Social Indicators Research

, Volume 51, Issue 3, pp 245–286 | Cite as

Health and the Quality of Life

  • Alex C. Michalos
  • Bruno D. Zumbo
  • Anita Hubley


The aim of this investigation was to explain theimpact of people’s self-reported health on theirlevels of satisfaction with their health, and theimpact of these things plus satisfaction with otherspecific domains of their lives on the perceivedquality of their lives. The latter was operationalized as general happiness, satisfactionwith life as a whole and overall satisfaction with thequality of life. Seven hundred and twenty-three (723)usable questionnaires returned from a mailout randomsample of 2500 households of Prince George, BritishColumbia in November 1998 formed the working data-setfor our analyses. Among other things, mean respondentscores on the SF-36 health profile were found to belower than published norms from the UK, USA,Netherlands and Sweden, but higher than scores fromAberdeen, Scotland. Mean scores on the CES-Ddepression scale also indicated that our respondentstended to have more depressive symptoms thancomparison groups in Winnipeg and the USA. A review oftrends in mean scores on 17 quality of life items(e.g., satisfaction with family life, financialsecurity, recreation, etc.) from 1994, 1997 and 1998revealed that there were only 7 statisticallysignificant changes across the four year period andthey were all negative. Multivariate regressionanalysis showed that health status measured with avariety of indicators could explain 56% of thevariation in respondents’ reported satisfaction withtheir health. A combination of health status plusdomain satisfaction indicators could explain 53% ofthe variation in respondents’ reported happiness, 68%of reported life satisfaction and 63% of reportedsatisfaction with the overall quality of life. Sixtypercent of the explained variation in happiness scoreswas attributable to self-reported health scores, whileonly 18% of the explained variation in satisfactionwith life and with the overall quality of life scoreswas attributable self-reported health scores.


Health Status Depressive Symptom Life Satisfaction Family Life Health Score 
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  1. Aaronson, N. K., F. S. A. M. van Dam, C. E. Polak and R. Zittoun: 1986, ‘Prospects and problems in European psychosocial oncology: a survey of the EORTC study group on quality of life’, Journal of Psychosocial Oncology 4, pp. 43-53.Google Scholar
  2. Affleck, G.: 1987, ‘Downward comparison and coping with serious medical problems’, American Journal of Orthopsychiatry 57, pp. 570-578.Google Scholar
  3. Andrews, F. M. and S. B. Withey: 1976, Social Indicators ofWell-Being (Plenum Press, New York).Google Scholar
  4. Andres, D., D. P. Gold, T. Arbuckle, A. Schwartzman and J. Chaikelson: 1990, Psychosocial determinants of self-reported health in elderly men, Paper presented at the Canadian Association on Gerontology conference, Victoria, BC.Google Scholar
  5. Angel, R. and P. Thoits: 1987, ‘The impact of culture on the cognitive structure of illness’, Culture, Medicine and Psychiatry 11, pp. 465-494.Google Scholar
  6. Balaban, D. J., P. C. Sagi, N. I. Goldfarb and S. Nettler: 1986, ‘Weights for scoring the quality of well-being (QWB) instrument among rheumatoid arthritis: a comparison to general population weights’, Medical Care 24, pp. 973-980.Google Scholar
  7. Barnes, G. E., R. F. Currie and A. Segall: 1988, ‘Symptoms of depression in a Canadian urban sample’, Canadian Journal of Psychiatry 33, pp. 386-392.Google Scholar
  8. Bergner, M.: 1989, ‘Quality of life, health status, and clinical research, Medical Care 27, pp. S148-S156.Google Scholar
