3. Quality of Life: Background, Components, Indicators, Measurement and Conceptualization

• 3.1. Background Summary
• 3.2. Quality of Life Components
• 3.3. Quality of Life Indicators
  • 3.3.1. Definition
  • 3.3.2. Subjectivity and objectivity
  • 3.3.3. Choosing the indicators
• 3.4. Basis for Measuring Quality of Life in Linear Project Assessments
• 3.5. Review of Four Models for Conceptualizing Quality of Life
  • 3.5.1. Conceptualizing environmental quality of life
  • 3.5.2. Conceptualizing community quality of life
  • 3.5.3. Conceptualizing urban quality of life
  • 3.5.4. Conceptualizing the quality of life in alpine cities

Quality of life is a recent and constantly changing concept that is growing more and more complex. It refers to a number of dimensions (e.g., social, economic and environmental), some of which go beyond what is required of an environmental assessment of linear projects. There are two possible approaches to studying quality of life. The first is to develop an objective picture of the situation using quantitative indicators. The second favours a subjective assessment that probes people's satisfaction with their environment. The choice of indicators and approach will depend on the purpose of the study. A combination of objective and subjective processes will produce a better picture of quality of life. The process should also involve public participation. No process can be implemented without a conceptual framework that reflects the research objective, in this case, the environmental assessment of linear projects.

3.1. Background Summary

The expression quality of life denotes a relatively recent idea that has grown more complex over time. It apparently made its first appearance in the United States in the 1950s. At first, it was defined as a good standard of living in the new consumer society: having modern appliances, cars and homes. Leisure time, savings for holidays and recreation were added later. In 1960, President Eisenhower's commission expanded the quality of life concept to encompass education, health and well-being, the economy and industrial growth as well as the defence of the free world (Fallowfield, 1990). The expression quality of life became mainstream after a speech made by President Lyndon B. Johnson in 1967 in which he stressed that the objectives he sought could not be measured in banking terms, but in terms of quality of life. Quality of life would therefore not necessarily reflect the quantities of consumer items and goods available. ⁵

Generally, we distinguish between quality of life and standard of living in our activities, published research and public opinion (Treasury Board of Canada Secretariat, 2000). ⁶

Quality of life is a more general concept than standard of living or well-being, which are seen as conditions of quality of life and not to be compared with it (Meeting of experts on indicators of environmental quality and quality of life, 1979). The International Society for Quality of Life Studies defines standard of living as a measurement of the quantity and quality of goods and services available to people, like the per capita gross domestic product (GDP), the number of doctors per thousand people, the percentage of GDP spent on health and education, or the number of television sets and telephones per household. It defines quality of life very differently as "the product of interaction between social, economic, environmental and health factors affecting human and social development." Indeed, the idea of quality of life originated as an alternative to the concept of the "affluent society," which was increasingly suspect as a measurement of a society's wealth. U.S. President Johnson echoed this in 1964 when he described the "great society" as concerned "not with the quantity of goods but with the quality of lives" (Treasury Board of Canada Secretariat, 2000).

However, we cannot deny that quality of life and level of income and services are interdependent: a person needs a living wage before he can start to concern himself with quality of life. For the masses who are homeless or practically collapsing from starvation, it seems absurd to speak of quality of life (Fradier, 1976). For many people, a greater income remains an objective necessity for a decent life. To enhance quality of life, we have to develop the necessary know-how, products, skills and services to keep the economy on the road to growth (Finance Canada, 2000).

In the Western world, the debate on quality of life has taken place in a social context characterized by two trends: the mounting awareness of the pollution emitted by industrial society and the negative effect of the race for economic growth; and the emergence of quality of life as a recognized social value (Mukherjee, 1989). Threatened by the negative impacts of growth, we have become aware of the need to review our economic orientations. Saturation thresholds seem to have been reached with regard to saving the world's resources and people's daily lives (Durand and Harff, 1977). The clash between quality of life and postwar economic growth and development will be expressed in terms of nuisances, pollution and degradation - in short, too high a price to pay for these advances (Lamau, 1992).

In the preface to his Environnement et qualité de vie, Bonnefous (Barrau et al., 1975) asks whether we can still afford to be demanding about quality of life as we watch the amount of wealth produced decline. The question highlights the relationship many perceive between the mainly biophysical environment and quality of life. Moreover, ad hoc environmental policies would not be good for the economy or necessarily enhance quality of life, even in a time of economic growth. The production processes and products created to obtain a better quality of life a few decades ago might become barriers to our current and future quality of life.

This background summary shows that the concept was developed for use nationally, with numerous indicators to be included over the years, rather than for local project development, with a limited number of components.

