QUALITY-OF-LIFE RESEARCH

Ruut Veenhoven

in: Bryant, C.D. & Peck, D.L. ‘21st Century Sociology, A Reference Handbook’
Sage, Thousand Oaks, California USA 2007. ISBN 978-1-4129-1608-0 Volume 2, chapter 7, pp 54-62

1 INTRODUCTION

As a fairly new interdisciplinary field of inquiry the quality of life research has benefited greatly
from the discipline of sociology. The field consists of five overlapping traditions, namely 1)
social indicators research, 2) happiness studies, 3) gerontology of successful aging, 4) psychology
of wellbeing and 5) health related quality-of-life research. The efforts of sociologists are
particularly prominent in the first two of these traditions. Quality-of-life is also a major issue in
the fields of the sociology of work and sociology of the family.
Quality-of-life has always been a topic of interest in philosophy where quality of life
or the good life is viewed as a virtuous life. However, philosophers tend to disagree on what
virtues are the most important. Thus, the philosophical approach is speculative and tends to be
based on the philosopher’s personal experiences in life. In the late 20th century, however, quality-
of-life became a topic of interest in the social sciences. Social scientists deal in a more empirical
way with the subject and systematically gather data on the experiences of other people. In 1995,
Quality-of-life research became institutionalized with the founding of the International Society
for Quality Of Life Studies.

Scientific roots
The theme of “quality-of-life” developed almost simultaneously in several fields of the social
sciences. In sociology, quality-of-life was often an implicit theme in socio-graphic studies, such
as the portraits of rural life in the United States conducted by Ogburn (1946). Quality-of-life
became a main issue in the 'social indicators research' that emerged in the 1960s as a reaction
against the domination of economic indicators in the policy process. Initially, the emphasis was
on ‘objective’ indicators of wellbeing, such as poverty, sickness and suicide, subjective indicators
were added during the 1970s. Landmark books in this latter tradition are Social Indicators of
Well-being: Americans Perceptions of Life Quality, by Andrews and Withey (1976) and ‘The
Quality of American Life: Perceptions, Evaluations and Satisfactions’ by Campbell (1981).
Perceived quality-of-life is now a central issue in social reports in most developed countries and
items on that matter are standard in periodical social surveys. Quality-of-life has also become an
area of interest within the sociology of work, the sociology of housing and family sociology
(Schuessler and Fisher 1985; Ferriss 2004).
In psychology, the first quality-of-life studies were conducted as a part of research into
‘successful aging’. A typical book of this kind would be ‘Personal Adjustment in Old Age’ by Cavan,
Burgess, Goldhamer, and Havighurst (1949). In the 1960s, the topic also appeared studies of
mental health such as ‘Americans View their Mental Health: A Nationwide Interview Survey’ by
Gurin, Veroff and Feld (1960) and the groundbreaking cross-national study on

Correspondence: Prof. Dr. Ruut Veenhoven Erasmus University Rotterdam, Faculty of Social Sciences,
P.O.B. 1738 3000 DR Rotterdam, Netherlands. www2.eur.nl/fsw/research/veenhoven
 Ruut Veenhoven 2 Quality-of-life research

The Pattern of Human Concerns by Cantril (1965) in a book by that same title now a common
issue in psychological research and is often referred to as "subjective well-being" (Diener, Lucas,
Smith, and Suh (1999).
In the 1980s, quality-of-life issues also began to appear in medical research with a focus
on patient perceptions of their condition. Typically measured using standard questionnaires such
as the Lancaster Quality-of-Life Inventory developed by Lehman (1988), this area of inquiry
field has focused on “Health Related Quality-of-Life” and on “Patient Reported Outcomes”.
Other medically related quality of life studies include residential care (e.g. Clark and Bowling
1990) and handicapped persons (e.g. Schalock 1997).
In the 1990s, quality-of life became also an issue in economy. An early bird n was
Bernard VanPraag who summarized much of his work in Happiness Quantified: A Satisfaction
Calculus Approach (2004). Another recent account is ‘Happiness and Economics’ by Bruno Frey
and Alois Stutzer (2002).

Social Roots
Quality-of-life research has its roots in several social developments. One is the rise in the
material standard of living and a concomitant reduction of famine and physical illness. The more
humans are free of these ills, the more evident ways for further improvement became. Interest in
quality-of-life was also stirred by the rise of individualism. The more choices available the more
interested people become in quality of life issues and alternative ways of living. Ideologically,
this orientation is manifested in a revival of utilitarian moral philosophy, in which happiness is
the central goal (Bentham 1789).
When the post-war economic boom of the 1960s was followed by disenchantment with
economic growth, a common slogan of that time was 'more well-being rather than more wealth',
and this raised questions of what well-being actually is and how it can be furthered. These period
of time also witnessed disenchantment with medical technology and a related call for more
'quality-of-life' rather than mere extension-of-life. Much of this criticism was voiced by the
patient-organizations that developed around this time. Health related quality-of-life research was
also furthered by the movement towards 'evidence based' treatment in healthcare that began to
come into force in the 1980s. Quality-of-life was soon seen as a relevant side effect of cure and
as a major outcome of care. Consequently, quality-of-life became one of the indicators in
systematic research into the effects of drugs and treatment protocols.

