 'Health and other aspects of the quality of life of older people', Social Indicators Research 54(1), p. xxx.

    Google Scholar 

  • Michalos, A. C. and B. D. Zumbo: 1999, 'Public services and the quality of life', Social Indicators Research 48, pp. 125-156.

    Google Scholar 

  • Michalos, A. C. and B. D. Zumbo: 2001, 'Ethnicity, modern prejudice and the quality of life', Social Indicators Research 53, pp. 189-222.

    Google Scholar 

  • Michalos, A. C. and B. D. Zumbo: tbe, 'Leisure activities, health and the quality of life'.

  • Michalos, A. C., B. D. Zumbo and A. Hubley: 2000, 'Health and the quality of life', Social Indicators Research 51, pp. 245-286.

    Google Scholar 

  • Mitchell, W. C.: 1918, 'Bentham's felicific calculus', Political Science Quarterly 33, pp. 161-183.

    Google Scholar 

  • Najman, J. M. and S. Levine: 1981, 'Evaluating the impact of medical care and technologies on the quality of life: A review and critique', Social Science and Medicine 15F, pp. 107-115.

    Google Scholar 

  • Nerenz, D. R., D. P. Repasky, F. W. Whitehouse and D. M. Kahkonen: 1992, 'Ongoing assessment of health status in patients with diabetes mellitus', Medical Care 30(5)(Supplement), pp. MS112-MS124.

    Google Scholar 

  • Noll, H.-H. and W. Zapf: 1994, 'Social indicators research: Societal monitoring and social reporting', in I. Borg and P. Ph. Mohler (eds.), Trends and Perspectives in Empirical Social Research (Walter de Gruyter, Berlin).

    Google Scholar 

  • Nord, E., T. Arnesen, P. Menzel and Jose-Luis Pinto: 2001, 'Towards a more restricted use of the term “quality of life”', Quality of Life Newsletter 26, pp. 3-4.

    Google Scholar 

  • Nussbaum, M. C. and A. Sen (eds.): 1993, The Quality of Life (Clarendon Press, Oxford).

    Google Scholar 

  • Patrick, D. L. and R. A. Deyo: 1989, 'Generic and disease-specific measures in assessing health status and quality of life', Medical Care 27(3), pp. s217-s232.

    Google Scholar 

  • Perry, R. B.: 1926, General Theory of Value (Harvard University Press, Cambridge).

    Google Scholar 

  • Perry, R. B.: 1954, Realms of Value (Harvard University Press, Cambridge).

    Google Scholar 

  • Pilowsky, I. et al.: 1983, 'The illness behavior assessment schedule: Reliability and validity', International Journal of Psychiatry and Medicine 13, pp. 11-28.

    Google Scholar 

  • Poff, D. C.: 1987, 'The loyal agent's argument revisited', in D. C. Poff and W. J. Waluchow (eds.), Business Ethics in Canada (Prentice-Hall Canada, Toronto), pp. 142-144.

    Google Scholar 

  • President's Research Committee on Social Trends: 1933, Recent Social Trends in the United States, Vols. 1 and 2 (McGraw-Hill, New York).

    Google Scholar 

  • Prigatano, G. P., E. C. Wright and D. Levin: 1984, 'Quality of life and its predictors in patients with mild hypoxemia and chronic obstructive pulmonary disease', Archives of Internal Medicine 144, pp. 1613-1619.

    Google Scholar 

  • Radloff, L. S.: 1977, 'The CES-D scale: A self-report deporession scale for research in the general population', Applied Psychological Measurement 1, pp. 385-401.

    Google Scholar 

  • Renwick, R. and I. Brown: 1996, 'The Centre for Health Promotion's conceptual approach to quality of life', in R. Renwick, I. Brown and M. Nagler (eds.), Quality of Life in Health Promotion and Rehabilitation: Conceptual Approaches, Issues and Applications (SAGE Publications, Thousand Oaks), pp. 75-86.

    Google Scholar 

  • Sandvik, E., E. Diener and L. Seidlitz: 1993, 'Subjective well-being: The convergence and stability of self-report and non-self-report measures', Journal of Personality 61, pp. 317-342.

