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They are asking to be freed from slavery to daddy and to brother and to husband. They are asking to be free to determine for themselves whether or not they shall engage in sexual activity and whether or not they will have any child they may carry, i.

What of the changes in other values which affect women? For instance, the conventional wisdom at the White House Conference on Children in stated that if a woman wanted federal support for her children, she had to stay home and take care of them. The conventional wisdom of the White House Conference on Children stated that the support would be forthcoming only if the mother worked.

For those attempting to construct indicators of quality of life the problem is further compounded by the great dearth of literature until recent years. The literature that has existed has been written mostly by men and is viewed by the "movement women" as reducing women to an inferior status.

The psychological problems of low self-esteem and low achievement motivation as it relates to women affect their concept of quality of life. According to Campbell, the "genocide question" is an important QOL matter from the minority perspective because it is real in a cognitive sense.

Given the fact that on half of the prison population of the country is black, that there is a higher percentage of blacks unemployed than whites, and that infant mortality is higher among blacks, it is not difficult to think in negative terms.

Belinsky can always change his name to Bell and move to the suburbs. No name change is going to enable a black to go unnoticed in a white suburb. The question is one of choice, and the options available to blacks are fewer than those of whites. Another QOL problem for blacks is the lack of black success models for the young. The affluent are usually pimps or dope pushers running around in expensive clothes, big automobiles, with beautiful women on their arms.

Although there is no written rule concerning the advent of new develop- ments, it is Campbell's view that for the present, it takes a crisis to bring the country to focus on difficulties in the black community. Watts and Attica are two cases in point. Although it is true that other ethnic and racial groups began in the slums of our cities, four significant differences exist: Color, as mentioned above you can change your name but not your color Earlier immigrants to the shores of America had crafts and skills that were needed There is no longer great opportunity in moving West in the great migrations There is the effect on psychological motivation of the heritage of working as slaves.

Physical short, tall, crippled, in wheel chairs, blind, deaf, dumb, ugly, etc. Geographical urban, suburban, country, mountain, valley, desert, plains, cold, heat, sun, rain, water, snow, sand, dust, etc. Social unrest which affects the QOL of the nation is rooted in the QOL of the nation's constituent minority groupings.

Jessie S. Gertman, Deputy Chief, Division on Aging of HEW, reported that by the year , it is estimated that there will be between 28 and 40 million "oldsters. Another serious QOL concern is that of retirement. People who are still able to work are forced to retire, some at 65, others earlier. Most oldsters, however, report high satisfaction or happiness. In a country that worships youth, the elderly are indeed the "unwanted generation.

While youth play increasingly important cultural and political roles in the West, the elderly play continually diminishing roles. Yet both groups are remarkably alike. Time is an obsession with both groups. Where youth is worshipped, however, the aged are avoided. The aged are treated as a "lower class", while youth are treated as an "upper class.

One of the most interesting aspects is that of senility. It is a catchword to describe old people. Yet senility is not peculiar to the elderly. In administered senility tests, college students were found to be more neurotic, negative, dissatisfied, socially inept and unrealistic than were the oldsters. Similar symptoms in oldsters were passed off as par for the course for the elderly. Many QOL factors are relevant from the perspective of the aging: isolation, joblessness, decrease in mobility, ill-health, low income, legal problems, death and dying, out of date education, low energy, loneliness, etc.

Although the more blatant injustices of "age-ism" can be alleviated by governmental action and familial concern, the basic issue will not be solved, it is suggested, until there is a fundamental reordering of the basic values of our society in respect to the aged. Recently, the aged have organized their "cane, crutch and Cadillac vote" to put pressure on banks and cities and have picketed in wheelchairs.

Due to their increased numbers, they are out to flex their political muscle and are being rather successful at it Isenberg, Important QOL questions for the future regard the roles the oldsters are expected to play and are allowed to play.

How are they to maintain their own sense of identity as they pass through the biological stages of life? How do they relinquish the role afforded by the social structure at an earlier period of their lives? What is the effect of having to let go? There is a wide-ranging continuum of life styles from which to view quality of life values. The perspectives presented at the conference were in no way representative of the nation as a whole.

The views presented may well have been representative only of those individuals making the presentations. Nevertheless, the conference illustrated just how basic the various sets of life style values are to the concept of Quality of Life. Each life style grouping needs its place in the sun. The QOL of each life style involves considerations related to the four factor areas of QOL: the social, the economic, the psychological, and the environmental.

