Social Indicators Research

, Volume 72, Issue 1, pp 1–50 | Cite as

Determinants of Health and the Quality of Life in the Bella Coola Valley

  • Alex C. MichalosEmail author
  • Harvey V. Thommasen
  • Rua Read
  • Nancy Anderson
  • Bruno D. Zumbo


The aim of this investigation is to obtain some baseline self-reported data on the health status and overall quality of life of all residents of the Bella Coola Valley of British Columbia aged 17 years or older, and to measure the impact of a set of designated health determinants on their health and quality of life. In the period from August to November 2001, a variety of procedures were used to ensure that all eligible residents of the Valley received a copy of our questionnaire, and 687 useable questionnaires were obtained for our working dataset. Health status was measured by SF-36 and the U.S. Centers for Disease Control healthy days items. Thirty-one items were used to measure the Provincial Health Officer’s designated determinants of health in four clusters, namely, biological, social and economic, health behaviours and health services determinants. Quality of life was measured by satisfaction levels in 13 specific domains of life (e.g., family, financial security), four global items (e.g., happiness, life satisfaction) and one global Subjective Well-Being Index. Besides obtaining baseline figures on all our measures for the Valley, we made some comparisons among our figures and those from other areas, e.g., Prince George, BC. Most of the measures indicated that the health status and quality of life of Bella Coola Valley residents were lower than those of Prince George residents. For the sample as a whole, SF-36 scores on the eight dimensions ran from 82.3 (physical functioning) to 50.0 (social functioning), with a mean of 62.7. Residents in the Valley averaged 6.5 days in the past 30 in which their health was physically not good, 5.5 days when it was mentally not good and 4.1 days when their health limited their usual daily activities. Eleven percent of respondents described their general health as “excellent” and another 27% said it was “very good”. On a 7-point scale from 1=very dissatisfied to 7=very satisfied, respondents had average life satisfaction and satisfaction with the overall quality of life scores of 5.5. For specific domains of life, the lowest mean level of satisfaction was reported for federal and provincial government officials (3.3) and the highest was reported for living partners and personal safety around home (5.8). Regarding bivariate relations, each of the eight dimensions of SF-36 was significantly correlated with a single item measure of general health, and five of the eight were significantly correlated with the number of good health days. Happiness and the Subjective Well-Being Index were positively but moderately correlated with six of the eight dimensions, and life satisfaction was positively correlated with five. Age was negatively related to general health, but positively related to life satisfaction. Not being of aboriginal descent was positively related to all of the four global health indicators and to the Subjective Well-Being Index. Education was positively related to the four global health measures but not to the three global quality of life measures. The Social Support and Good Family Indexes were positively related to all seven global measures. There was a positive correlation between six of the seven global measures and the frequency with which respondents participated in activities sponsored by voluntary organizations. Frequency of smoking was negatively associated with every global dependent variable except the Physical Health Index. Frequency of skipping meals was negatively associated and average hours of sleep per night was positively associated with all seven global measures. Turning to multivariate relationships, the four clusters of health determinants explained from 12% (SF-36 Mental Health Index) to 24% (general health) of the variance in the dependent global health variables, and from 20% (happiness) to 26% (Subjective Well-Being Index) of the variance in the dependent global quality of life variables. Adding domain satisfaction scores to the total set of predictors allowed us to explain from 20% (SF-36 Mental health Index) to 29% (general health) of the variance in the dependent global health variables, and from 39% (happiness) to 62% (life satisfaction) in the dependent global quality of life variables. By including measures of social support and good family relationships in our set of health determinants, we practically guaranteed that the latter would be relatively strongly predictive of global quality of life.


