PART TWO: QUALITY OF LIFE (QOL)
2.8. Philosophical Foundations of QOL Research
Foundations of recent QOL research are rooted in six main disciplines: economics, sociology, psychology, healthcare, environmental studies, and planning and quality of place studies (Flynn et al 2002; Kamp et al 2003; Sirgy et al 2006)1. Each of these disciplines represents a distinct perspective and theoretical approach, and therefore contributes towards the development of the holistic view of QOL. However, it should be also noticed that each discipline incorporates a sort of bias to overemphasise the importance of its own area. The attempts to relate the paternity of the development of the QOL concept to one discipline or another deprive it of the significance that may be given to it, and also narrow its area of applicability (Marginean 2004).
Economics was amongst the earliest disciplines to pay attention to the study and assessment of QOL. Its approach, however, rested solely on the utilitarian way of thinking, attempting to assess people’s standards of living by the use of materialistic
1 Details about the history of QOL studies in relation to each discipline can be obtained from Sirgy et al (2006), Rapley (2003), Flynn et al (2002) and Day & Jankey (1996).
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measures such as GNP. The Social Indicators Movement in the 1960s brought about a new impetus in QOL assessment using quantitative social data related to aspects such as education, housing, education, crime and social interaction. This movement was brought about by a view in society that life had in general become worse although the standards of living were improving considerably (ENVIS 209). However, the objectively measured social indicators were found to account for only a small extent of individuals’ QOL (Day & Jankey 1996). Psychological or subjective indicators were purported as an alternative that is more accurate to measure QOL. In that sense, Psychology has contributed to the field of QOL by signalling the subjective realm of human experience through applying the concept of life satisfaction as an essential component determining QOL (Haas 1999).
From a health perspective, QOL has a long tradition where debates over health and its boundaries in relation to happiness and QOL go back centuries. QOL and health care have been linked through the assessment of patients’ physical emotions and functional capabilities in respect to medical treatment. QOL research in medical settings centres most clearly on individual quality to denote the state of the patient in the deviation from psychic norms during rehabilitation process. In doing so, it focuses on the objective operationalisation, psychological and social post-treatment consequences, and functional and mental status particularly in the case of people suffering from disabilities and chronic illnesses.
Environmental studies on the other hand, emphasise attributes and conditions of the physical and biological environment. This is strongly associated with the sustainability discourse that pays a great deal of attention to the quality of the natural environment and the significant role it has in delivering better QOL for people. Hence, it works within a broader and more collective scale which goes beyond the level of the individual to that of the whole community and urban setting.
Another important root for QOL research is the study of quality of place usually carried out by researchers in the fields of urban design, spatial planning, geography and policies, and frequently in the social sciences. It is argued that QOL is principally a
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place-rooted concept on the basis that individuals and societies exist only in space and, therefore, their life is shaped - beside influences of time - by the conditions of that space (Castells 1983). In fact, apart from the psychological and healthcare schemes of conceptualising life quality, most other disciplines tackling QOL incorporate the component of place or location in their studies. Despite that, many researchers argue that quality of place is a far different concept from QOL (Landis & Sawicki 1988).
They refer to studies of place quality as being specific and focusing on some not all aspects of life quality; therefore, they cannot be considered the same. Others deem that it is hard to split life from its context and that in order to study and understand life quality it is necessary to pay attention to the context which reflects in a way the life embodied in it (Castells 1983).
The importance of place was among the issues raised from the 2nd International Conference on the QOL in Cities emphasising the notion that places are the grounds on which life quality varies between communities. Quality of place is seen as one of the QOL research forms focusing more on places than on individuals (Apparicio et al 2008). It is described as the measurement of conditions of place and how they are experienced and evaluated by individuals. Quality of place has a relatively long history of research. Since the 1960s, numerous studies have been conducted on quality principles and physical form, particularly on the urban scale to explore the potentials different places have that impact QOL of residents. Among those studies are the works of Jarvis (1993), Johanson (1988), Lang (1994) and Lennard (1987), all of which developed a framework or principles to describe or achieve the quality of place (Smith et al 1997). An attractive, diverse and tolerant urban environment is increasingly recognised as a key factor in attaining better life quality, making a particular location an attractive place of residence (Trip 2007).
Another widely used means of studying quality of place is what researchers refer to as the liveability studies, in which comparisons are drawn among different urban areas according to number of objective measures assumed to reflect QOL. This type of research attracted broad interest in political and commercial media using QOL as part of place promotion. Examples are the works of Garoogian and Weingart (1998), Meltzer
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(1998), Money (1998), Thomas (1994) and Toucan Valley (1997) (Cobb 2000). One of the earliest and mostly well known examples is the ‘Guide to the Places Rated Almanac’ which provided a comprehensive assessment of metropolitan areas in the US.
This trend is, though, criticised for focusing only on the overall QOL and providing less details about the position of individuals and that it tend to. In addition, there is a belief that this kind of studies usually emphasises on particular attributes over others and portrays QOL as only positive attribute (Trip 2007; Rogerson 1999).