  9. 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, pp. 787-805.Google Scholar
  10. Binik, Y. M. and G. M. Devins: 1986-1987, ‘Transplant failure does not compromise quality of life in end-stage renal disease’, International Journal of Psychiatry in Medicine 16, pp. 281-292.Google Scholar
  11. Blackwell, D. and L. Levy: 1987, ‘Hearing impairment, self-concept, and morale among elderly’, Free Inquiry in Creative Sociology 15, pp. 21-26.Google Scholar
  12. Blalock, S. J., B.M. DeVellis and R. F. DeVellis: 1989, ‘Social comparison among individuals with rheumatoid arthritis’, Journal of Applied Social Psychology 19, pp. 665-680.Google Scholar
  13. Blalock, S. J., et al.: 1990, ‘Adjustment to rheumatoid arthritis: the role of social comparison processes’, Health Education Research 5, pp. 361-370.Google Scholar
  14. Blodgett, C.: 1981-1982, ‘A selected review of the literature of adjustment to hemodialysis’, International Journal of Psychiatry Medicine 11, pp. 97-123.Google Scholar
  15. Breslow, L.: 1989, ‘Health status measurement in the evaluation of health promotion’, Medical Care 27, pp. S205-S216.Google Scholar
  16. Brown, R. I.: 1989, ‘Aging, disability and quality of life: a challenge for society’, Canadian Psychology/ Psychologie Canadienne 30, pp. 551-559.Google Scholar
  17. Bryant, F. B. and J. T. Marquez: 1986, ‘Educational status and the structure of subjective well-being in men and women’, Social Psychology Quarterly 49, pp. 142-153.Google Scholar
  18. Burckhardt, C. S.: 1985, ‘The impact of arthritis on quality of life’, Nursing Research 34, pp. 11-16.Google Scholar
  19. Busse, E. W., F. C. Jeffers and W. D. Obrist: 1970, ‘Factors in age awareness’, in E. Palmore (ed.), Normal aging: Reports from the Duke Longitudinal Study, 1955-1969. (Duke University Press: Durham, NC).Google Scholar
  20. Buunk, B. P., et al.: 1990, ‘The affective consequences of social comparison: either direction has its ups and downs’, Journal of Personality and Social Psychology 59, pp. 1238-1249.Google Scholar
  21. Callan, V. J. and J. F. Hennessey: 1988, ‘The psychological adjustment of women experiencing infertility’, British Journal of Medical Psychology 61, pp. 137-140.Google Scholar
  22. Callan, V. J. and J. F. Hennessey: 1989, ‘Psychological adjustment to infertility: a unique comparison of two groups of infertile women, mothers and women childless by choice’, Journal of Reproductive and Infant Psychology 7, pp. 105-112.Google Scholar
  23. Campbell, A. P., P. E. Converse and W. L. Rodgers: 1976, The Quality of American Life (Russell Sage Foundation, New York).Google Scholar
  24. Carp, F. M. and A. Carp: 1981, ‘Mental health characteristics and acceptancerejection of old age’, American Journal of Orthopsychiatry 51, pp. 230-241.Google Scholar
  25. Chuang, H. T., G. M. Devins, J. Hunsley and M. J. Gill: 1989, ‘Psychosocial distress and well-being among gay and bisexual men with human immunodeficiency virus infection’, American Journal of Psychiatry 146, pp. 876-880.Google Scholar
  26. Chwalisz, K., E. Diener and D. Gallagher: 1988, ‘Autonomic arousal feedback and emotional experience: evidence from the spinal cord injured’, Journal of Personality and Social Psychology 54, pp. 820-828.Google Scholar
  27. Cooper, A. F.: 1976, ‘Deafness and psychiatric illness’, British Journal of Psychiatry 129, pp. 216-226.Google Scholar
  28. Devellis, R. F., B.M Devellis, B. S. Wallston and K. A. Wallston: 1980, ‘Epilepsy and learned helplessness’, Basic and Applied Social Psychology 1, pp. 241-253.Google Scholar
  29. Devellis, R. F., et al.: 1990, ‘The relationship of social comparison to rheumatoid arthritis symptoms and affect’, Basic and Applied Social Psychology 11, pp. 1-18.Google Scholar