No public planning, no decision making should be attempted without first taking into consideration the varying and multitudinous values and priorities of the different life styles. The wide range of back- grounds of those at the QOL conference as well as the range of issues raised bear dramatic testimony of this fact.

The different disciplines of economics, sociology, environmental science, psychology, etc. The perspectives of each of these disciplines in approaching the QOL concept is the subject of this chapter. The purpose of the Airlie conference was to focus on QOL issues, not to solve the complex problems related to them. An effort has been needed to free the discipline-locked fragments of QOL research in order that they might be put together into a cohesive whole.

We have already discussed the difficulty of getting people of varying life styles to agree on what constitutes a quality life. Men and women of the different disciplines, of course, carry their personal values into their professional roles and approach subjects from the particular vantage point of their discipline. The QOL concept, to be an effective tool to decision makers, requires an interdisciplinary perspective. This chapter will attempt to weave together the many contributions made by the conference participants.

It will be difficult to assign credit, since so much of this is the result of the on-going synthesis, the interdisciplinary interaction, of the conference process. It might be useful to define our use of "inter- disciplinary" as opposed to "multi-disciplinary. One of the difficulties in approaching a subject such as QOL is that of basic methodology. At the conference, Maruyama made the point that our forms of logic and philosophy are not always up to the job at hand.

He calls for the abandonment of the traditional, absolute forms of logic, which are uniformistic, hierarchial, classificational, undirectional, competitive, quantitative, object-based, and self-perpetuating. He advocates that we adopt instead the emerging form of logic that is heterogenistic, interactionist, relational, mutualistic, symbiotic, qualitative, process-oriented, and self- transcending self-renewing.

There are others who would say just the opposite. The direction to take may well involve and integration of the two forms of logic in developing an interdisciplinary apporach. The quality of life concept cuts across these three areas. The question is thus raised as to whether or not a public consensus can be achieved that can be applied to the whole of society. Called for was a public and open discussion of the indices to be considered, plus the development of indices by which the citizen could evaluate government action.

Another suggestion was to adapt methodologies to the local level. Most symposium attendees agreed that the development of QOL indicators was necessary for several significant environmental reasons: As an early warning system to head off pending disaster As an educational device to arouse lethargic citizens about a danger or an opportunity to their environs To assist decision makers in ordering their priorities In approaching a definition of QOL, however, a caveat was issued regarding an attempt to compress it to fit a pet methodology.

Concern was expressed regarding how to relate labor, work, leisure, perfor- mance criteria, etc. Therefore, QOL measurement should be broad enough to include the whole environmental, economic, and social system. This could help develop either an overall index or at least demonstrate what such an overall index could not do. More theorizing, conceptualizing, and philosophizing about QOL definition and what to do about it were also suggested. Regardless, it was agreed that a solid, firm, intellectual base was necessary if correct decisions were to be made from adequate definitions.

In approaching QOL definitions from the environmental perspective, it was suggested that a real world model be used, which would mean a behavioral model. Conferees discussed the five major components for the more important environmental considerations raised by the Meadows group: Population increase Agricultural production Non-renewable resource depletion Industrial output Pollution generation Many participants considered that basic to a discussion of QOL was the ability to maintain a life support system for mankind and other forms of life.

According to Meadows, et al, the life support system is limited: the earth's resources cannot support present rates of economic and population growth much beyond the year , if that long, even with advanced technology. In the literature, Buckminster Fuller has suggested an approach whereby the problems pointed up by the Meadows book can be alleviated.

Do more with less. The consequences of this idea for those enamored with GNP are enormous; it doesn't necessarily mean reduced GNP,but it certainly implies a different way of measuring it. The vision of maximum abundance, which Fuller sees as now being within our grasp, is translated as Utopia. The only other alternative in his view is oblivion, which will be the result of using the means of destruction instead of the real wealth of the world: i. To accomplish this requires a "design revolution" that must come "in time to accomplish "Utopia" before "Oblivion" occurs.

As Commoner has pointed out, "peace among men The problems of the environment are not new. Interest in them, however, on a wide scale, however, is new. Environmental management is thus an important albeit new concern for decision makers, a concern that now includes a broader concept QOL and provides a new platform for our continuing analyses of our world.

QOL considerations are now possible because man is willing to redefine his relationship to his environment. From having feared the environment, man came to understand it, used it, then abused it, and is now concerned about what he has done and what he can do to invest his physical and biological world with quality National Goals Research Staff, The desire to achieve oneness with nature is what Burstein calls our new religion Burstein, There is a dawning recognition of the fact that the values of the society will determine the quality of the environment and that, depending upon the costs the citizen is willing to bear, that level of quality will be obtained.