5 - From this standpoint, a lot of seniors acknowledge that life was not perfect when they were young but, like the environment in which they lived, it did not lack quality (Fradier, 1976).

6 - A recent Ekos opinion survey on productivity reveals a profound gap between the ways we perceive standard of living and quality of life, indicating that Canadians do not equate the two terms. For example, answering a question on the national goal Canada should achieve by the year 2010, 66 percent of respondents stated that, if they were to take the prime minister's place for a day, they would rank "the best quality of life in the world" as the first national priority compared with "the highest standard of living of the industrialized nations," which was the second-lowest ranked answer, given by 30 percent of respondents (Ekos Research Associates Inc., 1999).

3.2. Quality of Life Components

Quality of life is defined in terms of many social, cultural, economic and environmental factors. The perceived degradation of one of these factors can be enough to threaten or affect the well-being of individuals and communities. Certain issues have to be considered when promoting or enhancing quality of life (University of Quebec in Abitibi-Témiscamingue, 1991):

• in environmental terms, protecting biological diversity, developing an integrated resource management plan and adapting it to global changes;
• in economic terms, long-term planning and prioritizing of individual needs (humanist vision), developing ecological technologies, exploring the social usefulness of production;
• in social terms, establishing equality among individuals and giving them the means for self-sufficiency (ability to influence their future, employment, education, etc.); and
• preserving the quality of living environments: i.e., wherever most human activities occur, from the family home to larger-scale systems (e.g., cities or regions), including their various components (e.g., services) and the relationship these environments have with each other or with the outside world (e.g., methods of communications).

Quality of life is multifaceted. It denotes timely access to quality health care as well as improved access to post-secondary education. It includes children's health, family security, community vitality and the ability to learn and adapt. It assumes benefits are shared with anyone needing special support to meet their basic needs or join the work force. It also includes participation, especially by youth, in community life, cultural activities and amateur sports (Finance Canada, 2000).

These issues can be expressed through many different factors, and a number of writers have tried to define and classify them (Flanagan, 1978, 1982; Campbell et al ., 1976). We readily concede that the complexity of quality of life makes it a somewhat elusive concept. Flanagan (1978, 1982) identified 15 factors defining quality of life and grouped them into five major categories:

• physical and material well-being (a. material comfort and financial security, b. personal and health security);
• relationships with others (c. spousal relationships, d. having and raising children, e. relationships with other family members, f. relationships with close friends);
• civic, community and social activities (g. helping and encouraging others, h. participation in local and governmental affairs);
• personal development and achievement (i. intellectual development, j. personal goal-setting and self-awareness, k. interesting, worthwhile and useful work, l. personal creativeness and experience); and
• leisure (m. socializing with others, n. passive or spectator recreational activities, active or participatory recreational activities).

Campbell et al. (1976) also identified various factors that can influence our degree of satisfaction in life: marriage, family life, health, neighbourhood, friendship, housework, work or lack of it, life in our country, urban or rural life, housing, the usefulness of education, standard of living, level of education, and savings. Quality of life is also defined subjectively. For some, it is based on certain aspects of their family life; for others, on factors reflecting their workplace or living conditions (Bar-On et al., 2000). The objective quality of urban facilities seems essential only to a minority of residents. And some urban facilities emerge as sources of pollution. We may conclude from this that development based solely on facilities is not enough to satisfy public needs. We also find that individual situations play a major role in assessing quality of life (Borsdorf, 1999).

Needless to say, linear projects do not directly affect all aspects of quality of life. These aspects should be pinpointed to better address the concerns most directly associated with linear projects.

3.3. Quality of Life Indicators

Measuring quality of life has been the focus of much attention. Writers place the resurgence of interest in developing a methodology for quality of life in the 1960s and early '70s, spurred by the U.S. government's recognition of the need to understand its meaning and role in decision making (Bauer, 1966; Environmental Protection Agency, 1973; Sheldon and Moore, 1968). The Treasury Board of Canada Secretariat (2000) ascribes this search for quality of life indicators to a general resurgence of interest in social indicators.

3.3.1. Definition

The indicators correspond to clearly defined objectives and are action-oriented. An indicator can be defined as a measurable or observable parameter, variable or value derived from these objectives that synthetically express the status of a particular system or phenomenon (Organization for Economic Co-operation and Development, 1982, quoted by André and Bryant, 2001). An indicator should therefore help to assess quality of life for various population segments at a given time and place based on the factors being considered. For example, a series of possible indicators has been developed by Statistics Canada and the Treasury Board of Canada Secretariat ( Table 1). They are sometimes complex indexes (e.g., the human development index), produced by combining social indicators in specific areas. Normative values are often attached to these indexes. Indicators also have "direction," meaning that an increase in that index heralds an improvement in quality of life.