2 CONCEPTS OF 'QUALITY-OF-LIFE'

All social science deals with ‘quality-of-life’ in some way. Sociological subjects such as income,
power and prestige can be seen as qualities and this is also true for psychological subjects such as
intelligence and mental health. The crux of quality-of-life research is in its inclusiveness, quality-
of-life research is not about specific qualities of life but about overall quality. The concept is
typically used to strike a balance and designate the desired overall outcome of policies and
programs (Schuessler and Fisher 1985: 129).
In practice the term 'quality-of-life' is used for different notions of the good life. For the
most part quality of life denotes bunches of qualities of life, bunches that can be ordered on the
basis of two distinctions. The first distinction is between opportunities for a good life and the
outcomes of life. This distinction is quite common in the field of public-health research. Pre-
conditions for good health, such as adequate nutrition and professional care are seldom mixed up
 Ruut Veenhoven 3 Quality-of-life research

with health itself. A second difference is between external and inner qualities. In the first case the
quality is in the environment, in the latter it is in the individual. This distinction is also quite
common in public health. External pathogens are distinguished from inner afflictions. The
combination of these two dichotomies yields a fourfold matrix, as shown in scheme 1.
In the upper half of the scheme, we see next to the outer opportunities in one's environment,
the inner capacities required to exploit these. The environmental conditions can be denoted by the
term livability, the personal capacities by the term life-ability. This difference is not new. In
sociology, the distinction between 'social capital' and 'psychological capital' is sometimes used in
this context, and in the psychology of stress the difference is labeled negatively in terms of 'burden'
and 'bearing power'.
The lower half of the scheme is about the quality of life with respect to its outcomes. These
outcomes can be judged by their value for one's environment and by their value for oneself. The
external worth of a life is denoted by the term utility of life, the inner valuation of which is called
appreciation of life.

2.1.1 Livability of the environment

The left top quadrant denotes the meaning of good living conditions, or 'livability'. One can also
speak of the 'habitability' of an environment, though that term is also used for the quality of
housing (Veenhoven 1996:7-9). Ecologists view livability in the natural environment and
describe it in terms of pollution, global warming and degradation of nature. Currently, livability
is typically associated with environmental preservation. On the other hand, city planners see
livability in the built environment and associate it with sewerage systems, traffic jams and ghetto
formation. Here the good life is seen as a fruit of human intervention. In public health this all is
referred to as a 'sane' environment.
Society is central in the sociological view. Firstly, livability is associated with the quality of
society as a whole. Classic concepts of the ‘good society’ stress material welfare and social equality,
sometimes equating the concept more or less with the welfare state. Current notions of community
emphasize close networks, strong norms and active voluntary associations; the reverse of this
livability concept is ‘social fragmentation’. Secondly, livability is seen in one’s position in society.
For a long time, the emphasis was on the ‘under-class’ but currently attention is shifting to “class
exclusion” or a class of people who are deprived and excluded.

2.1.2 Life-ability of the person

Life-chances or “life-ability” suggest how well people are equipped to cope with the problems of
life. The most common depiction of this aspect of quality of life is the absence of functional defects.
This is 'health' in the limited sense, sometimes referred to as 'negative health'. In this context, doctors
focus on unimpaired functioning of the body, while psychologists stress the absence of mental
defects. This use of words presupposes a 'normal' level of functioning. Good quality of life is the
body and mind working as designed. This is the common meaning used in curative care.
Next to absence of disease is the excellence of function, or “positive health” that is
associated with energy and resilience. Psychological concepts of positive mental health also involve
autonomy, reality control, creativity and inner synergy of traits and strivings. This broader definition
is the favorite of training professions and is central to the 'positive psychology' movement.

2.1.3 Utility of Life

The utility of life represents the notion that a good life must be good for something more than
itself. When evaluating the external effects of a life, one can consider the utility of life
functionality for the environment. In this context, doctors stress how essential a patient's life is to
their intimates. At a higher level, quality of life is seen in contributions to society, the contributions
 Ruut Veenhoven 4 Quality-of-life research

an individual can make to human culture. Moralists see quality in the preservation of the moral
order, and would deem the life of a saint to be better than that of a sinner. In this vein, the quality of
a life is also linked to effects on the ecosystem. Ecologists see more quality in a life lived in a
'sustainable' manner than in the life of a polluter. Gerson (1976: 795) calls this the ‘transcendentalist’
conception of quality of life.

2.1.3 Enjoyment of life

As we deal with conscious humans, the enjoyment of life is the subjective appreciation of life. This
is commonly referred to by terms such as 'subjective well-being', 'life-satisfaction' and 'happiness' in
a limited sense of the word.
Humans are capable of evaluating their life in different ways. We have an ability to
appraise our situation affectively. We feel good or bad about particular things and our mood level
signals overall adaptation. These affective appraisals are automatic, but unlike other animals
humans can reflect on this experience. Humans also have a sense of how they have felt in the
past. Humans can judge life cognitively by comparing their exerience with notions of how it
should be.

