QUALITY OF LIFE IN MALAYSIA (QoL)

CONCEPTS OF QoL
The concept of QoL entails changes by which an entire society and social system move away from a condition of life widely perceived as unsatisfactory towards a situation of life generally regarded as better. As such, the QoL encompasses not only economic development but also other aspects such as social, psychological, cultural, and political and the environment. (Dr Dasimah Omar). The Malaysian QoL is defined as encompassing personal advancements, a healthy lifestyle, access and freedom to pursue knowledge, and a standard of living which surpasses the fulfillment of basic needs of individuals and their psychological needs, to achieve a level of social well-being compatible with the nations aspirations (EPU, Malaysian QOL 1999).

DEFINITION QoL

MALAYSIA

According to Dr Dasimah Omar, more than 100 definitions of QoL have been noted in the different disciplines. Although diverse strands of research have been investigated individually, they have not been successful in providing us with a holistic understanding of QoL and how to improve it. In international comparisons, a major challenge is to cope with the diversity of societies arising from different economic development and the nature of the societies. Cultural and religious factors can influence the measure of QoL which is affected by different characteristics of the respondents giving their assessment. People defining QoL would vary accordingly to where they live and work. The diversity of these factors points to a multi-dimensional approach to understanding the concept of QoL. However, within a context, that is, a given time, place and society, some agreements can usually be reached on what would constitute QoL. In other words, peoples needs and the fulfillment of their aspirations and needs can be defined in a relatively precise manner within a specific cultural context.

There are sufficient elements of QoL held in common by members of a society for the concept of QoL to be meaningful. While there is no certainty as to what QoL means, QoL had been define as the degree of well-being, satisfaction and standard of living. It is also believed that the quality of a persons life is directly related to the persons capability. A capability is defined as the ability or potential to do or be something or more technically to achieve a certain level of functioning such as health and education.

NATIONAL

WHO defines Quality of Life as individuals perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, personal beliefs and their relationship to salient features of their environment.

MEASURING QoL
The use of indicators to guide decision-making can be traced to some 50 years ago. Some of the indicators that have been popularly used include Economic Indicators to track the performance of the economy and Social Indicators to measure a whole host of social conditions and progress. Economic indicators focus on material provision and rely heavily on the national income accounts. Social indicators have also been developed to measure social conditions. Objective social indicators look more broadly at the degree of fulfillment of basic needs in a society

PHYSICAL OF QoL INDEX

The Physical QoL Index (PQLI) is an attempt to measure the QoL or well being of a country. The value is the average of three statistics which are: Basic literacy rate Infant mortality

 Life expectancy at age one

This statistic values is all equally weighted on a 0 to 100 scale. It was developed for the Overseas Development Council in the mid-1970s by Morris David Morris, as a measures created due to dissatisfactions with the use of GNP as an indicator of development. PQLI might be regarded as an improvement but shares the general problems of measuring QoL in a quantitative way. It has also been criticized because there is considerable overlap between infant mortality and life expectancy.

HEALTH RELATED QoL (HRQoL)

Another method of measuring differences in QoL is as a difference in the "standard of living", according to the technical definition of that term. For example, people in rural areas and small towns are generally reluctant to move to cities, even if it would mean a substantial increase in their standard of living. Thus the QoL of living in a rural area is of enough value to offset a higher standard of living. Many of these focus on the measurement of health related QoL (HRQoL), rather than a more global conceptualization of QoL. They also focus on measuring HRQoL from the perspective of the patient and thus take the form of self completed questionnaires. The International Society for QoL was founded in response to this research and is auseful source of information on this topic

USING FREE AND PUBLIC DOMAIN DATA

Many indicators are used to measure national QoL and human development. These can be divided into single indicators and component sets. They review these approaches and describe public domain and free data that can be used to measure QoL. (Gene Shackman and Ya-Lin Liu are with the Global Social Change Research Project(GSCRP), and Xun Wang is a member of the Faculty in the Sociology Department at the University of Wisconsin, Parkside). A worthy goal of any government is to improve the QoL of its citizens. The government will know whether the QoL has improved or what the QoL is using the one common approach is to use QoL indicators, usually including measures of at least some of these dimensions: economic well being, health, literacy, environmental quality, freedom, social participation and self- perceived well being or satisfaction (Andr and Bitondo, 2001).

QoL indicators allow governments to evaluate how well they are doing compared with, for example, their development goals or the QoL in other countries. The indicators may also be used by outside observers or researchers to evaluate countries performance.