Source: Treasury Board of Canada Secretariat (1999).

Most indicators of living conditions - especially the ones using immediately available data - are indirect approximations rather than direct measurements. ⁷ They can, however, provide direct measurements in the case of percentages of the population or a segment of the population that has achieved a particular level of quality of life or standard of living according to specific criteria. The criteria determining quality of life must, however, be defined in advance. ⁸ The advantage of direct measurement is that it gives a more accurate quality of life indicator. ⁹ At least three conditions have to be met before a quality of life measurement can be interpreted as quantifying well-being (Slottje et al., 1991):

• the measurement has to be based on a wide range of objective attributes that make it useful;
• attributes have to be weighted objectively and rationally when establishing a general index of well-being; and
• the environment we live in is important for our well-being and, in practical terms, represents the physical aspect of quality of life.

There is no unanimous support for expressing quality of life in terms of indexes. A number of people feel this practice conceals information about components (Rossi and Gilmartin, 1980), grossly simplifies the concept and represents a so-called objective refuge for an intrinsically subjective concept.

7 - Health indicators include, for example, the percentage of GDP or government budgets spent on health, the number of doctors or beds available in rural health services, or the number of children vaccinated for certain diseases. These indicators can also measure the presumed consequences of good or poor health: life expectancy, the infant mortality rate, etc.

8 - This is the case with the APQLI (augmented physical quality of life index) used by the United Nations to classify countries by their state of development. The APQLI is a composite index of a number of parameters including level of primary and secondary education, the adult literacy rate, average daily calorie intake and life expectancy at birth.

9 - For example, the amount governments or households spend on health turns out to be a very poor indicator given the difficulty in defining health expenditures and the ambiguous link between more spending and increased health.

3.3.2. Subjectivity and objectivity

The concept of quality of life has two dimensions: subjective and objective. Which one you examine depends on the purpose of the study. The subjective dimension of quality of life refers to well-being and satisfaction with the environment; the objective dimension refers to satisfaction "with cultural and societal requirements in terms of material wealth, social status and physical well-being" [translation] (Noll, 1998). The two questions we have to answer are: How important is a given area for someone, and how satisfied is that person with this area (Oleson, 1990)? For Pacione (1982), any quality of life study will have an "internal" side (the satisfaction felt by individuals) and an "external" side (the physical object that causes or is related to the satisfaction). Considering the dual objective/subjective nature of this concept, the first studies attempting to identify life issues concluded that there are as many definitions of quality of life as individuals sampled (Cantril, 1965; Liu, 1973; Szalai and Andrews, 1980). The choice of indicators involves objectivity and subjectivity, as it calls for decisions on statistical issues and value judgments.

Some writers have suggested that the objective indicators of well-being (per capita income, rate of underemployment, etc.) were inadequate to define quality of life, because they did not take people's feelings into account. It has recently been found that, in countries with the lowest gross national product (GNP), satisfaction with income levels may increase subjective satisfaction. In countries with a high GNP, this effect could be the opposite or nil. The difference between these countries could be explained by Inglehart's "post-materialist" theory (1990): people in developed countries are affected less by income-related issues than by non-material ones. Quality of life criteria depend on the subjectivity of each social group that ranks its own criteria to reflect its preferences, traditions and way of life. A definition of quality of life that incorporated subjective social indicators from the public would represent tangible progress indeed.

Many people see no conflict between the quantitative and qualitative facets of quality of life or between its behavioural and perceptual facets. Recent studies show that European and American researchers advocate the use of both subjective and objective measurements to understand quality of life (Türksever and Gündüz, 2001). The research would be even more effective if quality and quantity, or subjectivity and objectivity, ceased to be treated as opposites. The knowledge gained through the two trends (quality toward quantity, and subjectivity toward objectivity) is reflected in variables related to perception and behaviour, which are properties of the components of quality of life (Mukherjee, 1989).

The labels "objective indicator" and "subjective indicator" can be misleading. It would be better to use "descriptive indicator" and "evaluative indicator" instead. With the descriptive indicators, people are asked to describe their resources and conditions (e.g., What is your monthly salary?). With the evaluative indicators, questions deal with living conditions or perceptions (e.g., Are you satisfied with your monthly salary?). We must not, however, overstate the difference between the two types of indicators, as descriptive indicators also contain evaluative elements (Erikson, 1993).

We will therefore try to integrate the objective and subjective dimensions of quality of life into our conceptual approach. We subscribe to the idea that these objective and subjective approaches to quality of life are complementary, whatever the scope of the study may be.

