FEM 4203ANALISIS KUALITI HIDUP

Sem ester 2, 2011/12Laily Bt. Hj Paimlaily@putra.upm.edu.my

1Konsep & model kualiti hidup1. Konsep dan pendekatan2. Dimensi

What comes to mind when we think of QOL . . .

Level vs. Standard vs. QOL

Level of living Standard of living Quality of lifeReal experience faced

by individual or group.

Quantity and quality of goods and services owned by individual (through purchasing

or provided for them)

Final output of the interaction between

social, health, economy and

environment which influence the social

development

Level and standard of livingLevel of Living• Real experience faced by individual or group. • Formed by combinations of complex consumption, work environment,

ownership, freedom, environment and many others (balanced and harmony).

• Related to fulfilling needs and wants.

Measurement of Level of Living

Direct measure– consumption (resources that are actually used).

Indirect measure (Proxy) – socio-economics variables. – income (wage from productive activity, transfer

income, and other income)

Relationship between Consumption & WB

• More is better ??• Gap between level and standard of

consumption • Balanced consumption elements • Goal achievement gap• Social comparison gap• Best previous experiences gap

Categories of Level of Living high ------ low

superior ------ inferiorexpensive ------ thriftyelaborate ------ simpleample ------ restricted

A well-balanced simple plane of living is much better as compared to an ill-balanced elaborate plane of living.

The Amish: plain dress and resisting modern conveniences. Ghandi: using one's resources in the most minimal way so as not

to deprive others."

Islam: Prophet (PBUH) has not adopted the ways of the rich but embraced a simple way of life which is the mode of Fuqara' - poor people. Thus, he remained contented with simple food and had no relish for extravagant feasts.

Standard of livingStandard of Living • Level that family wants to achieve, achievement portrays success and

failure causes frustration

Quality of life (QOL)

• Means a good life. A good life is the same as living a life with a high quality.

• All religions and philosophies have a notion of a good life. Notions about a good life are closely linked to the culture of which you are a part.

• The cultural conditioning makes us tend to include happiness, fulfillment of needs, functioning in a social context, etc.

Definition of QOL

• Is a product of interaction between various factors including social, health, economy, environment etc.

• Generally: QOL is what make individual/ family/ community happy.

• Can be defined from these aspects: – Physical: health, nutrition, basic needs and safety– Personal : work satisfaction, leisure, wealth, family and

friends, availability of goods.– Community: fair government, freedom, equity, education

for all.

Aspects of quality of lifeQOL ASPECTS

The subjective QOL

How good a life each individual feels he/she has. Each individual personally evaluates how he/she views things and

his/her feelings and notions. Content with life and happy reflect the subjective QOL.

The existential QOL

How good one’s life is at a deeper level. live life in accordance with certain spiritual and religious ideals

The objective QOL

How one’s life is perceived by the outside world. This view is influenced by the culture in which people live. The objective QOL = a person’s ability to adapt to the values of a

culture (e.g. social status/the status symbols one should have to be a good member of that culture).

Approaches in Examining QOLBasic needs approach. Looking into minimum level of living, it is defined from

the aspects of health status, eating habits and literacy. Elements in basic need approach are life expectancy, literacy rate and income per capita.

Human development approach Humans are important to achieve development goals

and are the main sources for economics growth. Capability approach. The capability of someone to do something meaningful

to achieve well-being which leads to a better life.

2Indikator & pengukuran1. Kekuatan dan kelemahan2. Domain dan indikator kualiti hidup3. Hubungan, kesejahteraan emosi, kesihatan, kesejahteraan4. Kebendaan, pekerjaaan dan aktiviti produktif, komuniti,

keselamatan,5. Persekitaran dan sebagainya6. Indeks Pembangunan Manusia (HDI, UNDP)7. Indeks Fizikal Kualiti Hidup (PQLI)8. Indeks Kesejahteraan Ekonomi (IEWB)9. Lain-lain indeks

Measurement of Quality of LifeTypes of measurementSubjectively – “good” feeling and satisfaction;Objectively – fulfilling social and cultural demand from the aspect of material, social status and physical well-being.

Perennial measurementThree aspects of quality of life for complete achievement is material, intellectual and spiritual.

Conventional measurementIn the form of material and quantity (example: GNP). There is cost/limit to over materialism including polluting the environment and human achievement, in real world it means material is not everything.