    Google Scholar 

  • Schilpp, P. A. (ed.): 1963, The Philosophy of Rudolf Carnap (Open Court, LaSalle).

    Google Scholar 

  • Schipper, H. et al.: 1984, 'Measuring the quality of life of cancer patients: The Functional Living Index — Cancer: Development and validation', Journal of Clinical Oncology 2, pp. 472-483.

    Google Scholar 

  • Schwarz, N. and H. Bless, 1992, 'Constructing reality and its alternatives: Assimilation and contrast effects', in L. L. Marting and A. Tesser (eds.), The Construction of Social Judgment (Erlbaum: Hillsdale, N.J.), pp. 217-245.

    Google Scholar 

  • Schwarz, N. and G. L. Clore, 1983, 'Mood, misattribution, and judgments of well-being: Informative and directive functions of affective states', Journal of Personality and Social Psychology 45, pp. 513-523.

    Google Scholar 

  • Schwarz, N. and F. Strack: 1999, 'Reports of subjective well-being: Judgmental processes and their methodological implications', in D. Kahneman, E. Diener and N. Schwarz (eds.), Well-Being: The Foundations of Hedonic Psychology (Russell Sage Foundation, New York), pp. 61-84.

    Google Scholar 

  • Schwarz, N. and F. Strack: 1991, 'Evaluating one's life: A judgment model of subjective well-being', in F. Strack, M. Argyle and N. Schwarz (eds.), Subjective Well-Being: An Interdisciplinary Perspective (Pergamon, Oxford), pp. 27-47.

    Google Scholar 

  • Sirgy, J.: in press, Handbook of Quality-of-Life Research: An Ethical Marketing Perspective (Kluwer Academic Publishers, Dordrecht).

  • Solomon, E.: 1980, Consultation of Research Network on the Quality of Life, Division for Socio-Economic Analysis, UNESCO, Paris, 3–5 December.

    Google Scholar 

  • Sprangers, M. A. G.: 1996, 'Response-shift bias: A challenge to the assessment of patients' quality of life in cancer clinical trials', Cancer Treatment Reviews 22(Supplement A), pp. 55-62.

    Google Scholar 

  • Sprangers, M. A. G. and C. E. Schwartz: 1999, 'Integrating response shift into health-related quality of life research: A theoretical model', Social Science and Medicine 48, pp. 1507-1515.

    Google Scholar 

  • Tatarkiewicz, W.: 1976, Analysis of Happiness (M. Nijhoff, Hague).

    Google Scholar 

  • Taylor, S. E. and J. D. Brown: 1988, 'Illusion and well-being: A social psychological perspective on mental health', Psychological Bulletin 103, pp. 193-210.

    Google Scholar 

  • Torrance, G. W.: 1986, 'Measurement of health state utilities for economic appraisal', Journal of Health Economics 5, pp. 1-30.

    Google Scholar 

  • Veenhoven, R.: 1984, Conditions of Happiness (D. Reidel, Dordrecht).

    Google Scholar 

  • Veenhoven, R. and P. Ouweneel: 1995, 'Livability of the welfare-state, appreciation-of-life and length-of-life in nations varying in state-welfare-effort', Social Indicators Research 36, pp. 1-49.

    Google Scholar 

  • Verbrugge, L. M., S. S. Merrill and X. Liu: 1999, 'Measuring disability with parsimony', Disability and Rehabilitation 21(5/6), pp. 295-306.

    Google Scholar 

  • Vogel, J.: 1994, 'Social indicators and social reporting', Statistical Journal of the United Nations ECE 11, pp. 241-260.

    Google Scholar 

  • Ware, J. E., K. K. Snow, M. Kosinski and B. Gandek: 1993, SF-36 Health Survey: Manual and Interpretation Guide (The Health Institute, New England Medical Center, Boston).

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute for Social Research and Evaluation, University of Northern British Columbia, Prince George, British Columbia, V2N 4Z9, Canada

    Alex C. Michalos

Authors
  1. Alex C. Michalos
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Michalos, A.C. Social Indicators Research and Health-Related Quality of Life Research. Social Indicators Research 65, 27–72 (2004). https://doi.org/10.1023/A:1025592219390

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1025592219390

Keywords

Search

Navigation