3.3.3. Choosing the indicators

Concerning the choice of indicators, Stanley (1979) finds that (1) we cannot measure everything and must therefore limit our choices; (2) the appropriateness of any indicator will depend on the objectives of interpretation and the theoretical values used for the study; and (3) the social and economic priorities are not the same in every country or in all regions of a country at any given time. From these principles, he deduces a few general practices that can guide the choice of indicators:

• empiricism and previous experience;
• choosing an appropriate set of indicators that reflect a pre-approved interpretation or action plan; and
• compliance with a theoretical model.

Quality of life indicators should meet the following criteria (adapted from André et al., 1999):

• be representative of quality of life;
• be simple and easy to interpret and communicate;
• illustrate long-term trends;
• react to changes in factors affecting quality of life;
• suit the scale of the study;
• derive their real meaning from a comparison with defined targets or specific thresholds;
• receive theoretical recognition and comply with standards generally accepted by the experts;
• be readily available or involve low acquisition costs;
• be recognized for their quality and supported by sound documentation; and
• be periodically updated at spatial and temporal intervals, using measuring and sampling procedures suited to the scale of quality of life.

Diener (1995) conducted an inventory of indicator selection practices for the quality of life index and found no standard way of choosing indicators for this index. As a rule, indicators are chosen intuitively. It is therefore appropriate to develop a specific selection approach for linear projects.

3.4. Basis for Measuring Quality of Life in Linear Project Assessments

One problem with defining quality of life is its multidimensionality. It varies with time and circumstances, and is subjective and objective, qualitative and quantitative, direct and indirect. Other aspects to consider include how much weight to give to public opinion (which is affected by circumstances) over directly observable facts, and the issue of the social system of reference. In all cases, the need to make value judgments involves public participation at a number of points in the process, especially in choosing and defining indicators, assigning values, receiving and interpreting results, and monitoring and fine-tuning indicators over time. Experts and citizens need to participate in developing a quality of life measurement system for it to be credible (Treasury Board of Canada Secretariat, 2000). This will require the use of customized approaches that reflect the circumstances. A large number of studies show that quality of life can be measured with some accuracy if an appropriate analytical and conceptual framework has been developed for this purpose (Cutter, 1985; Beesley and Russwurm, 1987; Rogerson et al., 1987).

Some studies are based on the assumption that qualitative indicators essentially have to reflect the assessments or opinions of the population concerned (or of a representative sample) (McGranahan et al., 1991). This approach gives priority to institutions and organizations in touch with people's concerns, as they are more likely to gauge the public's priority needs (University of Quebec in Abitibi-Témiscamingue, 1991). Cummins (2000) comes to the conclusion that objective and subjective indicators both provide useful estimates of quality of life. The interrelations of the variables measured in each dimension are complex. Although the objective and subjective indicators are fairly independent of one another, their dependence increases when objective living conditions are very poor. Cummins recognizes, however, that the point at which this correlation becomes observable varies with cultural and individual values that have yet to be explored. He gives the example of studies revealing that most of the people in certain Japanese and Nigerian communities were satisfied, despite their objectively poor housing conditions. He also cites the case described by the ethnographer Edgerton of a person with a mental disability who was relatively content in spite of objective living conditions that were, to say the least, marginal. Such disparities between objective measurements of living standards and subjective quality of life raise ethical problems with the use of subjective indicators to gauge the adequacy of living conditions.

The problem affects some indicators more than others. For example, is housing quality better measured by levels of expressed satisfaction/dissatisfaction or by technical quality criteria as established by a branch of government (McGranahan et al., 1991)? However, if we go with the level of satisfaction expressed by the people concerned, the assessment is partly determined by their aspirations (i.e., what they consider to be their due). This tells us that measuring people's satisfaction means measuring their adjustment to their current conditions. It may also be that people deliberately refuse to describe their circumstances as poor even when they know them to be unsatisfactory. Furthermore, people who have a long history of difficult living conditions and see them improve will tend to be more satisfied than people who had been used to very good living conditions and have seen them deteriorate somewhat.

When certain standards are used to assess the quality of life of people in different communities, the choice of criteria to examine should be a determining factor. In determining quality of life, should we, for example, give preference to local traditions and the values they express rather than a universal concept of well-being? On the one hand, respect for tradition makes it possible to adapt quality of life criteria to the local people but it may also preserve social inequities. On the other hand, using a universal concept may lessen or eliminate the inequities but be highly paternalistic and removed from local realities (Nussbaum and Sen, 1993). These questions lead back to the discussion about positivist vs. relativist approaches and directly affect the types of criteria selected for determining quality of life.