Not to be forgotten is that improvement of the environment provides other benefits, not the least of which are aesthetic and moral satisfaction in addition to contributing to life survival. A key factor in developing environmental QOL factors and components is weighting them. This is done through a series of trade-off analyses. How does one make trade-offs even among environmental factors without making it merely a trade of one form of pollution for another such as reducing air pollution by washing smoke and sluicing it out into the water courses; or reducing auto exhaust by limiting its use, but then precipitating transportation problems and affecting the micro-environments in which people work and live Perloff, How are human beings to be factored into environmental equations without automatonizing them?

For instance, the New York Academy of Sciences meeting in early featured a paper that advocated the "manage- ment of natural and man-made systems, on a local, regional, national, and global basis" by further developing homo sapiens into "mechanical man," which would be of a higher evolutionary form. A measurement system is vitally necessary if we are to be able to accurately assess the effects of dumping wastes in the oceans, the rivers, the skies, and anywhere else man can find to dump.

Will the mercury getting into fish seriously endanger the biosphere and the eco-cycle, for example? What will be the effect of unrestrained population growth: starvation, disease, catastrophic war? If we cannot measure adequately and accurately the results of current and projected environmental policies, then we cannot really plan for a balance and harmony between nature and man's relationship with nature.

Without this balance there can be no quality of life for human beings. Steps are being taken to address the knotty prob- lems of human action and behavior in economic methodologies. The economists are beginning to pay attention to the fact that such concepts as production and distribution, goods and services, commodities and performances are related to the human actors who control them and who, in turn, are controlled by them. The top priority for any nation historically has been its economic health.

Consideration of the humanistic elements of life, the stuff of social conscious- ness and social indicators, has generally come after the basic problems of eco- nomic survival and growth have been overcome. Thus in America today, the "economics of quality" is the subject of considerable study. The economic measure became the major indicator of prosperity and well-being of societies and nations. Thus, as long as Gross National Product rose, it was assumed that the prosperity and well-being of the individual were also rising.

Recent studies Agenda for the Nation, have shown, however, that economic prosperity has no high correlation with the solving of social ills. Fred Singer Conference Board Record, of the University of Virginia and an Airlie conference participant, has made the point that predicting the economic future is complicated since each GNP item behaves in a different way. Even GNP per capita is not the right index, since it corresponds to an index of national production rather than consumption.

We want to achieve the highest quality of life for the population as a whole. We must first define quality of life acceptably, and operationally-i. Our next job is to devise a way to translate national income accounts like GNP into a more meaningful expression of well-being-an index of quality of life QOL. He has presented a definition of QOL from an economic perspective: "In our society, where material comforts contribute importantly to what people perceive as happiness, a loose definition might be 'having as much money as possible left over after taking care of basic necessities, and having the necessary time and opportunities for spending it in a pleasant way.

It measures the quality of life in dollar terms by calculating potential consumption and assigning a monetary value to free time. Specifically, we start by examining the national income accounts, which aggregate the nation's output, to see which items contribute to QOL, and to what extent. We include amenities like leisure time and environmental quality-not counted in GNP.

We subtract items that enter into GNP but are really disamenities which don't contribute to quality of life. Among the most important are pollution and increased distribution costs in crowded urban areas. Income distribution is considered by many as a major component of an inspired quality of life for everyone. It has been assumed by some that QOL can only be achieved by providing everyone in the country with sufficient income support.

The economic approach is increasingly recognizing that materialistic quantifiers no longer suffice as the base of QOL. Many of these needs involve noneconomic factors. Ignoring these needs is what narrows many planners' and thinkers' vision to thinking of QOL only in terms of distribution of economic resources James, QOL, however, must be approached in terms of patterns, taking into consideration everything that makes up the mosaic of a life.

This question of what are man's fundamental needs is not a new one. Behavioral scientists, political scientists, theologians and philosophers alike have long debated the question. A consensus has formed over the years that human needs are many and varied, and that the particular socialization process of particular groups will greatly influence the sum and substance of the needs.

It has also been found that the distinction between the primary drives and the more complex secondary or learned social motives is quite often more apparent than real. Again, it depends upon the sociocultural systems family, neighbor- hood, geographical region, etc. Proshansky, et al, It could thus be said that "physical setting" needs are in most instances mediational or instrumental in character and provide the basis for understanding the emergence in the individual of such complex, environment-related phenomena as privacy, territorially, personal space, and others Proshansky, Related to and affected by these physical setting needs are existential needs.