Life Satisfaction Domain Satisfaction Good Family Health Determinant Life Variable 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. CDC. 2000. Centers for Disease Control and Prevention, Measuring Healthy days, Atlanta, Georgia, November.Google Scholar
  2. FPTC. 1999. Federal, Provincial and Territorial Advisory Committee on Population Health, Statistical Report on the health of Canadians (Statistics Canada, Ottawa, Cat. #82-570-X1E, revised March 2000, Scholar
  3. Garratt, A.M., Ruta, D.A., Abdullha, M.I., Buckhingham, J.K., Russell, I.T. 1993‘The SF-36 health survey questionnaire: an outcome measure suitable for routine use within the NHS?’British Medical Journal30614401444PubMedGoogle Scholar
  4. Han, T.S., Tijhuis, M.A.R., Lean, M.E.J., Seidell, J.C. 1998‘Quality of life in relation to over-weight and body fat distribution’American Journal of Public Health8818141821PubMedGoogle Scholar
  5. Hudson, W.W. 1982The Clinical Measurement Package: A Field ManualDorsey PressHomewood IllinoisGoogle Scholar
  6. McHorney, C.A., Ware, J.E., Raczek, A.E. 1993‘The MOS 36-Item Short-Form health Survey (SF-36): IIPsychometric and clinical tests of validity in measuring physical and mental health constructs’. Medical Care31247263Google Scholar
  7. McHorney, C.A., Ware, J.E., Lu, J.F.R., Donald Sherbourne, C. 1994‘The MOS 36-Item Short-Form health Survey (SF-36): IIITests of data quality, scaling assumptions, and reliability across diverse patient groups’. Medical Care324066Google Scholar
  8. Michalos, A.C. 1986‘Job satisfaction, marital satisfaction, the quality of life: a review and a preview’Andrews, F.M. eds. Research on the Quality of LifeInstitute for Social ResearchUniversity of Michigan Ann Arbour5783Google Scholar
  9. Michalos, A.C. 1991Global Report on Student Well-Being: Volume 1. life satisfaction and happinessSpringer-VerlagNew YorkGoogle Scholar
  10. Michalos, A.C. 2002‘Policing services and the quality of life’Social Indicators Research41118Google Scholar
  11. Michalos, A.C. 2004‘Social indicators research and health-related quality of life research’Social Indicators Research652772CrossRefGoogle Scholar
  12. Michalos A.C., Zumbo B.D. 2000. ‘Quality of life in Quesnel, British Columbia’. Institute for Social Research and Evaluation, UNBC.Google Scholar
  13. Michalos, A.C., Zumbo, B.D. 2001‘Ethnicity, modern prejudice and the quality of life’Social Indicators Research53189222CrossRefGoogle Scholar
  14. Michalos A.C., Zumbo B.D. 2003. ‘Leisure Activities, health and the Quality of Life’. In: Michalos A.C. (eds), Essays on the Quality of Life. Kluwer Academic Publishing, pp. 217–238.Google Scholar
  15. Michalos, A.C., Zumbo, B.D., Hubley, A. 2000‘Health and the quality of life’Social Indicators Research51245286CrossRefGoogle Scholar
  16. Provincial health Officer1994A Report of the health of British Columbians: Provincial health Officer’s Annual Report 1994Ministry of health and Ministry Responsible for SeniorsVictoria, BCGoogle Scholar
  17. Stock, W.A., Okun, M.A., Haring, M.J., Witter, R.A. 1983‘Age differences in subjective well-being: a meta-analysis’Evaluation Studies Review Annual8279302Google Scholar
  18. Sullivan, M., Karlsson, J., Ware, J.E. 1995‘The Swedish SF-36 health survey – 1. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden’Social Science and Medicine4113491358CrossRefPubMedGoogle Scholar
  19. Thommasen, H.V., Newbery, P., Watt, W.D. 1999‘Medical history of Central Coast of British Columbia’B.C. Medical Journal41464470Google Scholar
  20. Ware, J.E., Donald Sherbourne, C. 1992‘The MOS 36-Item Short-Form health Survey (SF-36): IConceptual framework and item selection’. Medical Care30473483Google Scholar
  21. Ware, J.E., Kosinsky, M., Keller, S.D. 1994SF-36 Physical and mental health Summary Scales: A User’s ManualThe health Institute, New England Medical CenterBoston, MassachusettsGoogle Scholar
  22. Ware, J.E., Snow, K.K., Kosinski, M., Gandek, B. 1993SF-36 health Survey: Manual and Interpretation GuideThe health Institute, New England Medical CenterBoston, MassachusettsGoogle Scholar
  23. Zumbo, B.D., Michalos, A.C. 2000‘Quality of life in Jasper, Alberta’Social Indicators Research49121145CrossRefGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Alex C. Michalos
    • 1
    Email author
  • Harvey V. Thommasen
    • 2
  • Rua Read
    • 3
  • Nancy Anderson
    • 4
  • Bruno D. Zumbo
    • 5
  1. 1.Institute for Social Research and EvaluationUniversity of Northern British ColumbiaCanada
  2. 2.University of Northern British ColumbiaCanada
  3. 3.Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  4. 4.Faculty of MedicineUniversity of British Columbia Bella Coola Medical ClinicBella CoolaCanada
  5. 5.Measurement, Evaluation and Research Methodology ProgramUniversity of British ColumbiaVancouverCanada

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