MALAYSIA QoL INDEX (MQLI)

To measure the changes in the QoL, the Malaysian QoL Index (MQLI) was devised.The MQLI is a composite measurement based on ten selected factor, namely income and distribution, working life, transport and communications, health, education, housing,

environment, family life, social participation and public safety. These areas are assumed to be of equal importance for the well-being and the QoL of the population and as such, were assigned equal weightage. A total of 38 indicators were used in the computation of the Index (Refer Table 1 & 2). The indicators were selected on the basis of their importance, how best they reflect that particular area and the availability of data on a time series basis (Refer Table 3). The indicators are aimed at providing an aggregate measure of the QoL in order to assess the impact of economic development on the population. In formulating the MQLI, the data used were for the period 1980-1998, with the exception of data on environment, which were available only from 1985. The year 1990 was chosen as the base year as it was a relatively normal year, besides being sufficiently recent.

Table 1 : Components of Malaysian Quality of Life Index

Factor 1.Income and Distribution Real per Capita GNP Gini Coefficient Incidence of Poverty 2.Working Life Unemployment Rate Trade Disputes

Indicator

Man-Days Lost Due to Industrial Actions Industrial Accident Rate 3.Transport and Private Motorcars and Motorcycles

Communications

Commercial Vehicles Road Development Telephones Average Daily Newspaper Circulation Life Expectancy at Birth (Male) Life Expectancy at Birth (Female) Infant Mortality Rate Doctor-Population Ratio Hospital Bed-Population Ratio Pre-School Participation Rate Secondary School Participation Rate University Participation Rate Literacy Rate Primary School Teacher-Student Ratio Secondary School Teacher-Student Ratio Average Housing Price Low-Cost Housing Unit Housing Units with Piped Water Housing Units with Electricity Air Quality Clean Rivers Forested Land Divorces Crude Birth Rate Household Size Juvenile Crimes Registered Voters Membership in Selected Voluntary Organizations Public Safety Crimes Road Accidents

4.Health

5.Education

6.Housing

7.Environment

8.Family Life

9.Social Participation

Table 2 : Components of Malaysian Quality of Life Index

Factor 1.Income and Distribution Real per Capita GNP Gini Coefficient Incidence of Poverty 2.Working Life Trade Disputes

Indicator

Industrial Accidents Transport and Communications Private Motorcars and Motorcycles Public Transports Telephones 3.Health Infant Mortality Rate Doctor-Population Ratio 4.Education Primary School Teacher-Student Ratio Secondary School Teacher-Student Ratio Primary School Average Class Size Secondary School Average Class Size 5.Housing Average Rental to Household Income Ratio Average Prices of Houses to Household Income Ratio 6.Environment River Quality Index Solid Waste per Kapita 7.Family Life Divorces Household Size 8.Public Safety Crimes Road Accidents 9.Community Participation Registered Voluntary Organizations Rukun Tetangga Members Registered Voters Culture and Leisure Library Membership Sports and Recreation Club 10.Urban Services Expenditure on Social Services

 Expenditure on Landscaping

Table 3: The Rationale for the Selection of Areas

Details 1.Income and Distribution

Rationale Gross income or per capita income reflects welfare or standard of living. Incomes provide the condition that allows individuals to sustain themselves and their families, while the distribution of income reflects equity and resources. distribution of economic

2.Working Life

Working life is important because being employed provides a source of income that contributes to the standard of living and QoL

3.Transport and Communications

Transport and communications are vital factors for progress an development since they relate to the mobility of and accessibility to resources as well as opportunity for employment, education and movement of goods and services.

4.Health

Health, which includes physical and mental well being, enables people to work productively and participate actively in the social and economic life of the community.

5.Education

The education systems are the principal instruments for transmitting knowledge and culture from one generation to the next. It provides the foundation from which the technology to sustain and improve the QoL is developed and enhanced.

6.Housing

Housing is a basic social need that is necessary for decent living, security and shelter for the family.

7.Environment

Environment has a direct effect on the well-being of the population. Air and water pollution and forested land are some indicator of the quality of environment

8.Family Life

The family unit represents the core institutions within the societal structure and its functioning fulfills the social

economic and psychological needs of individuals. Social participations is the reflection of the peoples commitment and willingness to be involved in social, political, religious and community activities. 10.Public Safety Public safety is essential as it ensures social peace and stability

9.Social Participation

NATIONAL QUALITY OF LIFE INDEX

OBJECTIVE APPROACHES

According to Sharpe and Smith (2005), the best known composite QoL scale is the United Nations Development Program's Human Development Index, HDI (UNDP, 2004). This index is a single value measuring health and longevity, knowledge (literacy and schoolenrollment) and standards of living (GDP per capita). Countries are rated on how well they are doing on each component compared to the range of possible values for that component. The HDI value averages the ratings of the three components. To calculate an individual country's comparative rating, the UNDP sets minimum and maximum values for the components. However, the minima and maxima and the country ratings themselves can vary greatly from year to year, even if conditions do not change much. In addition, Quality of Life score depends on the achievements (or failures) of other countries. Thus, the score cannot be used to chart the progress from year to year of any one country, compared only to its own previous achievements. Other international composite scales are Prescott-Allen's (2001) Index of the Well being of Nations and Estes' (1997) Index of Social Progress.

