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CHAPTER 1.4. DEFINING WELL-BEING

4.1 The concept "well-being" suffers from the same type of definitional problems as QOL. In their systematic review of the definition and measurement of child well-being, Pollard and Lee describe well-being as "a complex, multi-faceted construct that has continued to elude researchers' attempts to define and measure it". ¹¹⁹ The inconsistency of definitions used, even within individual disciplines, is so great that producing a comprehensive overview of definitions in use within the literature is a formidable task. And, as with QOL, too often researchers do not feel the need to explicitly define the term they are attempting to measure. ¹²⁰

4.2 Because well-being is a particular concern of the economics literature, a fuller discussion of the term, as used within economics, is provided by Professor David Bell in Annex 1. Here we give a broad indication of the range of different types of definition, a selection of examples of which are presented in Annex 4. As these definitions indicate, well-being is conceptualised, variously, as uni- or multi-dimensional; and as either subjective or a combination of the subjective and objective. Distinctions are also made between the cognitive and emotional aspects of well-being.

Well-being: uni- or multi-dimensional?

4.3 Within the field of happiness economics, where the concept of subjective well-being is defined as life satisfaction, it can be both uni- or multi-dimensional. In other words from an economic standpoint, subjective well-being can be defined and measured as both satisfaction with life in general (uni-dimensional) and satisfaction with different aspects, or domains, of life (multi-dimensional). David Bell ( Annex 1) describes how data from the British Household Panel Suvey has been used for economic analyses of subjective well-being. This asks respondents to rate their satisfaction or dissatisfaction with life overall, as well as with a series of life domains, including household income, house/flat, spouse/partner, job, social life, amount of leisure time and use of leisure time.

4.4 Other experts view well-being as either one or the other, but definitions vary even within individual disciplines. An example is the field of social indicators research, where the well-being or QOL or welfare (the term varies) of individuals within different geographic units are being measured and compared. Christoph and Noll argue that subjective well-being is a component part of "welfare", a term they imply is interchangeable, in this context, with "quality of life". ¹²¹ They define subjective well-being in terms of life satisfaction, measuring the subjective well-being of the population in each EU member state using cross-national data on general life satisfaction derived from the European Union's Eurobarometer surveys and data on satisfaction with specific aspects of life derived from the European Community Household Panel. ¹²² Life satisfaction is also, implicitly, the definition employed by Christakopoulou et al in their study of community well-being within urban populations in the UK, Ireland and Greece. However they view well-being as a multi-dimensional concept, which they measure in terms of satisfaction with various aspects of the local community: as a place to live; as a social community; an economic community; a political community; as a personal space with psychological significance for its residents; and as a part of its city. ¹²³

4.5 Similarly, in a study of regional well-being and exclusion within EU regions, Stewart offers no explicit definition of well-being, but describes the concept of well-being in terms of five dimensions, claiming that this definition is "widely used and accepted, although with variations". ¹²⁴ The five dimensions are: material well-being, health, education and literacy, participation in the productive sphere, and participation in the social sphere. Stewart notes that these five dimensions also form part of the Swedish Level of Living Surveys (with the addition of four more domains), and that the indicators selected for these are broadly similar to those used in the UNDP Human Poverty Index for industrialised countries, and to common measures of social exclusion. ¹²⁵ In their review of the child well-being literature, Pollard and Lee identified five separate domains of well-being: physical, psychological, cognitive, social and economic, with each domain spanning a range of indicators, both positive and negative.

4.6 Lastly, the New Zealand government uses the concept of "cultural well-being", which it defines as

"the vitality that communities and individuals enjoy through: participation in recreation, creative and cultural activities; and the freedom to retain, interpret and express their arts, history, heritage and traditions". ¹²⁶

4.7 It is regarded as one of four interconnected forms of well-being, the others being economic, social and environmental. Local authorities are asked to "integrate and balance these four types of well-being in planning and practice." ¹²⁷

"Well-being" and "subjective well-being"

4.8 Writers who view well-being as interchangeable with QOL, sometimes differentiate between well-being - which may incorporate objective conditions - and subjective well-being, which is well-being as defined, or assessed, by individuals themselves, and which may include subjective response to objective conditions. ¹²⁸ For example Haas criticises the common interpretation of well-being as purely psychological or emotional - for some it is synonymous with mental health or "psychological well-being" ¹²⁹ - and argues that well-being "is concerned with all dimensions of life. Like satisfaction with life, it is a subjective assessment." ¹³⁰

4.9 Many authors use the terms "well-being" or "subjective well-being" without an explicit definition. Instead the types of measurements suggested, or the way in which the term is used, imply a meaning. Thus assessments of well-being often measure individuals' happiness or satisfaction with life. For example, the Australian Unity Well-being Index is described as a "barometer of Australians' satisfaction with their lives, and life in Australia". ¹³¹ Other authors suggest that subjective well-being can be measured using self-rating questions about "happiness" and "life satisfaction". ¹³² Helliwell and Putnam distinguish between these two terms, explaining that:

"Generally speaking, self-ratings of 'happiness' turn out to reflect relatively short-term, situation-dependent (affective) expressions of mood, whereas self-ratings of 'life satisfaction' appear to measure longer-term, more stable (cognitive) evaluations". ¹³³ (parentheses added)

4.10 Evidence from psychology studies suggests that ratings of life satisfaction/ dissatisfaction are a reasonably reliable indicator of how people feel about their lives, providing a good sense of individuals' subjective well-being. ¹³⁴ On this basis, economists have generally come to accept life satisfaction as a useful measure of subjective well-being ( See Bell, Annex 1). However economists also accept the evidence from psychology studies that individuals' expressions of life satisfaction reflect a number of different aspects of their self-perception, related to their life opportunities and outcomes. These may be both subjective and objective ("inner" and "outer" qualities), and the extent to which individuals value each of these may vary. This is illustrated in Table 4.1.