The concept of consensual asset (Campbell et al., 1976) can be helpful in determining when to use objective and subjective indicators. According to these authors, certain assets are seen as consensual when their importance is more or less generally recognized. But, as previously mentioned, some traditional societies see assets as consensual, because they have never been perceived otherwise. It may be, for example, that the female members of a deeply patriarchal society cannot imagine living any other way. In such circumstances, the empirical recognition of a consensual asset may be used as a pretext for supporting or justifying the status quo.

3.5. Review of Four Models for Conceptualizing Quality of Life

Here, we review four models for conceptualizing quality of life drawn from current literature. These models are shown in Appendix 3.

3.5.1. Conceptualizing environmental quality of life

Rogerson (1997) attempted to reconcile the subjective evaluation of quality of life with people's objective situations while keeping in mind the impact of communities on individual quality of life. The model has been applied to an urban project in Istanbul, Turkey. Rogerson conceptualizes quality of life by defining a new term, "environmental quality of life," as a combination of the material and personal realms of life. The material realm consists of a series of goods, services and other attributes of the physical, economic and social environment in the geographic area where individuals live. The personal realm is defined by individuals' characteristics and assessment of their own well-being and satisfaction.

In terms of methodology, a questionnaire about satisfaction with day-to-day life was administered to 384 residents from 22 Istanbul neighbourhoods using a stratified random sample. This questionnaire was based on 18 indicators ranked on a satisfaction scale of 1 to 4 and it considered the following as independent variables: shopping convenience, environmental pollution, level of education, cost of living, noise level, climate, job opportunities, transportation to work, crowding, relations with neighbours, housing conditions, parks, green space, health, recreational and sports opportunities, access to public transport and traffic congestion.

3.5.2. Conceptualizing community quality of life

Raphael et al . (1998), of the University of Toronto's Health Promotion Centre, tried a health-based approach to assessing community quality of life. The model was applied to Toronto, Vancouver and other North American cities. This community approach to quality of life is centred on people's perception of what would or would not make their lives satisfactory. We assume that certain community factors affect people's quality of life, and the proposed model draws attention to these. Quality of life is also assessed on the basis of three major areas, each including three components and a series of indicators:

• "being," which reflects "who the individual is" and has physical, psychological and spiritual components;
• "belonging," which involves people's relationship with their physical, social and community environments; and
• "becoming," which involves individual activities to achieve individual goals, hopes and aspirations.

There are four stages to the methodology.

• Preparation: setting up an advisory committee, looking for objective information about the community, contacting community members through community groups and agencies, identifying ways of talking to community members not associated with the network (interviewing them, working with agencies), finding incentives for community participation, meeting with a few participants to validate the process, and preparing for the session.
• Data gathering: discussion groups and a forum with community members, individual interviews with service providers and elected representatives, validation, gathering information from community members through community interviewers.
• Data analysis: sorting information, identifying and presenting themes in writing, content analysis and classification.
• Conveying the results: scientific and community reports, administrative summary.

3.5.3. Conceptualizing urban quality of life

Murdie et al. (1992) attempted to develop a conceptual framework for quality of life in an urban setting that incorporated a substantial number of elements taken from traditional writings on quality of life. This framework has four main components (from Maclaren, 1996).

• The first outlines the social, political and economic context in which the municipal government makes its decisions. It measures the influence of local conditions on quality of life.
• The second includes quantitative measurements of objective inputs that typify the municipal environment and local facilities.
• The third covers measurements of intermediate outputs, which constitute the results of input measurements. For example, per capita spending on secondary education (an input measurement) can be tied to the drop-out rate in secondary schools (an output measurement).
• The fourth and most complex component is based largely on qualitative data. It is assumed that overall satisfaction with quality of life is indirectly affected by a household's characteristics, which are themselves affected by personal characteristics. These two kinds of characteristics can alter perceptions of objective reality and interpretations of the discrepancy between what is possible or desirable and what is actually going on.

3.5.4. Conceptualizing the quality of life in alpine cities

Borsdorf (1999) tried to consider objective and subjective criteria simultaneously in determining the quality of urban life. His goal was to quantify the gap between the assessment of quality of life and the measured level of facilities and living standards of the residents of Innsbruck, Austria. The idea of quality of life denotes the convergence of objectively good living conditions in a specific setting and a subjective assessment of these conditions perceived as factors of personal well-being. According to this theoretical position, a quality of life assessment would be incomplete without measuring and analysing how residents themselves perceive it.

In methodological terms, a representative survey of 300 urbanites aged 19 and over was conducted between 1991 and 1993, resulting in a diachronic analysis.