Planning is another discipline becoming strongly engaged with the concept of QOL.
The concept of life quality lies close to the heart of planning given that the central purpose of planning is to attain general welfare and the public well-being ensuring better future for people. This reference to better is bound up with the concepts of fairness, freedom, justice, liberty, efficiency and sustainability all of which are critically important to QOL (Massam 2002). The comprehensive nature of QOL corresponds well with the long-standing concern for comprehensive planning. Protecting QOL is a goal that citizens’ groups and business leaders share, and hence can afford a strong potential basis for consultation and cooperation efforts as well as providing a prime vehicle for carrying out planning goals and settings processes (Myers 1988).
The study of QOL in planning rests to a large extent on the assumption that variations in QOL among individuals, groups or places can be identified, and that perspective measures should be taken to eliminate the differences. Unlike many other professions, planners believe in QOL as a dynamic concept, and so profit from the longitudinal perspective that integrates QOL into the developmental process. This developmental perspective emphasises changes over time and is a key foundation for understanding and assessing QOL in planning (Myers 1988). It is best described as a loop running from QOL to urban development and back. Implicit in this view is the principle that QOL is both a cause and effect within a planning process, where QOL encourages development at a certain phase and is altered by the resulting growth at another (Massam 2002). Effective planning can slow down the rate at which negative effects of growth move through the system to lessen the undesired feedback from growth to QOL.
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The most important objective of measuring QOL from the planning point of view is to inform policy-makers and allow the identification and evaluation of which factors have the greatest impact on QOL, and which are amenable to improvement (Grayson &
Young 1994). This helps bring about positive change where indicators show a lack of progress. In that sense, QOL studies provide a critical starting point for planning and development through providing the means of self-assessment and valuable policy conclusions which require prior definition of the problem (Shookner 2002).
2.8.1. Trends in QOL research
In light of this multiplicity of disciplines, research on QOL has gone into two main streams that can be noticed from the literature. The first stream implies theorising and conceptualising QOL. This is mainly undertaken by academic research in the fields of psychology and healthcare and to a certain extent in the fields of social sciences and planning. The second group of research focuses on measuring or assessing QOL. This presents the main stream of QOL research and is carried out by both academics and professionals from a wider range of specialists that include social sciences and behavioural studies, economics, planning and urban design, architecture, geography, politics and environmental studies. Under each stream, every research undertakes a distinct notional approach that ranges between being theoretical to empirical depending on the scope and aim of the research in question.
Theoretical models represent hypothetical relations between concepts, while empirical models represent factual relations between different concepts. Both attempt in a way to describe the cognitive, affective, and symbolic processes through which individuals assess, determine, and experience the QOL. Ideally both go hand in hand: from a theoretical framework a conceptual measurement or model is formulated and empirically tested. Nevertheless, in practice, some conceptual models are of such a high level of abstraction that testing is not possible. In that case we speak of ‘thinking models’. At the other extreme are models that are empirically explorative; more or less coincidental elements are combined into a framework. This again reflects the diversity of approaches undertaken to study QOL (Kamp et al 2003). Table 2.5 shows a brief comparison between the two QOL trends, providing examples for each.
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Trend Aim & Methodology Discipline Examples
- Psychology Verdugo et al (2010); Schalock (2004);
Ventegodt et al (2003);Veenhoven
- Sociology Dunning et al (2008); Das (2008);
Royuela (2006); Bowling & Windsor - Architecture Ozsoy & Gokmen (2005), Romice
- QOL for the Pikes Peak Region (2007, 2009)
- A Quality of Life Index for Ontario (1998)
- Quality of Life in Jacksonville:
Indicators for Progress (1985)
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2.8.2. Scopes of QOL research
The difference in QOL research trends is accompanied with diversity of the scales or scopes of interest. This diversity of QOL studies and programmes brought by literature represents a broad range of facets within which QOL can be studied. Besides the conventional distinction between objective and subjective dimensions, QOL is approachable at varying levels of generality from the assessment of community well-being to the specific evaluation of the situations of individuals or special groups. In addition, QOL can be researched on the scale of an identifiable component (domain) or part of it, or across the whole life, i.e. global- or domain-specific. The subsequent case is reflected for instance in such phrases as the quality of urban life, the quality of work life and the quality of housing and family life (Schuessler & Fisher 1985). QOL can also be assessed across different time scales and at different geographical boundaries ranging from the local to the regional to the national and even the international level, or in other terms, from the micro to the meso to the macro scales, although it is believed to be mostly influential at the local scale. This distinction is reflected below in the figure presented by Pacione (1986) illustrating the four dimensional structure of QOL investigations and which provides clear guidance for anyone interested in conducting any QOL research or study.
Figure 2.3: A four dimensional structure of QOL investigations Source: Pacione (1986)
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Massam (2002) provided an additional sort of categorization. He referred to three basic dimensions regarding the study of QOL that could be of direct interest. The first indicates that the focus can be on either the ‘private/individual or ‘public/collective’
angle. The second distinguishes the study of QOL as a focus on either means or ends, while the third presents a distinction between place and person.