Good Health is Not the Same as a Good Life: Survey Results from Brandon, Manitoba

摘要

The aim of this investigation was to obtain some baseline self-reported data on the health status and overall quality of life of a sample of residents of the city of Brandon, Manitoba aged 18 years or older, and to measure the impact of a set of designated health determinants, comparison standards and satisfaction with diverse domains of life on their health and quality of life. In May and June 2010, 2,500 households from the city of Brandon, Manitoba were randomly selected to receive a mailed out questionnaire and 518 useable, completed questionnaires were returned. Baseline health status data were obtained using the 8 SF-36 dimensions of health and 13 items from the United States Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System. Determinants of health and overall quality of life included measures of socializing activities, a Good Neighbourhood Index, Social Support Index, Community Health Index, a measure of free-time exercise levels, health-related behaviours, use of drugs, health care issues, a set of domain-specific quality of life items, a set of measures concerning criminal victimization, worries and behaviours concerning victimization and the basic postulates of Multiple Discrepancies Theory. Overall life assessment, dependent variables included Average Health, happiness, a single item measure of satisfaction with life as a whole, a single item measure of satisfaction with the overall quality of life, the Satisfaction With Life Scale, Contentment with Life Assessment Scale and a Subjective Wellbeing Index. Using multiple regression, we explained as much as 75% of the variance in Subjective Wellbeing scores and as little as 45% in happiness scores. Four clusters of health determinants explained from 20% (Happiness) to 44% (Average Health) of the variance in the dependent variables. Adding comparison standards and domain satisfaction scores to the set of health determinants increased our total explanatory power by only 2% points for Average Health (from 44 to 46%), but more than doubled our explanatory power for Happiness (from 20 to 45%) and for satisfaction with the overall quality of life (from 31 to 67%). As well, our explanatory power for the single item of Life Satisfaction increased from 34 to 66%, for the Satisfaction With Life Scale from 39 to 74%, for the Contentment With Life Assessment Scale from 36 to 60%, and for Subjective Wellbeing from 42 to 75%. This provided very clear evidence that self-perceived good health is not equivalent to perceived quality of life, confirming evidence reported in our earlier studies. The three most important take-home messages from this investigation are (1) in assessing the relative influence of any alleged determinants of health and the quality of life, different sets of alleged determinants will appear to be more or less influential for different dependent variables. Therefore, (2) researchers should use diverse sets of determinants and dependent variables and (3) it is a big mistake to use measures of health status as if they were measures of the perceived quality of life.