Comprehensive Model of QOL

Quality of Life

Being

Physical

Psychological

Spiritual

Belonging

Physical

Social

Community

Becoming

Practical

Leisure

Growth

Quality of Life Research Unit, University of Toronto

B E I N G

Physical Being Being physically able to get around. My nutrition and the food I eat.

Psychological Being

Being free of worry and stress. The mood I am usually in.

Spiritual Being Having hope for the future. My own ideas of right and wrong.

BE L O N GI N G

Physical Belonging

The house or apartment I live in. The neighborhood I live in.

Social Belonging

Being close to people in my family. Having a spouse or special person.

Community Belonging

Being able to get professional services (medical, social, etc.) Having enough money.

Practical Becoming

Doing things around my house. Working at a job or going to school.

BE C O M I N G

Leisure Becoming

Outdoor activities (walks, cycling, etc.) Indoor activities (TV, cycling, etc.)

Growth Becoming

Improving my physical health and fitness. Being able to cope with changes in my life.

QOL: A System Model

Family and friends

Work

Neighborhood/shelter

Community

Health

Education

Spiritual

Quality of Life/ sense of wellbeing

Culture

Socio-economic condition

Demographic characteristics

Input Perception/opinion Output

Feedback

Index and elements in measuring QOLElemen Indeks

Human dev

(UNDP)

Physical QOL

(Morris)

Economic WB

American Demograph

ic

Dasgupta & Wales (1992)

WHO (1993)

Cummins (1997)

Hagerty et al.

(2001)

Schalock (2000)

Felce (1996)

Relationship with family & friends

√ √ √

Emotional Well-being

√ √ √ √ √

Health √ √ √ √ √ √Material Well-being

√ √ √ √ √ √ √

Work & Productivity

√ √ √ √

Feeling of belonging to the local society

√ √ √ √ √ √

Personal security/ safety

√ √ √ √ √

Quality of Environment

√

Malaysian Quality of Life

“Encompassing personal advancements, a healthy life style, access and freedom to pursue knowledge and a standard of living which surpasses the fulfillment of the basic needs of individuals and their psychological needs, to achieve a level of social well being compatible with nation’s aspiration”

Malaysian Quality of Life 1999.

Malaysian QOL Index

Income & DistributionWorking life

Transport & communication

Health

Education

HousingEnvironment

Family life

Social participation

Public safety

Culture & Leisure

0

100

200

199020022009

Area and indicator of MQOL IndexArea Indicator

Income & Distribution Real Per Capita Income Gini Coefficient Incidence of Poverty

Working Life Unemployment Rate Trade Disputes Man Days Lost due to Industrial Actions Industrial Accident Rate

Transports & Communications

Private Motorcars & Motorcycles Commercial Vehicles Road Development Index Telephones Internet Subscribers Average Daily Newspaper Circulation

Area IndicatorHealth Male Life Expectancy at Birth

Female Life Expectancy at Birth Infant Mortality Rate Doctor-Population Ratio

Education Literacy Rate Pre-School Participation Rate Secondary School Participation Rate University Participation Rate Primary School Teacher-Student Ratio Secondary School Teacher-Student Ratio

Housing Average Price of Low-Medium-Cost House Low-Cost Housing Units Housing Units with Piped Water Housing Units with Electricity

Area and indicator of MQOL Index

Area IndicatorEnvironment Air Quality

Water Quality Forested Land

Family Life Divorces Crude Birth Rate Household Size Juvenile Crimes

Social Participation Registered Voters Membership in Registered Non-Profit Organizations Registered Residents’ Associations

Public Safety Crimes Road Accidents

Culture & Leisure Membership in Public Libraries Television Viewers Domestic Hotel Guests

Area and indicator of MQOL Index

Physical Quality of Life Index(Morris)

Encompassing literacy, infant mortality rate and life expectancy.

Quality of life indicators, Life During Growth, (World bank).

• Individual rights and democracy• Political stability and war• Education• Health• Transportation and Communication• Class and gender inequality• “BAD”

Easterly, W. (March 1999).

Quality of life indicatorsEasterly, W. (March 1999). Life During Growth, World Bank.

1.1: Individual Rights and Democracy•Freedom from expropriation•Government does not break contracts•Bureaucratic quality•Rule of law•Freedom from corruption•Civil liberties•Human rights rating•% Of children (age 10-14 ) working (-) •Political rights•Index of independence of politics from military

Quality of life indicatorsEasterly, W. (March 1999). Life During Growth, World Bank.