3 MEASURES OF QUALITY OF LIFE

Quality-of-life research is about measurement. Hence the field can be aptly described by the
measures used, of which there are many. In the following sections examples of measures used in
quality-of-life research are presented. The substantive dimensions these measures are thought to
represent will be brought to light using the Scheme 1 classification.

3.1 Meanings in multi-dimensional measures of quality of life

Most of these measures are 'multi-dimensional' and assess different qualities of life, which are
aggregated in one 'quality-of-life score'. Often, the different qualities are also presented
separately in a 'quality-of-life profile'. Multi-dimensional measures figure in medical ‘quality of
life’ research, gerontological research on ‘successful ageing’, psychological ‘wellbeing’ research,
sociologically oriented research on individual ‘welfare’ and comparative studies on quality-of-
life in nations. Below I present some.

3.1.1 Example of a medical quality of life index

One of the most common measures used in health-related quality-of-life research is the 'SF-36
Health Survey' (Ware 1996). It is a questionnaire on topics on physical limitations in daily chores
(10 items); physical limitations to work performance (4 items); bodily pain (2 items); perceived
general health (6 items); vitality (4 items); physical and/or emotional limitations to social
functioning (2 items), emotional limitations to work performance (3 items); self characterizations
as nervous (1item); and recent enjoyment of life (4 items). Scheme 2 shows how these topics fit
the above classification of qualities of life. Most elements of this scale refer to performance
potential and belong in the life-ability quadrant right top. This will be no surprise, since the scale
is aimed explicitly at health. Still, some of the items concern outcomes rather than potency, in
particular the items on recent enjoyment of life (last on the list). As a proper health measure, the
SF-36 does not involve outer qualities. So the left quadrants in scheme 2 remain empty.
 Ruut Veenhoven 5 Quality-of-life research

Several other medical measures of quality of life involve items about environmental
conditions that belong in the livability quadrant. For instance, the 'Quality Of Life Interview
Schedule' by Ouelette-Kuntz (1990) is about availability of services for handicapped persons. In
this supply centered measure of the good life, life is better the more services are offered and the
more greedily they are used. Likewise, the Quality of Life Index for cancer patients (Spitzer et al
1981) lists support by family and friends as a quality criterion. Some medical indexes also
include outer effects that belong to the utility quadrant. Some typical items are continuation of
work tasks and support provided to intimates and fellow patients.
Similar indexes have been developed in sociology, mostly in the context of marketing research
for the welfare state. One of the first attempts to chart quality of life in a general population was the
made in the Scandinavian ‘Study of comparative welfare’ under the direction of Erik Allardt (1976).
Welfare is measured using the following criteria: income; housing; political support; social relations;
being irreplaceable; doing interesting things;health; education; and life-satisfaction.
Allardt classified these indicators using his, now classic distinction, between 'having', 'loving’ and 'being'.
These indicators can also be ordered in the fourfold matrix proposed here (See scheme 3).
Most of the items belong in the left-top quadrant because they concern pre-conditions for a good life rather
than good living as such, and because these chances are in the environment rather than in the individual.
This is the case with income, housing, political support and social relations. Two further items also denote
chances, but these are internal capabilities. This is the health factor and level of education. These items are
placed in the top-right quadrant of personal life-ability. The item 'being irreplaceable' belongs in the utility
bottom left quadrant. It denotes a value of life to others. The last two items belong in the enjoyment bottom
right quadrant. 'Doing interesting things' denotes appreciation of an aspect of life, while life-
satisfaction concerns appreciation of life as a whole.

3.1.2 Example of a measure of quality of life in nations

Next to these measures for comparing quality-of-life within nations, there are also multi-dimensional
measures for comparing quality-of-life across nations. These measures are typically meant as an
alternative to the common economic metric for quality-of-life, that is, GNP per head. They all offer
something more, but differ in the mix of additions. The most commonly used indicator in this field is
the 'Human Development Index'. This index was developed for the United Nations Development
Program, which describes the progress in all countries of the world in its annual 'Human
Development Reports' (UNDP 1990). The Human Development Index is the major yardstick used in
these reports. The basic variant of this measure involves three items, namely public wealth,
measured by buying power per head; education, as measured by literacy and schooling; and life-
expectancy at birth.
Later variants of the HDI involve further items gender-equality measured using the 'Gender
empowerment index’, which involves male-female ratios in literacy, school enrolment and income
and poverty measured by prevalence of premature death, functional illiteracy and poverty.
In a theoretical account of this measure the UNDP states the focus should be on how
development enlarges people's choice, and there by, their chances for leading long, healthy and
creative lives (UNDP 1990: 9).