Together they comprise the substance of various theories of "needs hierarchies. Martin Buber approached QOL although he did not use the phrase in terms not of material abundance and status acquisition but of satisfaction from living "the good life" and relating to others in a non-objective way. Skinner suggests a behaviorist theorem: to achieve the QOL you want change the environment around you.

For Skinner, the important factor is not man's choice but rather the environment natural and social. Skinner would have us jettison such sacred cows as freedom, mind, dignity, will, and virtue. In Skinner's world, man would be "controlled by the world around him, and in large by other men. Toffler viewed QOL as something that a person could attain if he learned to cope with change. Having "copability" would prevent "future shock.

It can also be considered in terms of the impact of family structure on personality formation, which would include child-rearing tech- niques, the nature of the family relationships, and the experiences in alternative family styles, such as the communes or intentional communities.

The impact of group membership on attitudes and behavior groups, gangs, fraternities, the army, etc. All of these factors relate to the fulfillment of some need. Yet in our search for QOL approaches we find that little is really known about the relationship between attitudes and behavior. The hierarchy of needs theory attempts to bridge this gap.

According to the various theories, a person moves from one needs level to another when the current level no longer satisfies. The most famous needs theory is that of Abraham Maslow He is the father of the concept of "self-actualization. The five levels are survival, security, belongingness, esteem, and self-actualization. To Maslow, the self-actualized people are "gratified in all their basic needs-embracing affection, respect, and self-esteem Graves lists eight levels with the caveat that there may be more; but so far, all he has been able to identify empirically are eight.

Each level of existence has its own existential state. Each level of existence has its own motivational system and end values. Most important to the theory and a major distinction from other theories, each existential level has its own peculiar existential problem. Thus, no matter how "high" you go, you cannot become perfect or self-actualized.

In a recent and significant book in the field by Campbell and Converse , , they discuss quality of life from the standpoint of the quality of personal experience. They discuss such states as frustration, satis- faction, disappointment, and fulfillment. They say these are from the individual perspective, as in "the eye of the beholder.

Maslow developed his theory on a study of his interviews with very wealthy, successful men. Graves developed his theory over a period of twenty years, observing and testing individuals from every socioeconomic level. Although this is not the place to take up the age old question of what is happiness, we can nonetheless avoid some pitfalls by not trying to equate well-being, satisfaction, and fulfillment with a position on an income scale.

Paukers comment, on the Watts mood cited earlier, is a good example. The social perspective is best seen through the discipline of sociology. What many policy analysts and decision makers seem to forget all too ofter is that their backgrounds in relation to these categories greatly influence their "scientific" approach to the development of indicators that will measure the quality of life.

Sociology can provide insights valuable to anyone concerned with action in society; but this action need not mean "social" work or humanitarian work. Knowledge established scientifically can be used for good or evil. Sociology is "value-free" in that its purpose is scientific inquiry and integrity Berger, , But sociology is very important in the understanding of the search for QOL definition.

Our increasingly complex and variegated society i. The sociological view is a particularly necessary element of an inter- disciplinary approach to QOL definition in a vastly pluralistic society such as ours. For instance, sociology has brought to our attention the fact that modern man is the first to be provided with discretionary leisure time.

Although the development of leisure time has been hailed by many, for others who do not know how to fill their leisure time, it is a curse. One of the major methods related to QOL is that of social indicators. They reveal that society is a community of individual and collective meanings, that are objective and subjective.

Both must be taken into account and quantified. The social perspective can be used to help clarify some of the confusion between ends and means or output and input and to help focus on the distinction between the two Terleckyj, Two components significant to the discussion but often confused are those of "class" and "race and ethnicity. Parents want their children to live in neighborhoods and to go to school with children of comparable class position.

Without making a value judgment, we can state that one factor in QOL definition for many parents is to be able to shield their children from the social and cultural realities of lower-class life, particularly if. Important in ascertaining QOL components is that value preferences are more akin to socioeconomic position than to race.

Rokeach and Parker , found that, as economic differences between the races disappear, other differences disappeared also. Thus, different QOL definitions may be necessary for each of the different classes. One of the biggest components in the equation of QOL definition is that of change.

A feeling for the extent and magnitude of change in modern life can be seen from the chart below regarding the evolution of socioeconomic organiza- tion as a structural underpinning of society Molitor, The actual result of this and of its implications are not yet clear,but it seems safe to say that a major shift in social values will result.