A composite scale is useful as an overall indicator. However, a single composite may sometimes be problematic, as different scales use different indicators or give different weights to indicators, and the construction of the composite scale may not always be clearly explained. Single scales may oversimplify the concept and do not present information about its components (Andr and Bitando, 2001). Finally, many QoL scales also correlate fairly highly with income percapita and thus may not add much useful information to this simpler

economic indicator. Thus, a set of key indicators may also be useful, because they cover a range of topics and avoid the need for combining or weighting individual components. Several of the organizations measuring QoL described above (e.g., Estes, 1997; UNDP, 2004) also use sets of indicators. In fact, this is the primary approach of the UNDP. The sets used by the UNDP and Estes include measures of health, education, economic well being, environment and technology, and tend to focus on 'objective' measures. The indicators are aggregate level measures, using the country as the unit of analysis.

ALTERNATIVE APPROACHES

Alternatives to these major approaches include attempting to measure the non-economic aspects of the QoL; well being as a hierarchy of needs; and 'Gross National Happiness' (GPI Atlantic, undated). This last approach "links the economy with social and environmental variables to create a more comprehensive and accurate measurement tool" (GPI Atlantic,undated).

QUALITY OF LIFE INDICES

It has long been accepted that material wellbeing, as measured by GDP per person,cannot alone explain the broader QoL in a country. One strand of the literature has tried to adjust GDP by quantifying facets that are omitted by the GDP measure but the approach has faced insurmountable difficulties in assigning monetary values to the various factors and intangibles that comprise a wider measure of socioeconomic wellbeing. There have been numerous attempts to construct alternative, non-monetary indices of social and economic wellbeing by combining in a single statistic a variety of different factors that are thought to influence QoL. The main problem in all these measures is selection bias and arbitrariness in the factors that are chosen to assess quality of life and, even more seriously, in assigning weights to different indicators (measured on a comparable and meaningful scale) to come up with a single synthetic measure. Some researchers have invoked the UNs Universal Declaration of Human Rights to identify the factors that need to be included in a QoL measure.

LIFE SATISFACTION SURVEYS

The starting point for a methodologically improved and more comprehensive measure of QoL is subjective life-satisfaction surveys (surveys of life satisfaction, as opposed to surveys of the related concept of happiness, are preferred for a number of reasons). These surveys ask people the simple question of how satisfied they are with their lives in general. A typical question on the four-point scale used in the Eurobarometer studies is, On the whole are you very satisfied, fairly satisfied, not very satisfied, or not at all satisfied with the life you lead?

The results of the surveys have been attracting growing interest in recent years. Despite a range of early criticisms (cultural non-comparability and the effect of language differences across countries; psychological factors distorting responses), tests have disproved or mitigated most concerns. One objection is that responses to surveys do not adequately reflect how people really feel about their life; they allegedly report how satisfied they are expected to be. But people know very well how satisfied they are. Responses to questions about life

satisfaction tend to be prompt; non-response rates are very low.

This simple measure of life satisfaction has been found to correlate highly with more sophisticated tests, ratings by others who know the individual and behavioural measures. The survey results have on the whole proved far more reliable and informative than might be expected. Another criticism is that life-satisfaction responses reflect the dominant view on life, rather than actual QoL in a country.

Life satisfaction is seen as a judgment that depends on social and culturally specific frames of reference. But this relativism is disproved by the fact that people in different countries report similar criteria as being important for life satisfaction, and by the fact that most differences in life satisfaction across countries can be explained by differences in objective circumstances. In addition, it has been found that the responses of immigrants in a country are much closer to the level of the local population than to responses in their motherland. Answers to questions on satisfaction in bilingual countries do not reveal any linguistic bias arising from possibly differing meanings and connotations of the words happiness and satisfaction. Self reports of overall life satisfaction can be meaningfully compared across nations.

WORLD HEALTH ORGANIZATION QUALITY OF LIFE

The structure of the WHOQOL-100 reflects the issues that a group of scientific experts as well as lay people in each of the field centres felt were important to quality of life. The six broad domains of quality of life, and the twenty-four facets covered within each domain are shown below. Four items are included for each facet, as well as four general items covering subjective overal QOL and health.