As shown in Scheme 4, this index can have three meanings. First, it is about living conditions in the
basic index material affluence in society and, in the variants, the degree of social equality. These
items belong in the top left quadrant. In the case of wealth it s acknowledged that this environmental
merit is subject to diminishing utility. Secondly, the HDI includes education abilities. Although a
 Ruut Veenhoven 6 Quality-of-life research

high level of education does not guarantee high physical and mental health, it means that many
citizens at least hold basic knowledge. Finally, the item 'life-expectancy' is an outcome variable.
However, the bottom left quadrant remains empty since the UNDP's measure of development does
not involve indicators of utility of life.
The HDI is the most concise measure of quality of life in nations. Extended variants in this
family provide more illustration. For instance, Naroll's (1984: 73) 'Quality of Life Index' includes
contributions to science by country, which fits the utility lower left quadrant. This index also
includes suicide rates and mental health, which belongs in life-ability-quadrant left top. The power
of these indices is that they summarize the various qualities of life in one number thereby
allowing comparison with others and monitoring over time. Since most of these measures consist
of sub-indexes, they also provide an overview of strong and weak points. Further, these indexes
have public appeal; they list things that are typically valued.
Yet there are also weaknesses to this multi-dimensional measurement approach. One
such limitation is that the lists of valued things are never complete, but are restricted to a few
measurable items. We may value true love and artistic innovations, but these dimensions are not
to be captured in numbers nor is a list of valued things time-bound. Because valued things may
reflect the current political agenda, these are ill-suited for extended periods of monitoring.
Typically all items are treated alike, but the relative importance can differ. Differential
weights are used in some cases, but the basis for this is typically weak and does not acknowledge
that the importance of living-conditions depends on life-abilities.
A more basic problem is found in aggregation in that one cannot meaningfully add
environmental chances to life-abilities. It is the fit of chances and abilities that counts for quality
of life, not the sum. Likewise it makes no sense to add chances for a good life (both top
quadrants) and the outcomes of life (right below), certainly not if one wants to identify critical
chances. This lack of a clear meaning reduces the descriptive relevance of these measures, and it
impedes explanation.

3.2 Measures for specific qualities of life

Next to these encompassing measures of quality of life there are measures that are used to denote
specific qualities. These indicators can also be mapped on the matrix. Again some illustrative
examples will suffice.

3.2.1 Measures of livability

Environmental life-chances are measured in two ways, by the possibilities embodied in the
environment as a whole, and by relative access to these opportunities. The former measures
concern the livability of societies, such as nations or cities. These indicators are typically used in
developmental policy. The latter are about the relative advantage or deprivations of persons in
these contexts, and are rooted mostly in the politics of redistribution.
Measures of livability of society focus on nations; an illustrative example is Estes' (1984)
'Index of Social Progress'. This measure involves aspects such as wealth of the nation, peace with
neighbors, internal stability and democracy. There are similar measures for quality of life in cities
and regions. There are also livability counts for institutions such as army bases, prisons, hospitals
for the mentally ill and residences for geriatrics. Measures of relative deprivation focus on
differences among citizens for such things as: income, work and social contacts. Differences in
command of these resources are typically interpreted as differential access to scarce resources.
All these measures work with a points system and summate scores based on different criteria in
some way.
 Ruut Veenhoven 7 Quality-of-life research

These inventories have the same limitations as multi-dimensional measures of quality-of-

life, but one problem specific to the measurement of livability is in the implicit theories behind
the measure. The ingredients of these indexes are things believed to add to the quality of life, but
these beliefs are not necessarily rooted in knowledge of what people really need. In this respect
measures of the livability of the social environment differ from the indicators used for the
physical environment. On the basis of much research we can now estimate fairly well how certain
pollutants will affect illness and longevity. However, a similar evidence base is largely lacking
for the livability of social environments, leaving a vacuum that is typically filled with ideological
prepossession. . As a result there is some circularity in the use of the measures, though they are
meant to show policy makers the way to the good life, they draw heavily on what policy makers
believe already.

3.2.2 Measures of life-ability

Different measures exist to assess “capabilities for living.” First there is a rich tradition of
health measurement in the healing professions. Second there is a trade in psychological skill
measurement which serves selection within education and at work.
Measures of health are, for the greater part, measures of negative health. There are various
inventories of afflictions and functional limitations, several of which combine physical and
mental impairment scores. Assessment is based on functional tests, expert ratings and self-
reports. There also are self –report inventories for positive health in the tradition of personality
assessment (e.g. Ryff and Keyes 1995)
As in the case of livability, these measures do not provide a complete estimate of life-
ability. Again we meet the same fundamental limitations of completeness and aggregation.
Unlike the case of livability, there is some validation testing in this field. Intelligence tests in
particular are gauged by their predictive value for success at school and at work. Yet many of the
other ability-tests lack any validation.

3.2.3 Measures for utility of life

There are many criteria for evaluating the usefulness of a life, of which only a few can be
quantified. When evaluating the utility of a person's life by the contribution that life makes to
society one aspect is good citizenship as measured by law abidance and voluntary work. Where
the utility of a life is measured with its effect on the environment, consumption is a relevant
aspect. And while there are several measures of ‘green living’, it is less easy to quantify moral
value. For some criteria we have better information at the aggregate level. Wackernagel's (1999)
measure of ecological footprint indicates the degree to which citizens in a country use
irreplaceable resources. Patent counts per country give an idea of the contribution to human
progress and are part of Naroll’s (1984) index.