Table 4.1. Four kinds of being "well"

Source: Veenhoven (1988) ¹³⁵

4.11 Diener and Suh propose a model of subjective well-being which requires measures of 3 factors: life satisfaction, pleasant and unpleasant affect. An individual can have high subjective well-being on one of these, but be low on the others. ¹³⁶

"As the term indicates, subjective well-being is primarily concerned with the respondents' own internal judgements of well-being, rather than what policymakers, academics, or others consider important." ¹³⁷

4.12 They conclude however that an accurate QOL assessment requires a combination of subjective well-being and social indicators approaches. ¹³⁸

How does well-being relate to quality of life?

4.13 There are competing views about the relationship between QOL and well-being. ¹³⁹

Some regard the terms as interchangeable, while others regard well-being as one component of the broader concept of QOL. ¹⁴⁰ This is reflected in the findings of a systematic review of health-related QOL models carried out by Tailleffer et al which found that of the 68 models evaluated, the concept of well-being was found in the definition of QOL of 27.9/ 30.9% of these. ¹⁴¹ In other words, in the majority of models well-being was regarded as a concept related to, but separate from, the concept of QOL.

4.14 Economists make a clear distinction between well-being, which in their view pertains to individuals, and QOL, which they see as concerned with comparisons of welfare between individuals (through social indicators for example), an objective viewed with scepticism. ¹⁴² However economists' models of subjective well-being are similar to QOL models to the extent that subjective well-being is associated with a range of objective, external factors relating to a person's life:

"Taken together, the now extensive subjective well-being literature in economics has convincingly demonstrated important associations between how individuals describe their level of satisfaction and observable characteristics of both themselves and the society they live in." ¹⁴³

4.15 These include external characteristics of individuals, such as gender, age, family and employment status, income, education and volunteering, as well as external characteristics of the social environment in which individuals live including GDP, the quality of governance and levels of interpersonal trust (social relationships). ¹⁴⁴ Whereas QOL experts advocate the use of combination methods, economic studies of subjective well-being tend to be based on the statistical analyses of quantitative data alone.

4.16 Amongst the quarter to one third of QOL models which utilised the concept of well-being, some defined QOLas well-being (explicitly - Felce and Perry (1995), Naess (1999), Kahn and Juster (2002) or implicitly - Janse et al (2004). In other words, QOL and well-being are one and the same. Alternatively QOL is sometimes equated with other subjective concepts such as satisfaction with life. ¹⁴⁵

4.17 Other models regard well-being as a component of QOL. For example, Vittersø sees the term QOL as combining both objective and subjective dimensions, which he describes as "objective well-being" and "subjective well-being". Subjective well-being is described as comprising "people's evaluative responses to their lives", both cognitive ("satisfaction") and emotional ("happiness"). ¹⁴⁶

4.18 Schalock's definition of individual QOL contains 3 domains associated with specific aspects of well-being, suggesting that well-being is a determinant of QOL. However, he also says that "The term " QOL domains" refers to the set of factors composing personal well-being." ¹⁴⁷ The concepts of well-being and QOL are therefore very closely related in Schalock's model, but the exact relationship appears confused.

4.19 Subjective assessment is required to evaluate well-being. It would therefore seem to be separate from QOL, which is most commonly regarded as combining both subjective and objective components.

4.20 Haas describes the relationship, and differentiation between QOL and related concepts such as well-being (she also mentions life satisfaction, functional status and health status) as the second major area that requires further study in QOL research. ¹⁴⁸ She concludes on the necessity to "tease out the fine distinctions among these closely related concepts." ¹⁴⁹

4.21 Haas proposes the following as a "step out of the quagmire of poorly defined QOL"

"First, the terms QOL, satisfaction with life, functional status, and well-being can no longer be used interchangeably. They represent different levels and aspects of the broad concept of QOL. If one chooses to focus on the subjective aspects of QOL, then it must be clear that that is what is being discussed is either 'well-being' or 'subjectively perceived QOL.' For those who choose to focus on objective indicators of QOL, it must be clearly identified as either 'functional status' or 'objectively perceived QOL.' Those who study satisfaction with life must either clearly state that as the purpose of their investigation or make it clear that they are interested in studying an aspect of well-being or subjectively perceived QOL. Those who claim to be reporting on QOL must provide evidence of subjective and objective indicators. If they do not, they should acknowledge that a particular aspect of QOL is being addressed." ¹⁵⁰

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