quality of life

The idea of (improving) quality of life is central to many community programmes, to public policy, to development initiatives, and to much social legislation. However the concept itself is controversial.

The most commonly used indicators are straightforwardly economic-such as per capita GNP-but increasingly even economists recognize that these are crude measures of a citizen' quality of life. An alternative ‘capability approach’ suggests that the quality of life each person leads corresponds to the freedom that he or she has to live one kind of life rather than another. This is reflected in the combination of doings and beings (‘functionings’) that are possible, ranging from elementary matters such as being properly nourished and healthy, through to much more complex functionings such as having self-respect, preserving human dignity, and taking part in the life of the wider community. This approach suggests that an adequate measure of quality of life must be plural and should recognize that distinct components of well-being are irreducible to each other.

The Level of Living Surveys set up by the Swedish government to measure the welfare of individuals, and conducted periodically since 1968, use a wide variety of indicators. These measure (among other things) health and access to health care (ability to walk 100 metres, various symptoms of illness); employment and working conditions (unemployment experiences, physical demands of work); education and skills (years of education, qualifications obtained); housing (amenities, and number of persons per room); security of life and property (exposure to violence and thefts); and recreation and culture (vacations, access to leisure facilities)- as well as the more obvious economic resources (income, wealth, property, and so on).

Debates about the quality of life are not unlike discussions of poverty and deprivation; for example, the same issues of cultural relativism are raised, and similar measurement problems arise. Should measurement be related to the needs or resources of individuals? Which indicators should be used and how can these be summarized to give an overall picture of quality of life? (How do we compare a rich man who suffers from an untreatable illness which interferes with his enjoyment of life and a poor woman who keeps perfect health and enjoys life?) For a useful and wide-ranging discussion of the concept and the many methodological issues it raises see, The Quality of Life (1993).