3.2.4 Measures of appreciation of life

Measurement of the subjective appraisal of life is relatively straightforward. Interviews are
conducted though direct questioning such as an interview or a questionnaire. Since the focus is on
'how much' the respondent enjoys life rather than 'why', the qualitative interview method is
limited in this field. Most assessments are self-reports in response to standard questions with
fixed response options.
Many of these measures concern specific appraisals such as satisfaction with ones sex life
or perceived meaning of life. As in the case of life-chances, these aspects cannot be meaningfully
added in a whole, because satisfactions cannot be assessed exhaustively and differ in
 Ruut Veenhoven 8 Quality-of-life research

significance. Yet humans are also capable of overall appraisals. As noted earlier, we can estimate
how well we feel generally and report on that. So, encompassive measurement is possible in this
quality quadrant.
There are various ways to ask people how much they enjoy their life-as-a-whole. One way
is to ask them repeatedly how much they enjoy it right now, and to average the responses. This is
called 'experience sampling'. This method has many advantages, but is expensive. The other way
is to ask respondents to estimate how well they feel generally or to strike the balance of their life.
Almost all the questions ever used for this purpose are stored in the 'Item Bank' of the 'World
Database of Happiness'.
Questions on enjoyment of life typically concern the current time. Most questions refer to
happiness 'these days' or 'over the last year'. Obviously the good life requires more than this,
hence happiness must also be assessed over longer periods. In several contexts we must know
happiness over a lifetime, or better, how long people live happily. At the individual level it is
mostly difficult to assess how long and happy people live, because we know only when they are
dead; however at the population level the average number of years lived happily can be estimated
by combining average happiness with life expectancy. For details of this method see Veenhoven
(1996).
There are doubts about the value of these self-reports, in particular about interpretation of
questions, honesty of answers and interpersonal comparability. Empirical studies, however, show
reasonable validity and reliability. There are also qualms about comparability of average response
across cultures, it is claimed that questions are differently understood and that response bias
differs systematically in countries. These objections have also been checked empirically and
appeared to carry no weight. This literature is aptly summarized in Diener et. al. (1999) and
Schyns (2003). (see Scheme 5)

4 SOCIOLOGY OF HAPPINESS

Sociologists have studied happiness at two levels, at the macro level for comparing across nations
and at the micro-level for identifying differences within nations. The magnitude of insight these
quality-of-life measures provide is somewhat difficult to assess simply because they measure
many different aspects of life. However, happiness is one of the most important of these and, for
this reason, the following summary discussion to measurement of the happiness provides a focus
on one of the most inclusive measure of quality-of-life, especially when combined with life
expectancy in happy life years.

4.1 Happiness and society

Comparative research on happiness started in the 1960s with Cantril's (1965) global study on 'the
pattern of human concern'. The range of Happiness item is commonly used for international survey
programs such as the World Values Survey. This standard item of life satisfaction is:
Taking all together, how satisfied or dissatisfied are you currently with your life as a whole?
1 2 3 4 5 6 7 8 9 10
Dissatisfied Satisfied

The data can also be used for measuring inequality in quality-of-life among citizens and this
 Ruut Veenhoven 9 Quality-of-life research

dimension can be quantified using the standard deviation of responses. Mean and standard deviation
are combined into an index of ‘Inequality-Adjusted Happiness’. Mean happiness can also be
combined with indications of physical thriving, such as life expectancy and for example an index
of ‘Happy Life Years’ (Veenhoven 1996). In the year 2005 comparable data are available for 90
nations. In the following I offer some insights into what these data suggest about the quality-of-life
in contemporary societies.

4.1.1 Level of happiness in nations

Most level of happiness research has focused on average happiness finding sizable and consistent
differences across nations (see Diener and Suh 2000). As shown in Scheme 6, average happiness is
above neutral in most countries, meaning that great happiness for a great number is possible.
However for Russia and for most former Soviet states the average score is less than 5. One
possible reason for this finding is the result of the political, social and economic transformations
undertaken in these countries. Average happiness is also low in several African countries.
There is a system in these differences. People live happier in rich nations than in poor ones
and happiness is also higher in nations characterized by rule of law, freedom, good citizenship,
cultural pluriformity and modernity. However, happiness is not related to everything deemed
desirable. Income inequality in nations appears to be unrelated to average happiness, though it
does accompany some inequality of happiness as shown for 90 nations in the 1990s and
presented in scheme 7.
There is considerable interrelation between the societal characteristics. The most affluent
nations are also the most free and modern ones. It is therefore difficult to estimate the effect of
each of these variables separately. The correlations are much abated when level of income is
controlled and the correlation with social security can even become negative. Still, with the
exception of inequality, sizable correlations remain. Whatever their relative contribution, these
variables explain 83% of the differences in average happiness across nations.
Comparable data on average happiness are available for the USA since 1945, for Japan since
1958 and for the first eight member states of the European Union since 1973. These data show that
happiness rose somewhat in the U. S. and the EU, but stagnated in Japan.
These findings do not fit the common theory that happiness depends on social comparison.
Since people compare with compatriots in the first place, this would imply little difference across
nations and no change over time. The findings neither fit the theory that happiness is a fixed mental
trait, if so, there would not be such strong correlations with societal qualities, nor any change over
time. The findings fit best with the 'livability-theory of happiness, which holds that happiness
depends on the gratification of innate human needs and that not all societies meet human needs
equally well (Veenhoven 1995). Another noteworthy implication of the above findings is that
modern society is not so badly livable as much of problem-focused sociology suggests.