  30. Devins, G. M.:1989, ‘Enhancing personal control and minimizing illness intrusiveness’, in N. G. Kutner, D. D. Cardenas and J. D. Bower (eds.), Maximizing Rehabilitation in Chronic Renal Disease (PMA Pub. Group, New York), pp. 109-136.Google Scholar
  31. Devins, G. M. and T. P. Seland: 1987, ‘Emotional impact of multiple sclerosis: recent findings and suggestions for future research’, Psychological Bulletin 101, pp. 363-375.Google Scholar
  32. Dupuy, H. J.: 1984, ‘The psychological general well-being (PGWB) index’, in N. K. Wenger, M. E. Mattson, C. D. Furberg and J. Elinson (eds.), Assessment of Quality of Life in Clinical Trials of Cardiovascular Therapies (Le Jacq Pub., New York), pp. 170-183.Google Scholar
  33. Fayers, P. M. and D. R. Jones: 1983, ‘Measuring and analysing quality of life in cancer clinical trials: a review’, Statistics in Medicine 2, pp. 429-446.Google Scholar
  34. Garratt, A. M., D. A. Ruta, M. I. Abdalla, J. K. Buckingham and I. T. Russell: 1993, ‘the SF-36 health survey questionnaire: an outcome measure suitable for routine use within the NHS’, British Medical Journal 306, pp. 1440-1444.Google Scholar
  35. Gfellner, B.M.: 1989, ‘Perceptions of health, abilities, and life satisfaction among very old adults’, Perceptual and Motor Skills 68, pp. 203-209.Google Scholar
  36. Gillman, A. E., A. Simmel and E. P. Simon: 1986, ‘Visual handicap in the aged: self-reported visual disability and the quality of life of residents of public housing for the elderly’, Journal of Visual Impairment and Blindness 79, pp. 588-590.Google Scholar
  37. Goodinson, S. M. and J. Singleton: 1989, ‘Quality of life: a critical review of current concepts, measures and their clinical implications’, International Journal of Nursing Studies 26, pp. 327-341.Google Scholar
  38. Gray, H., D. Brogan and N.G. Kutner: 1985, ‘Status of life-areas: congruence/noncongruence in ESRD patient and spouse perceptions’, Social Science and Medicine 20, pp. 341-346.Google Scholar
  39. Haes, J. C. J. M. de and F. C. E. Van Knippenberg: 1985, ‘The quality of life of cancer patients: a review of the literature’, Social Science and Medicine 20, pp. 809-817.Google Scholar
  40. Han, T. S., M. A. R. Tijhuis, M. E. J. Lean and J. C. Seidell: 1998, ‘Quality of life in relation to overweight and body fat distribution’, American Journal of Public Health 88(12), pp. 1814-1821.Google Scholar
  41. Hays, R. D. and C. E. Ross: 1986, ‘Body and mind: the effect of exercise, overweight, and physical health on psychological well-being’, Journal of Health and Social Behavior 27, pp. 387-400.Google Scholar
  42. Healthy Communities Committee: 1997, Report on the Quality of Life in Prince George (City of Prince George, BC).Google Scholar
  43. Hollandsworth, J. G.: 1988, ‘Evaluating the impact of medical treatment on the quality of life: a 5-year update, Social Science and Medicine 26, pp. 425-434.Google Scholar
  44. Hubley, A. M.: 1991, ‘The relationship of personality trait variables to two measures of subjective age identity: A symbolic interactionist perspective’, Unpublished Master’s thesis (University of Victoria, Victoria, BC).Google Scholar
  45. Hurny, C., E. Piasetsky, R. Bagin and J. Holland: 1987, ‘High social desirability in patientsbeing treated for advanced colorectal or bladder cancer: eventual impact on the assessment of quality of life’, Journal of Psychosocial Oncology 5, pp. 19-29.Google Scholar
  46. Jenkinson, C., A. Coulter and L. Wright: 1993 Short form 36 (SF-36) health survey questionnaire: normative data for adults of working age’, British Medical Journal 306, pp. 1437-1440.Google Scholar