Several shifts may occur; for example, Incentives to discourage people from working may be devised Work may become a privilege and a coveted status symbol, not a necessity Life without work from cradle to grave may be possible Use of leisure time may become our main preoccupation An economy of abundance, not one of scarcity may prevail Undreamed-of equality, and economic sharing may become possible Such epochal changes in the society make it clear not only that are we in the midst of a values revolution, but also that hard definitions of QOL at the macro level will be impossible except in the most general terms.

The implications for QOL measurement are clear: whatever measurement system s is are devised must be fluid, flexible, and capable of rapid adjustment to the new technological realities and their ramifications.

Also people must realize contemporary society, more than ever before, needs citizens with the ability to understand the situations and social worlds of others Berger and Berger, b Indeed, it should be clear that the quality of life concept has yet to provide us with the full understanding of how its utilization will be of greatest benefit to decision makers. The discipline of history provides some insights that could be most useful to the QOL definition task before us.

A sense of history can help to dispel the "national hypochondria" that has caused our "imprisonment in the present" Boorstin, A sense of history enables comparisons and brings to bear the wisdom of ancestors and the culture of kindred nations.

The historical perspective is one check on the sometimes emotional and Utopian programs suggested as well as the sometime emotional and Utopian re-interpretation of past history. We compare our smoggy air not with the odor of horsedung and the plague of flies and the smells of garbage and human excrement which filled cities in the past, but with the honeysuckle perfumes of some nonexistent City Beautiful.

We forget that even if the water in many cities today is not as spring-pure nor as palatable as we would like, for most of history the water of the cities and of the countryside was undrinkable. We reproach ourselves for the ills of disease and malnourishment, and forget that until recently enteritis and measles and whooping cough, diphtheria and typhoid, were killing diseases of childhood, puerperal fever plagued mothers in childbirth, polio was a summer monster.

These are all factors of what we would call "negative" QOL. In their own day they were considered "facts of life. It is true that "Doomsday is quite within our reach, if we will only stretch for it" Wainwright, But, to prevent it, decision makers need to hear not only the "awful truth," such as in The Limits to Growth by MIT or A Blueprint for Survival from scientists of Great Britain Meadows, ; "A Blueprint," , but also what can be done to prevent the awfulness.

The Federal Government is more than aware that our environmental problems stem from not only our technological and economic successes but from our philosophical view of nature as well National Goals Research Staff, One of the reasons for attempting to factor the QOL into ecological studies is to provide an unprecedented expansion of our knowledge if considera- tions regarding our current technological and economic alternatives are to be made in light of what we are beginning to discover as necessary to achieve true long-range ecological balance Viewing QOL from the perspective of the various disciplines as well as from the perspective of varying life styles should help to facilitate the development of new means by which decision makers can do their jobs.

There are different life quality perspectives associated with various life styles, and we have touched on some of them. There are also disciplinary perspectives to the problem of defining QOL, reflecting economic, psychological, sociological and ecological viewpoints.

And there are widely different views on what quality of life actually means, as conditioned by the insight one wishes to gain. The social researcher, in other words, has different needs, and hence different perspectives, from the decision maker or government planner. Unfortunately this multidimensional nature of the life quality concept, though it implies an intellectual richness, limits the usefulness of the concept. In essence, it is too illusive a concept, at least as we now understand it, to serve as more than a focus for loosely structured philosophical discussion.

This is particularly so since there is widespread discussion of the possibility that QOL measures may be useful in government decision making, planning and evaluation. Without a precise definition of what is meant by QOL and that definition may of course vary somewhat as a function of context and without some valid and reliable procedure for measuring whatever parameters are associated with QOL, however, there is no way in which the concept can be used in a meaningful way as a planning tool.

Indeed, without such quantifi- cation, or at least a clearly defined algorithm for attempting such quantification, the concept cannot be intelligently discussed because there is no common framework for comparison of different ideas or approaches. One can legitimately ask why is it necessary to compare what may seem to be intangible elements of QOL in a quantitative way, and we shall consider the types of concerns which generate such questions shortly.

For the moment, however, the point is simply this: If QOL is to be applied to improve the way in which we make decisions about our social programs and our future, then it must be quantified in the best, and most acceptable, way we can devise. Though we shall focus primarily on the concerns expressed by those conferences opposed to QOL quantification, it is important to emphasize that these are "positive" concerns as well. Virtually all those who favor a research effort to explore QOL quantifi- cation recognize that there are pitfalls to be avoided and serious concerns to be dealt with.