4.1.2 Inequality of happiness in nations

The cross-national pattern of inequality of happiness resembles the pattern of differences in average
happiness. Inequality of happiness is typically lower in the economically most developed nations of
this time. Inequality is also lower in the freest nations and in the best-governed ones. Not
surprisingly, inequality of happiness is higher in nations with relatively large income disparities.
Comparison over time shows a consistent decline in inequality of happiness in modern
nations over the last decade. Inequality of happiness has declined even in Japan, where the average
remained unchanged (Veenhoven 2005a). These findings contradict common belief about new
inequalities causing a growing split in modern society, rather they suggest that the equalizing effects
 Ruut Veenhoven 10 Quality-of-life research

of modernization are still holding. The findings also show that inequality-in-quality of life is not
merely a matter of distribution of scarce resources, it also depends on the general level of living and
on freedom in society.

4.1.3 Inequality adjusted happiness in nations

Level and inequality of happiness in nations can be combined in an index of ‘Inequality-Adjusted
Happiness’ (IAH) that marries together the utilitarian wish for greater happiness of a greater number
with the egalitarian wish for fairness. The rank-order of nations is again similar to average happiness
and the correlations with nation characteristics are also alike, which indicates that there is little
conflict between utilitarian and egalitarian policy.

4.1.4 Happy life years

People prefer a long and happy life to a short but happy life and hence the length of life is taken into
account by adjusting life-expectancy for average happiness. This is analogous to the computation of
Disability Adjusted Life Years in international health statistics (WHO 2001). The number of ‘Happy
Life Years’(HLY) is computed by multiplying life expectancy with happiness expressed on a 0 to 1
scale. For example, if in a country average life expectancy is 60 and average happiness on scale 0 to
10 is 6, HLY is 60 x 0,6 = 36 years.
In Scheme 6 wide differences in HLY across nations are shown: almost 63 in Switzerland
and less than 13 in Zimbabwe. The rank order is similar to but not identical to average happiness.
For instance, the Japanese are not too happy, but live long and therefore rank higher on HLY than on
happiness. The pattern of correlation with nation characteristics is also similar, but the explained
variance of HLY is higher. HLY rose in all modern nations in the late 20th century. Since 1973,
Europeans have gained 4.3 happy life years, the Japanese 4.4 and Americans 5.2. This means that
the quality-of-life has improved in modern society and this trend is likely to extend well into the 21st
century (Veenhoven 2005b).

4.2 Happiness and place in society

Sociological studies of happiness have focused on differences within societies, looking primarily
for links between happiness and social position. As summarized in scheme 8, in western societies
Happiness is moderately related to social rank; the correlations tend to be stronger in non-western
nations. Happiness is also related to social participation and this relation seems to be universal.
Being linked into a primary network appears to be most crucial to happiness, especially being
married. This relation is universal, but the presence of offspring is unrelated to happiness, at least
in contemporary western nations.
Little data exists for assessing trends in these correlations over time. Some basic findings
suggest that in the United States people of African descent have become somewhat happier
(Thomas and Hughes 1986) and that happiness has also risen among the elderly (Witt et. al.
1979). But there have been no systematic studies on shifts in social conditions for happiness.

5 PROSPECTS FOR THE 20TH CENTURY

The main objective of sociological quality-of-life research is to guide public policy. In this area
multi-dimensional indexes are useful for informing policy makers only about how they are doing.
As noted above, these measures typically reflect the current political agenda and thus the scores
inform policy makers how they have advanced along a chosen way. Happiness research also
Ruut Veenhoven 11 Quality-of-life research

provides information about the way to choose, at least if ‘greater happiness for a greater number’
is a policy aim. The idea that happiness should be promoted is the core of ‘utilitarian’ moral
philosophy (Bentham 1789) and the application of this idea in public policy is known as ‘rule-
utilitarianism’. This ideology is currently gaining ground and consequently there is a
corresponding growth of interest in the implications of empirical research findings on happiness.
For example the British government commissioned research by Donovan et. al. (2003) and
several more reviews have been published recently (Frey and Stutzer, 2002, Layard, 2005,
Veenhoven 2004). Since the evidence base is expanding rapidly, this literature is likely to
continue to develop in the 21st century.
Quality-of-life research also can be used to assist individuals to make informed choices in
their private life, such as choosing an occupation, having children, and the appropriate time to
retire. Predicting how much satisfaction will be derived from behavioral options is not very exact;
for this reason we can profit from the documented experiences of others. Such information
would be particularly useful in the contemporary ‘multiple-choice society’, but current quality-
of-life research does not meet this demand very well. The focus is still very much on given
conditions of life, such as social class and personality and not on things one can choose, such as
early retirement. Moreover, most of the current research is in the form of correlations and does
not inform about causal effects. Still another problem is that there is little specification by kinds
of people, yet this is required if one is to obtain tailored advice. This then defines yet another task
for research on quality-of-life in the 21st century.
Ruut Veenhoven 12 Quality-of-life research

REFERENCES

Allardt, Eric. (1976)

Dimensions of Welfare in a Comparative Scandinavian Study.
Acta Sociologica 19: 227-239.