Factor 1 .Physical health Energy and fatigue

General Health Indicator Pain and discomfort Sleep and rest

2.Psychological appearance

Bodily

image

and Negative feelings Positive feelings Self-esteem Thinking, learning, memory and concentration

3. Level of Independence Mobility

Activities of daily living Dependence on medicinal substances and medical aids Work Capacity

4. Social relationships Personal relationships

Social support Sexual activity

5. Environment

Financial resources Freedom, physical safety and security Health and social care: accessibility and quality Home environment Opportunities for acquiring new information and skills

Participation in and opportunities for recreation/ leisure Physical environment (pollution/noise/ traffic/climate) Transport 6.Spirituality/Religion/Personal beliefs Religion /Spirituality/Personal beliefs

The Economist Intelligence Units index

The nine quality-of-life factors, and the indicators used to represent these factors are:

Factor 1. Material wellbeing

Indicator GDP per person, at ppp in $. Source: Economist Intelligence Unit

2. Health

Life expectancy at birth, years. Source: us Census Bureau

3. Political stability and security

Political stability and security ratings. Source: Economist Intelligence Unit

4. Family life

Divorce

rate

(per

1,000

population),

converted into index of 1 (lowest divorce rates) to 5 (highest). Sources: un;

Euromonitor 5. Community life Dummy variable taking value 1 if country has either highrate of church attendance or trade-union membership; zero otherwise. Sources: ilo; World Values Survey 6. Climate and geography Latitude, to distinguish between warmer and colder climes. Source: cia World Factbook

7. Job security

Unemployment rate, %. Sources: Economist Intelligence Unit; ilo.

8. Political freedom

Average of indices of political and civil liberties. Scale of 1 (completely free) to 7 (unfree). Source: Freedom House

9. Gender equality

Ratio of average male and female earnings, latest available data. Source: undp Human Development Report

HUMAN DEVELOPMEN INDEX (HDI)

The United Nations Development Programme made a major contribution to the development of composite indicators with the publication of the first Human Development Report in 1990. This report contained a new indicator, the Human Development Index (HDI), which captured three dimensions of the development process; income, health, and knowledge, in a single indicator (UNDP, 1990). The UNDP has since refined some of these measures in its annual reports, and has developed supplementary measures, such as the Gender Development Index and the Gender Empowerment Measure, which reflect the degree of womens inclusion in a society. Canadas high ranking, including leading the list of countries with high human development for most of the 1990s, became a point of pride for some Canadian politicians, despite the fact that there is very little difference in the HDI scores of the most developed countries. However, Aboriginal people have not experienced the same high levels of human development, according to a modified version of the index which compares Registered Indians in Canada to other Canadians, developed by the Strategic Research and Analysis Directorate of Indian and Northern Affairs Canada (Beavon and Cooke, 2003; Cooke,

Beavon, and McHardy, 2004).

WEIGHTED INDEX OF SOCIAL PROGRES S( WISP)

The WISP was developed in by Richard Estes (1997) of the University of Pennsylvania, as an improvement on his Index of Social Progress (Estes, 1984). The new index uses statisticallyderived weights and 46 indicators in 10 sub-indices to identify changes in the adequacy of social provision in countries throughout the world between 1970 and 1990. The sub-indices include education, health status, womens status, defence effort, economy, demography, geography, political participation, cultural diversity, and welfare effort.

The QOL (Diener, 1995) was developed to include value-based elements of the quality of life, as well as the objective measures of physical health and economic activity (Diener and Suh, 1997). The measures chosen represent three universal requirements of human existence; biological needs, coordinated social interaction, and the survival and welfare needs of groups. The QOL also uses different indicators for developed and developing countries, in order to account for their substantially different social and economic contexts. Following Schwartz (1994), Diener identifies seven value regions, each of which is measured by a separate indicator. These regions and their indicators for developed countries are mastery (physicians per capita), affective autonomy (subjective well-being), intellectual autonomy

(college/university attendance), egalitarian commitment (income equality), harmony (major environmental treaties), conservatism (monetary savings rate), and hierarchy (per capita income). These components contribute equally to the total quality of life, an average of the scores on these variables. spects of quality of life are important dimensions of life in First Nations communities, including health, the condition of the natural environment, and freedom from crime.

Reference Dr Dasimah Omar, Quality of Life, Lectures Notes MARA Dr Dasimah Omar, Town and Country Planning and Quality of Life in Malaysia, Lectures Notes of TRP513, University Technology MARA

of TR513, University Technology

Gene Shackman, Ya-Lin Liu and Xun Wang, Measuring quality of life using free and public domain data, retrieved on November 2, 2008

The Economist Intelligence Unit QoL Index , THE WORLD IN 2OO5