  47. Johnson, J. P., C. R. McCauley and J. B. Copley: 1982, ‘The quality of life of hemodialysis and transplant patients’, Kidney International 22, pp. 286-291.Google Scholar
  48. Kaplan, R. M., J. W. Bush and C. C. Berry: 1976, ‘Health status: types of validity for an index of well-being’, Health Services Research 11, pp. 478-507.Google Scholar
  49. Katz, J. N., M. G. Larson, C. B. Phillips, A. H. Fossel and M. H. Liang: 1992, ‘Comparative measurement sensitivity of short and longer health status instruments’, Medical Care 30, pp. 917-925.Google Scholar
  50. Kibele, A.: 1989, ‘Occupational therapy’s role in improving the quality of life for persons with cerebral palsy’, American Journal of Occupational Therapy 43, pp. 371-377.Google Scholar
  51. Klonoff, P. S., L. D. Costa and W. G. Snow: 1986, ‘Predictors and indicators of quality of life in patients with closed-head injury’, Journal of Clinical and Experimental Neuropsychology 8, pp. 469-485.Google Scholar
  52. Lehman, A. F.: 1983, ‘The well-being of chronic mental patients’, Archives of General Psychiatry 40, pp. 369-373.Google Scholar
  53. Lehman, A. F., N. C. Ward and L. S. Linn: 1982, ‘Chronic mental patients: the quality of life issue’, American Journal of Psychiatry 139, pp. 1271-1276.Google Scholar
  54. Lewinsohn, P. M., J. R. Seeley, R. E. Roberts and N. B. Allen: 1997, ‘Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults’, Psychology and Aging 12, pp. 277-287.Google Scholar
  55. Lezak, M. D.: 1987, ‘Relationships between personality disorders, social disturbances, and physical disability following traumatic brain injury’, Journal of Head Trauma Rehabilitation 2, pp. 57-69.Google Scholar
  56. Logan, J. R., R. Ward and G. Spitze: 1992, ‘As old as you feel: Age identity in middle and later life’, Social Forces 71, pp. 451-467.Google Scholar
  57. Lomas, J., L. Pickard and A. Mohide: 1987, ‘Patient versus clinician item generation for quality-of-life measures’, Medical Care 25, pp. 764-769.Google Scholar
  58. Magilvy, J. K.: 1985, ‘Quality of life of hearing-impaired older women’, Nursing Research 34, pp. 140-144.Google Scholar
  59. Mai, F.M., F. N. McKenzie and W. J. Kostuk: 1990, ‘Psychosocial adjustment and quality of life following heart transplantation’, Canadian Journal of Psychiatry 35, pp. 223-227.Google Scholar
  60. Markides, K. S. and C. Pappas: 1982, ‘Subjective age, health, and survivorship in old age’, Research on Aging 4, pp. 87-96.Google Scholar
  61. Mayer, T. and H. B. Andrews: 1981, ‘Changes in self-concept following a spinal cord injury’, Journal of Applied Rehabilitation Counseling 12, pp. 135-137.Google Scholar
  62. McHorney, C. A., J. E. Ware and A. E. Raczek: 1993, ‘The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and Clinical Tests of Validity in Measuring Physical and Mental Health Constructs’, Medical Care 31(3), pp. 247-263.Google Scholar
  63. McHorney, C. A., J. E. Ware, J. F. R. Lu and C. Donald Sherbourne: 1994, ‘The MOS 36-Item Short-Form Health Survey (SF-36): III Tests of Data Quality, Scaling Assumptions, and Reliability Across Diverse Patient Groups’, Medical Care 32(1), pp. 40-66.Google Scholar
  64. Mechanic, D. and R. J. Angel: 1987, ‘Some factors associated with the report and evaluation of back pain’, Journal of Health and Social Behavior 28, pp. 131-139.Google Scholar
  65. Mechanic, D. and S. Hansell: 1987, ‘Adolescent competence, psychological wellbeing, and self-assessed physical health’, Journal of Health and Social Behavior 28, pp. 364-374.Google Scholar
  66. Michalos, A. C.: 1985, ‘Multiple discrepancies theory (MDT), Social Indicators Research 16, pp. 347-413.Google Scholar