Generally speaking, the points raised by these cautious optimists echo those of the negativists, though with reduced intensity. Hence by discussing the negative viewpoints expressed at the conference, we will treat most of the major concerns. Those who argue that one cannot possibly quantify QOL in a meaningful way raise a number of compelling points. The one voiced most frequently is that the parameters, or factors, which are important in determining QOL are so highly individual that any attempt to describe QOL for a group, no matter how small, will inevitably miss the mark as far as the individuals in that group are concerned.

Virtually everybody acknowledges that there are distinct differences between, for example, urban slum dwellers, midwest farmers, and suburban housewives. While the broad differences between cultures, races, economic strata, age groups, and so on are widely recognized, even by the most enthusiastic advocates of QOL quantification, there are some who will admit to no common groupings of QOL parameters at all.

These champions of the entirely individualistic view of QOL argue that each person's view of life is unique and that it is not possible, or acceptable, to compare that person's satisfactions, happiness, achievement, or whatever with anybody else's. In brief, this view holds that any aggregation of QOL measures, even if such measures could be obtained, would so totally distort the individual's situation as to make the aggregated measure meaningless.

Apprehension about the statistical approach to establishing QOL measures quite properly reflects a concern about the sublimation of the individual to the group, but it overlooks an important point, namely that we, as a nation, do conduct social programs aimed primarily at groups rather than individuals. If we collectively acknowledge that such programs have value, then we may legiti- mately look for ways to measure their success or failure from the group perspective.

Hence any outright rejection of some degree of community in QOL factors or parameters must inexorably be coupled with an equally adamant rejection of any group oriented programs, no matter how apparently beneficial they may be. A second group in the "cannot do it" camp holds the view that, even if a suitable set of common QOL factors could be produced, no valid measurements of these factors are obtainable.

The concern, quite simply, is that QOL, being a highly subjective concept involving profound feelings, values, and attitudes, cannot be reduced to quantitative measures. Then there is the widely expressed concern that, even if an individual claims to be offering a carefully reasoned evaluation of his QOL situation, he may, in fact, not be articulating his true views at all, but may instead be attempting to offer an "acceptable" response that will please the interviewer.

Each of these concerns, and a number of others not yet enumerated, can be treated as raising implicitly a scientific question. In essence they question the feasibility, or even possibility, of developing valid and reliable methods for measuring an individual's QOL in a scientific fashion.

Fortunately such concerns can, because they are essentially scientific, be answered in principle. Later we shall deal with these matters in more detail when we treat measurement problems. Among the concerns voiced by those who argue that we "should not" attempt to quantify life quality, two stand out as particularly pervasive. The first is epitomized by the work of Maruyama who argues that the entire notion of quantifying quality of life is inextricably linked with a traditional Western logic system that is being replaced by a new approach stressing the symbiotic rather than the competitive.

As a consequence, Maruyama concludes that any attempt to classify and quantify QOL factors merely serves to prolong an outdated system, and hence should not be undertaken. The second of the dominant "should not" concerns does not dwell on the philosophical or even the scientific questions associated with QOL quantifi- cation.

Rather it focuses on the kind of harmful use to which a QOL index might be put. There is no truly effective counter to these deeply held concerns, though one can argue with some conviction that if a bureaucracy is to act, it is better that it base its actions on some information about the state of society, no matter how incomplete, than on total ignorance. What has been presented here is a rationale for progressing in an attempt to attach precision and quantitative measures to the QOL concept, as well as a highlighting of some concerns, even fears, that are expressed about such a program.

Where, then, does all this lead? One can certainly make a strong case. Because the business of trying to define and quantify QOL is an intellectual challenge, it will certainly be undertaken unless of course we enter a period of complete thought suppression. Hence we had best go about it in as systematic and as scientific a way as possible, and with all due dispatch. Furthermore, several excellent reviews of the subject are already available Dalkey, , Campbell and Converse, , Sheldon and Moore, The intent is rather to focus on the ideas presented at the EPA Conference or by conference participants in their contributed papers.

In this discussion we will not advocate any particular approach to QOL quantification but will present, as clearly as possible, the alternatives that have been suggested at the conference and in literature and the difficulties associated with each of them. In addition we will describe, and comment on, the experiments in QOL quantification conducted at the conference. The first step in any attempt to attach quantitative measures to the quality of life concept must necessarily be to establish a rigorous, working definition of what this illusive concept actually means.

As the preceding chapters have made abundantly clear, however, even this first step along the road to quantification presents a major hurdle. As Dalkey points out, even the word "quality" can be thought of in two ways: it can refer to a condition or it can imply a degree of excellence.