1.2: Political instability and war•Cabinet changes (-)•Deaths from political violence, per capita (-)•General strikes (-)•Government crises (-) •Number of assassinations per million per year (-)•Number of coups per year (-)•Number of revolutions per year (-)•Purges (-) •Riots (-) •War deaths per capita (-) •Freedom from external conflict risk•Freedom from civil war risk•Absence of racial tensions•% Involved in separatist movements (-)

Quality of life indicatorsEasterly, W. (March 1999). Life During Growth, World Bank.

1.3: Education•schooling years for adult population (25+) •% literate•% "no schooling" in population (-) •gross enrollment ratio for higher education •gross enrollment ratio for secondary education •gross enrollment ratio for primary education •museums per capita•Book titles published per capita

Quality of life indicatorsEasterly, W. (March 1999). Life During Growth, World Bank.

1.4: HealthLife Expectancy at age zero Mortality - infant (-) Mortality -under-5 (-)Daily calorie intakeDaily protein intakeHospital beds per capita Physicians per capita Nurses per capita% With access to safe water% Rural with access to safe water% Urban with access to safe waterAccess to sanitationAccess to sanitation (rural)Access to sanitation (urban)

Quality of life indicatorsEasterly, W. (March 1999). Life During Growth, World Bank.

1.5: Transport and Communications• Paved Roads as share of all Roads•Road length per car•Railroad Mileage per square mile•Telephones per capita•International telexes, minutes per capita•telegrams per capita•Radios per capita•TVs per capita•Mail Per capita•Fax machines per capita

Quality of life indicatorsEasterly, W. (March 1999). Life During Growth, World Bank.

1.6: Inequality across class and gender•Gini coefficient (-)•Share of income of bottom 20%•Share of income held by middle 60%•Share of income of top 20% (-)•Female to male schooling years (age 26+)•Ratio of Women's Literacy to Men's•Female to male primary enrollment•Female to male secondary enrollment•Female to male higher enrollment

Quality of life indicatorsEasterly, W. (March 1999). Life During Growth, World Bank.

1.7: "Bads"Fraud Rate per capita (-)Freedom from political terrorism (-)Homicide rate per capita (-)Manslaughter per capita (-)Robbery rate per capita (-)Rapes per capita (-)Drug crimes per capita (-)Carbon dioxide emissions per capita (-)Industry CO2 emissions per capita (-)Sulfur dioxide emissions per capita (-)Nitrogen oxides emissions per capita (-)Suspended particulate matter (-)Annual forest area change (%)Waste paper production per capita (-)Injuries at work (per 1000 workers) (-)Suicides per capita (-)

The World Health Organization QOLInstruments

Domain Facets incorporated within domainsOverall Quality of Life and General Health

1. Physical health Energy and fatiguePain and discomfortSleep and rest

2. Psychological Bodily image and appearanceNegative feelingsPositive feelingsSelf-esteemThinking, learning, memory and concentration

3. Level of Independence

MobilityActivities of daily livingDependence on medicinal substances and medical aidsWork Capacity

The World Health Organization QOLInstruments

Domain Facets incorporated within domains

Overall Quality of Life and General Health

4. Social relationships Personal relationshipsSocial supportSexual activity

5. Environment Financial resourcesFreedom, physical safety and securityHealth and social care: accessibility and qualityHome environmentOpportunities for acquiring new information and skillsParticipation in and opportunities for recreation/leisurePhysical environment (pollution/noise/traffic/climate)Transport

6. Spirituality/ Religion/ Personal Beliefs

Religion /Spirituality/Personal beliefs

Factors and Indicators of QOLFactor Indicator Source

1. Material wellbeing GDP per person Economist Intelligence Unit

1. Health Life expectancy at birth, years. US Census Bureau

1. Political stability and security

Political stability and security ratings. EconomistIntelligence Unit

1. Family life Divorce rate (per 1,000 population), converted into index of 1 (lowest divorce rate) to 5 (highest).

UN; Euromonitor

1. Community life Dummy variable taking value of 1 if country has either high rate of church attendance or trade-union membership; zero otherwise.