Andrews, Frank and Stephen Withey. (1976)

Social Indicators of Wellbeing: American Perceptions of Life Quality.
New York: Plenum Press.

Bentham, Jeremy. (1789)

An Introduction into the Principles of Morals and Legislation.
London: Payne.

Campbell, Angus, Philip E. Converse and Willard L. Rodgers. (1981)

The Quality of American Life Perceptions, Evaluations and Satisfactions
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Cavan, Ruth S., Ernest W. Burgess, Herbert Goldhamer and Robert J. Havighurst. (1949)
Personal Adjustment in Old Age
Chicago: Science Research Associates.

Cantril, Hedly. (1965)

The Pattern of Human Concerns
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Clark, Patricia and Ann P.Bowling. (1990)

Quality of Everyday Life in Long-Stay Institutions for the Elderly. An Observational Study of
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Diener, Ed, Richard E. Lucas, Heidi L. Smith and Eunkook M. Suh. (1999)
Subjective Well-Being: Three Decades of Progress.
Psychological Bulletin 125:276-301.

Diener, Ed and Eunkook M. Suh. (2000)

Culture and Subjective Well-Being.
Cambridge, USA: MIT Press.

Donovan, Nick, David Halpern and Richard Sargeant. (2003)

Life Satisfaction: The State of Knowledge and Implications for Government,
Discussion Paper, Strategy Unit, Government UK.

Estes, Richard. (1984)

The Social Progress of Nations.
New York: Preager.
Ruut Veenhoven 13 Quality-of-life research

Ferriss, Abbott L. (2004)

The Quality of Life Concept in Sociology,
The American Sociologist 35: 37-51.

Frey, Bruno S. and Alois Stutzer. (2002)

Happiness and Economics,
Princeton, NY: Princeton University Press.

Gerson, Elihu M. (1976)

On Quality of Life,
American Sociological Review 41:793-806.

Gurin, Gerald, Joseph Veroff and Sheila Feld (1960)

Americans View their Mental Health. A Nationwide Interview Survey,
New York: Basic Books.

Layard, Richard (2005)

Happiness. Lessons from a New Science,
New York: Penguin.

Lehman, Anthony F. (1988)

A Quality of Life Interview for the Chronically Mentally Ill.
Evaluation and Program Planning 11:51-62.

Linley, P.A. and S. Joseph, S. (2004)

Positive Psychology in Practice,
London: Wiley. 658-678.

Naroll, Raoul. (1984)

The Moral Order.
London: Sage.

Ogburn, William F. (1946)

A study of Rural Society.
Cambridge: Riverside Press.

Ouelette-Kuntz, Helene (1990)

A Pilot Study in the Use of the Quality Of Life Interview Schedule.
Social Indicators Research 2:283-298.

Ryff, Caroll D. and Corey L. Keyes. (1995)

The Structure of Psychological Well-Being Revisited.
Journal of Personality and Social Psychology. 69:719-727.

Schalock, Robert L. (1997)

Quality of Life: Volume II Application to Persons with Disabilities,
Washington: AAMR.
Ruut Veenhoven 14 Quality-of-life research

Schuessler, Karl F. and G. A. Fisher. (1985)

Quality of Life Research in Sociology.
Annual Review of Sociology 11: 39-149.

Schyns, Peggy (2003)

Income and Life Satisfaction. A Cross-National and Longitudinal Study.
Delft:Eburon.

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Shepherd. (1981)
Measuring the Quality of Life of Cancer Patients.
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Thomas, Melvin E. and Michael Hughes. (1986)

The Continuing Significance of Race: A Study of Race, Class, and Quality of Life in America.
1972-1985.
American Sociological Review 51:830-841.

United Nations Development Program (UNDP). (1990)

Human Development Report 1990.
New York: Oxford University Press.

VanPraag, Bernard M. (2004)

Happiness Quantified. A Satisfaction Calculus Approach.
Oxford University Press UK.

Veenhoven, Ruut (1995)

The Cross-National Pattern of Happiness. Tests of Predictions Implied in Three Theories of
Happiness.
Social Indicators Research 34:33-68.

Veenhoven, Ruut (1996)

Happy Life-Expectancy.
Social Indicators Research, 39:1-58.

Veenhoven, Ruut. (2004c)

Happiness as a Public Policy Aim: The Greatest Happiness Principle.
In Positive Psychology in Practice, John Wiley & Sons, NY, USA. Ch. 39, ISBN 047159062

Veenhoven, Ruut. (2005a)

Inequality of Happiness in Nations.
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Ruut Veenhoven 15 Quality-of-life research

Veenhoven, Ruut. (2005b)

Is Life Getting Better? How Long and Happy People Live in Modern Society,
European Psychologists
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Veenhoven, Ruut (2005c)

World Database of Happiness: Continuous register of scientific research on subjective enjoyment
of life,
Erasmus University Rotterdam, Netherlands. http://worlddatabaseofhappiness.eur.nl
Wackernagel, Mathis, .Larry Onisto, Patricia Bello, Aleandro Callejas Linares, Ina S Lopez-
Falfan, Jezus Mendez Garcia, Anna I Suarez Guerrero & Ma. Guadalupe Suarez Guerrero (1999)
“National Natural Capital Accounting with the Ecological Footprint Concept.”
Ecological Economics 29:375-390.