Many authors have avoided the definitional problem altogether by simply listing a series of QOL components and defining the concept in terms of its parts. Even this approach can easily lead to controversy, however, There are, for example, differences of opinion on the types of factors that should be included in a QOL component list. Some researchers favor inclusion of only those external, or objective, factors that are amenable to direct measurements; others opt for inclusion of various internal, or subjective, factors.

Later in the discussion we will present a tableau of QOL factor lists prepared by various authors to illustrate both the diversity of the components included and their common features. In order to emphasize the diversity of potential definitions of QOL, it is instructive to consider the variety of definitions offered by participants at the EPA conference. A number of researchers have focused on the individual psychological aspects of QOL.

For instance, Dalkey has defined QOL "to mean a person's sense of well-being, his satisfaction or dissatisfaction with life, or his happiness or unhappiness. Mitchell et al have also emphasized the "phenomenological, direct or psychologically oriented measures as distinct from the behavioristic, inferential or physiologically oriented ones " in defining QOL as "an individual's overall perceived satisfaction of his needs over a period of time.

The apparent difficulties inherent in treating the subjective or psychological aspects of QOL in a rigorous, scientific fashion and we shall return to these problems shortly have led many researchers to restrict their scope by defining QOL in terms of objectively measurable parameters. This point of view was represented at the EPA conference by Hornback and Shaw , who defined QOL "as a function of the objective conditions appropriate to a selected population and the subjective attitude toward those conditions held by persons in the population.

Emphasis on objectively measurable parameters has been the hallmark of the "social indicators movement" in QOL research. Even within the framework of social indicators research, however, there are various perspectives reflecting different views on the definition of social indicators and how they should be developed.

Brooks et al have summarized this situation very clearly and have identified four principal approaches, viewing social indicators as: Instruments for detecting changes in the QOL of individuals, groups or societies Instruments to monitor progress toward societal goals, thereby reducing the normative implications inherent in the QOL concept A widely referenced list of such indicators was proposed in the document "Toward a Social Report", U.

This list includes: health; social mobility; physical environment; income; public order and safety; learning, science and art; participation and alienation. They do, however, express preference for the use of social indicators as parameters in a social system model designed to provide a basis for making effective policy decisions. This approach offers wide horizons for concrete, scientific research while avoiding the definitional morass that accompanies less precise conceptual perspectives.

There is no way to reconcile the divergences of opinion on how to define QOL, nor should any attempt be made to do so. The important thing, from the point of view of making scientific progress is that each research effort be based on a carefully conceived definition which is then adhered to rigidly. That some research teams are focusing on objective QOL measures and others on subjective measures is not at the present stage particularly critical.

In time the outputs of both efforts will meld into one, more comprehensive, understanding of the QOL concept. Once a precise definitional framework has been established for proceeding with research on QOL quantification, the next step is to develop a series of hypotheses that can be tested scientifically. If we keep emphasizing the scientific approach to the problem, it is for good reason. Without a reasoned, logical approach to answering well-posed questions, it is not possible to make any real progress at all.

A usual first step after definitions have been established is to make a series of assumptions or constraints to guide the research effort. Such assumptions can limit the scope of the problem. In order to simplify it, they can provide classification guidelines, and so on. To illustrate, it is appropriate to comment briefly on some assumptions that have been made in the research efforts reported at the EPA conference.

The approach taken by Dalkey , for example, is based on two assumptions: That "the basic components of QOL are common to practically all individuals, and are only weakly dependent on ethnic or socio- economic status" That "differences between individuals in their relative emphasis on various QOL components are due in large part to the fact that tradeoffs among the components are dependent on how much the individual is receiving of each. Mitchell, Logothetti and Kantor also established a series of attributes to be satisfied by any QOL quantification procedure.

Though very different in character from the constraints just proposed, they satisfy the basic requirement of internal consistency with the QOL definition established by Mitchell and his coworkers. This is an important observation because it reflects, already, a tendency toward some universality of approach.

The strong subjective emphasis in this work differs strikingly from the more objective orientation of other researchers. However, one may expect that, as knowledge accumulates, the apparent divergences between the objective and subjective approaches will become less pronounced.

Before leaving the subject of definitional constraints or assumptions, it is worth commenting briefly on another class of such assumptions, that dealing with the requirements for a QOL component classification scheme. One of the more basic, and widely quoted, sets of classification criteria is that proposed by Ayres The four principal criteria he suggested are that: The classification be unambiguous i.