  67. Michalos, A. C.: 1991, Global Report on Student Well-Being, Vol. 1, Life Satisfaction and Happiness (Springer-Verlag, New York).Google Scholar
  68. 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
  69. Michalos, A. C.: 1993, Global Report on Student Well-Being, Vol. 3, Employment, Finances, Housing and Transportation (Springer-Verlag, New York).Google Scholar
  70. Michalos, A. C.: 1993a, Global Report on Student Well-Being, Vol. 4, Religion, Education, Recreation and Health (Springer-Verlag, New York).Google Scholar
  71. Michalos, A. C. and B. D. Zumbo: 1999, ‘Public services and the quality of life’, Social Indicators Research, 48, pp. 125-156.Google Scholar
  72. Milligan, W. L., D. A. Powell, C. Harley and E. Furchtgott: 1985, ‘Physical health correlates of attitudes toward aging in the elderly’, Experimental Aging Research 11, pp. 75-80.Google Scholar
  73. Montepare, J. M. and M. E. Lachman: 1989, “You’re only as old as you feel’: self-perceptions of age, fears of aging, and life satisfaction from adolescence to old age’, Psychology and Aging 4, pp. 73-77.Google Scholar
  74. Mulkay, M., M. Ashmore and T. Pinch: 1987, ‘Measuring the quality of life: a sociological invention concerning the application of economics to health care’, Sociology 21, pp. 541-564.Google Scholar
  75. Mutran, E. and P. J. Burke: 1979, ‘Personalism as a component of old age identity’, Research on Aging 1, pp. 37-64.Google Scholar
  76. Nadel, C. and J. J. Clark: 1986, ‘Psychosocial adjustment after renal retransplants, General Hospital Psychiatry 8, pp. 41-48.Google Scholar
  77. Naughton, M. J., S. A. Shumaker, R. T. Anderson and S. M. Czajkowski: 1996, ‘Psychological aspects of health-related quality of life measurement: tests and scales’, in B. Spilker (ed.), Quality of Life and Pharmacoeconomics in Clinical Trials (Lippincott-Raven, Philadelphia) pp. 117-131.Google Scholar
  78. Okun, M. A., W. A. Stock, M. J. Haring and R. A. Witter: 1984, ‘Health and subjective well-being: a meta-analysis’, International Journal of Aging and Human Development 19, pp. 111-132.Google Scholar
  79. Pearlman, R. A. and A. Jonsen: 1985, ‘The use of quality-of-life considerations in medical decision making, Journal of the American Geriatrics Society 33, pp. 344-352.Google Scholar
  80. Query, J. M., C. Reichelt and L. A. Christoferson: 1990, ‘Living with chronic illness: a retrospective study of patients shunted for hydrocephalus and their families’, Development Medicine and Child Neurology 32, pp. 119-128.Google Scholar
  81. Radloff, L. S.: 1977, ‘The CES-D scale: A self-report depression scale for research in the general population’, Applied Psychological Measurement 1, pp. 385-401.Google Scholar
  82. Ramund, B. and R. Stensman: 1988, ‘Quality of life and evaluation of functions among people with severely impaired mobility and non-disabled controls’, Scandinavian Journal of Psychology 29, pp. 137-144.Google Scholar
  83. Sabourin, S., L. Bourgeois, P. Gendreau and M. Morval: 1989, ‘Self-deception, impression management, and consumer satisfaction with mental health treatment, Psychological Assessment: A Journal of Consulting and Clinical Psychology 1, pp. 126-129.Google Scholar
  84. Sabourin, S., et al.: 1989, ‘Social desirability, psychological distress, and consumer satisfaction with mental health treatment’, Journal of Counseling Psychology 36, pp. 352-356.Google Scholar
  85. Scheier, M. F., et al.: 1989, ‘Dispositional optimism and recovery from coronary artery bypass surgery: the beneficial effects on physical and psychological wellbeing’, Journal of Personality and Social Psychology 57, pp. 1024-1040.Google Scholar