ILO; World Values Survey

1. Climate and geography Latitude, to distinguish between warmer and colder climates.

CIA World Factbook

1. Job security Unemployment rate, %. Economist IntelligenceUnit; ILO.

1. Political freedom Average of indices of political and civil liberties. Scale of 1 (completely free) to 7 (unfree).

Freedom House

1. Gender equality Ratio of average male and female earnings, latest available data.

UNDP Human Development Report

Characteristics of ideal measurement for QOL

(1) Dynamic, which means measurement that can show potential development as compared to only showing the current development status,

(2) Measurement according to changes in human’s perception of development,

(3) Taking into consideration the changes in main motivating power such as information technology.

3Aktiviti ekonomi dan kemiskinan1. Konsep2. Pengukuran3. Aktiviti ekonomi pasaran dan bukan pasaran4. Insiden kemiskinan di Malaysia dan negara lain5. Unsur rintangan dan sokongan ke arah meningkatkan

kesejahteraan hidup keluarga

Household production

• The production of goods and services by the members of a household;– For their own consumption– Using their own capital– Their own unpaid labor.

• Goods and services produced by households for their own use include;– Accommodation– Meals– Clean clothes– Child care

• The transformation of purchased intermediate commodities (supermarket groceries and power-utility electricity) into final consumption commodities (meals and clean clothes).

• Households use their own capital (kitchen equipment, tables and chairs, kitchen and dining room space) and their own labor (hours spent in shopping, cooking, laundry and ironing).

Process of household production

Production/Consumption Model

Production

HumanCapital

Good and services

for sale/ gift/ exchange

Input

Commodity Consumption Well-being

The who, what, where, when, why and how of a measure of consumption poverty

What:What resource

measure is going to be used?

Who: Whose standard of

living is being measured?

When:What time period is

used?

Where:Do the measures differ

by geographic location?

Why:What is the purpose of

these measures?

How:Which measure and thresholds are used?

Measurement issues

Ruang &kontek

s

Universaliti

Multidimension

aliti

Unit diukur

Perspektif masa

Sebab kemiskin

an

• Sumber vs utiliti?• Apa yang boleh dicapai vs apa yang sebenarnya dicapai?• Aspek apa yang patut di ambilkira? Material, sosial,

budaya, politik?

• Bagaimana tentukan garis kemiskinan • Mutlak vs relatif?• Boleh diguna pakai pada masyarakat lain• Objektif vs subjektif• value judgement mempengaruhi definisi &pengukuran• Siapa yang patut menentukan• Perbezaan sistem ekonomi eg. Sosialis &kapitalis?

•Boleh guna satu indeks?•Bagaimana memilih dimesi?•Bagaimana menggabungkan dimensi?

Individu vs keluarga vs sempadan geografi

Jangka pendek vs jangka panjang

Patut ambilkira sebab kemiskinan

What difference a measure makes• Using consumption-based measures, in comparison with income-based

measures– The levels of poverty and inequality tend to decrease – The WB of the elderly tends to increase relative to other groups (mainly due

to the inclusion of a value for owner-occupied housing in the measure of consumption).

• Consumption and income definitions have somewhat different implications for who is counted as poor. – A consumption resource definition will

• include the people who are income-rich but consumption-poor (people who choose to spend at levels below the poverty threshold when they actually have incomes that would support consumption above that level).

• exclude people who are income-poor (e.g., because they lost a job), but who sustain their consumption at a level above the poverty threshold (by spending from savings, borrowing from relatives, or charging to their credit cards).

– An income resource definition will exclude people who have adequate income during the measurement period, whether they spend it or not.

Masalah mengukur pendapatan

PENDAPATAN

Perbelanjaan lebih stabil berbanding

pendapatan

Perbelanjaan lebih mudah diingat drpd

pendapatan

Perbelanjaan kurang silap berbanding

pendapatanTak suka soalan

pendapatanPerbelanjaan > pendapatan kalangan berpendapatan rendah

Under-reported -- Anggaran simpanan

yang jauh lebih rendah

Poverty Line IncomeRural Urban Rural Urban

Johor 711 647 Perlis 667 621Kedah 683 636 Selangor 760 677Kelantan 618 572 Tganu 664 662Melaka 710 653 Sabah 821 802N.Semb 684 680 Swak 779 756Pahang 703 651 KL 880P.Pinang 751 704 Labuan 821 802Perak 666 630Model household: One male and one female (aged 18-29), two boys aged 3 and 9, and a girl aged 5.