Ware, John E. Jr. (1996)

The SF-36 Health Survey.
Spilker, B. Quality of Life and Pharmaco-economics in Clinical Trials.
Philadelphia: Leppincott-Raven Publishers. 337-345.

Witt, David D., Evans W. Curry, George D. Lowe, and Charles W. Peek. (1979)
The Changing Association between Age and Happiness: Emerging Trend or Methodological
Artifact?
Social Forces, 58:1302-1307.

WHO. (2001)
The World Health Report 2000.
Geneva.
Ruut Veenhoven 16 Quality-of-life research

Scheme 1: Four qualities of life

Outer qualities Inner qualities

Life chances Livability of environment Life-ability of the person

Life results Utility of life Enjoyment of life

Ruut Veenhoven 17 Quality-of-life research

Scheme 2: Meanings measured by Ware's SF 36 Health Survey

Outer quality Inner quality

No limitations to work and

Life-chances social functioning
Not nervous
Energetic
General health good

No pain
Life results No bad feelings
Happy person
Ruut Veenhoven 18 Quality-of-life research

Scheme 3: Meanings measured by Allardt's 'Dimensions of Welfare': having, loving, and being

Outer quality Inner quality

Income (h) Health (h)

Life-chances Housing (h) Education (h)
Political support (h)
Social relations (l)

Doing interesting things (b)

Life results Being irreplaceable (b) Life-satisfaction (b)
Ruut Veenhoven 19 Quality-of-life research

Scheme 4: Meanings measured by the UNDP's 'Human Development Index'

Outer quality Inner quality

Material wealth
Life-chances Gender equality Education
Income equality

Life results Life-expectancy

Ruut Veenhoven 20 Quality-of-life research

Scheme 5: Measures for specific qualities of life

Outer quality Inner quality

Quality of society Impairment indexes

Life-chances Livability scores Positive health inventories
Capability tests
Position within society Educational grades
Deprivation indexes

Satisfaction summations
Life-results ? Self-ratings of happiness
Happy life-years
Ruut Veenhoven 21 Quality-of-life research

Scheme 6: Happiness in nations around 2000 Derived indicators and illustrative scores

Nation Average Happy Life Years Inequality Inequality

happiness adjusted
happiness
mean life expectancy standard-
on scale 0-10 multiplied by deviation on scale 0-100 index
0-1 happiness 0-10

Switzerland 8.3 62.9 1.9 73

Sweden 7.9 58.9 2.0 69

USA 7.4 56.9 2.1 67

Argentina 7.0 49.6 2.5 60

Germany (W) 6.9 54.8 2.2 64

France 6.7 51.5 2.2 58

Philippines 6.3 43.7 2.7 54

Japan 6.1 49.6 2.1 55

Iran 5.9 41.5 2.7 51

Poland 5.8 42.8 2.8 50

India 4.6 42.8 2.8 48

Russia 4.1 35.7 2.7 35

Zimbabwe 3.3 12.5 3.1 23

Source: World Database of Happiness, Distributional Findings in Nations, Finding Reports 2005
Ruut Veenhoven 22 Quality-of-life research

Scheme 7: Happiness and society; 90 nations in the late 1990s

Condition in nation Correlation with

Average Inequality Inequality Happy

happiness of Adjusted Life Years
happiness Happiness

• Purchasing power per head

Wealth
+.67 –.64 +.68 +.78

• Lethal accidents
Security

• Social security
-.51 +.37 –.51 –.50
+.31 –.51 +.32 +.55

• Economic freedom
Freedom

• Political freedom
+.59 –.48 +.61 +.64

• Personal freedom
+.46 –.34 +.43 +.59
+.44 –.74 +.51 +.48

• Disparity in incomes
Inequality

• Discrimination of women
+.06 –.33 +.02 –.17
–.45 +.38 -.48 –.76

• Tolerance
Brotherhood

• Trust in people
+.50 –.33 +.50 +.49

• Voluntary work
+.37 –.50 +.54 +.39
+.04 +.22 –.00 –.11

• Rule of law
Justice

• Respect of civil rights

+.53 –.57 +.56 +.68

• Corruption
+.56 –.44 +.54 +.61
–.60 +.65 –.63 –.74

Explained variance: Adjusted R2 83% 71% 85% 87%

Data: World Database of Happiness, States of Nations.

Ruut Veenhoven 23 Quality-of-life research

Scheme 8: Happiness and position in society

________________________________________________________________________________

Correlation Similarity of correlation

within western nations across all nations
________________________________________________________________________________

• Income
Social rank

• Education
+ –

• Occupational prestige
± –
+ +

• Employment
Social participation

• Participation in associations
± +
+ +

• Spouse
Primary network

• Children
++ +

• Friends
0 ?
+ +

____________________________________________________________________________
++ = Strong positive + = Similar correlations
+ = Positive ± = Varying
0 = No relationship - = Different correlations
- = Negative
? = Not yet investigated ? = No data
_____________________________________________________________________________________
Source: World Database of Happiness, Correlational Findings.