  86. Schulz, R. and S. Decker: 1985, ‘Long-term adjustment to physical disability: the role of social support, perceived control and self-blame’, Journal of Personality and Social Psychology 48, pp. 1162-1172.Google Scholar
  87. Schulz, R. and S. Fritz: 1987, ‘Origins of stereotypes of the elderly: an experimental study of the self-other discrepancy’, Experimental Aging Research 13, pp. 189-195.Google Scholar
  88. Shadish, W. R., R. G. Orwin, B. G. Silber and R. R. Bootzin: 1985, ‘The subjective well-being of mental patients in nursing homes’, Evaluation and Program Planning 8, pp. 239-250.Google Scholar
  89. Shmueli, A.: 1998, ‘The SF-36 profile and health-related quality of life: an interpretive analysis’, Quality of Life Research 7(3), pp. 187-195.Google Scholar
  90. Spilker, B.: 1996, Quality of Life and Pharmacoeconomics in Clinical Trials (Lippincott-Raven, Philadelphia).Google Scholar
  91. Spitzer, W. O. et al.: 1981, ‘Measuring the quality of life of cancer patients’, Journal of Chronic Disease 34, pp. 585-597.Google Scholar
  92. Staats, S., K. Heaphey, D. Miller, C. Partlo, N. Romine and K. Stubbs: 1993, ‘Subjective age and health perceptions of older persons: Maintaining the youthful bias in sickness and in health’, International Journal of Aging and Human Development 37, pp. 191-203.Google Scholar
  93. Steitz, J. A. and A. M. McClary: 1988, ‘Subjective age, age identity and middleage adults’, Experimental Aging Research 14, pp. 83-87.Google Scholar
  94. Stensman, R.: 1985, ‘Severely mobility-disabled people assess the quality of their lives’, Scandinavian Journal of Rehabilitation Medicine 17, pp. 87-99.Google Scholar
  95. Suchman, E. A. and B. S. Phillips: 1958, ‘An analysis of the validity of health questionnaires, Social Forces 36, pp. 223-232.Google Scholar
  96. Sullivan, M., J. Karlsson and J. E. Ware: 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 Medicine 41(10), pp. 1349-1358.Google Scholar
  97. Taylor, S. E.: 1983, ‘Adjustment to threatening events: a theory of cognitive adaptation’, American Psychologist 38, pp. 1161-1173.Google Scholar
  98. Thomas, D. R., E. Hughes and B. D. Zumbo: 1998, ‘On variable importance in linear regression, Social Indicators Research 45(1-3), pp. 253-275.Google Scholar
  99. Thomas, W. C.: 1981, ‘The expectation gap and the stereotype of the stereotype: images of old people’, Gerontologist 21, pp. 402-407.Google Scholar
  100. Wacker, D. P., D. C. Harper, W. J. Powell and A. Healy: 1983, ‘Life outcomes and satisfaction ratings of multihandicapped adults’, Developmental Medicine and Child Neurology 25, pp. 625-631.Google Scholar
  101. Ware, J. E., M. Kosinsky and S. D. Keller: 1994, SF-36 Physical and Mental Health Summary Scales: A User’s Manual (The Health Institute, New England Medical Center, Boston, Massachusetts).Google Scholar
  102. Ware, J. E. and C. Donald Sherbourne: 1992, ‘The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection, Medical Care 30(6), pp. 473-483.Google Scholar
  103. 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, Massachusetts).Google Scholar
  104. Williams, A.: 1985, ‘Economics of coronary artery bypass grafting, British Medical Journal 291, pp. 326-329.Google Scholar
  105. Wood, J. V., S. E. Taylor and R. R. Lichtman: 1985, ‘Social comparison in adjustment to breast cancer’, Journal of Personality and Social Psychology 49, pp. 1169-1183.Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Alex C. Michalos
    • 1
  • Bruno D. Zumbo
    • 2
  • Anita Hubley
    • 2
  1. 1.Institute for Social Research and EvaluationUniversity of Northern British ColumbiaPrince George
  2. 2.Institute for Social Research and EvaluationUniversity of Northern British ColumbiaPrince George

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