The preceding discussion has dealt at some length with a variety of alternative assumptions and constraints in order to illustrate the kind of careful, logical process that must be followed in developing a QOL quantification scheme. We must acknowledge that it is virtually impossible to produce a scheme that is above criticism on philosophical grounds.

If the QOL researcher is consistent within the scientific framework of definition and assumption he establishes, however, then he will quite likely make a useful contribution to our knowledge about QOL quantification, and that must be the main objective at this stage of development of the field. Establishing working definitions and assumptions is the first step to be taken in beginning a research program on QOL quantification, and in our preliminary remarks we have sampled some typical definitional constraints to illustrate the diversity of approaches adopted by various research groups.

The next step in the quantification process is to identify the principal elements that must be included. We have already touched on the key points in our earlier discussion. Most researchers agree on the following five basic features: Factors, indicators or components: Various names are used to describe the categories or characteristics that contribute to overall life quality.

One might refer to these elements in more scientific terms as variables. Classifications: The factors are typically ordered according to a logic that makes sense to the researchers. Some criteria may be invoked to guide this classification, and frequently the classification scheme is fundamental to the method of quantification. Measures: A set of measures must be obtained to describe each factor or group of factors.

These measures may be objective in nature e. Where a series of measures for the same factor is available, some kind of condition on the correlation between these measures may be imposed. One necessary condition is that some type of universal scale be established for each measure.

Weights: It is essential to develop some form of hierarchy of factors in order to compare the measures associated with them. A common way to achieve this relative ranking of factors is to obtain individual weightings from each member of the sample population.

Frequently it is difficult to distinguish between the subjective measures and relative weights, and often the distinction is not made formally. Aggregation: Once specific QOL factors have been assigned quanti- tative measures, it is necessary to obtain a QOL index appropriate to each individual in the sample population and then to aggregate the results for a selected group of individuals to obtain an average or effective QOL index or measure.

It is on this subject of aggregation that one encounters the most disagreement and uncertainty among QOL researchers, largely because so little concrete and testable work has been done. The remainder of the discussion in this chapter will be devoted to a review of some recent attempts to develop a QOL quantification scheme and a synopsis of the severe research problems that have been encountered.

We will focus on each of the five elements introduced above and will endeavor to point out what may be some useful avenues of research relating to each element. A more thorough review of the available literature on the problem has been conducted by the EPA Fellows and is presented in their recent report Hornback et al, The state of social research in this field has been admirably summarized in two recent books: The Human Meaning of Social Change by Campbell and Converse and Studies in the Quality of Life by Dalkey and coworkers The work by Campbell and Converse provides a comprehensive statement of the evolving need for new measurement techniques that transcend those characteristic of a social accounting system relying primarily on economic and demographic data.

It draws together the most advanced concepts that have evolved during the last decade of research on measuring the state of society. Delphi has its historical roots in the disciplines of decision theory and technological forecasting but, as clearly demonstrated by Dalkey and his colleagues, it is a technique that has much to recommend it as a tool in QOL quantification. It is not the intent of this discussion to repeat or even to summarize these outstanding reviews or any of the others that are available in the social science literature.

Instead we shall comment on the ideas presented at the EPA Conference, both in the plenary sessions and in group discussions. Primarily the emphasis at the conference was on establishing a definitional framework for thinking about the QOL concept and on developing a preliminary list of components or factors characterizing life quality. Indeed this has been the primary emphasis of professional research on the subject as well. The research problem one faces is, then, to develop a composite list of factors that describe every aspect of QOL.

As Ayres properly points out, establishing a factor or component list that is both totally inclusive and yet nonredundant is extremely difficult, particularly so since a wide variety of life styles must be accommodated by such a list. An alternative approach is to abandon the idea of a comprehensive list and develop instead a classificational scheme for QOL levels and then attach separate factor lists to each level.

This attack has been suggested by a number of authors, most notably Maslow , , and has recently been pursued by Mitchell et al We will come back to a discussion of this approach shortly but, since the idea of a comprehensive factor list has attracted considerable attention, it is appropriate to look first at the types of factor lists that have been generated.

With only a few exceptions, factor lists have been produced by the "armchair" method-that is, the research team arrives at a consensus as to which factors are important on the basis of, at best, minimal survey research. One such list uses four criteria: 1 that the list should be as comprehensive as possible; 2 that it should not contain any redundancies; An outstanding example of this kind of research is that being conducted by F.

The resulting list consists of nearly thirty items grouped under six main component headings: Economic Environment Political Environment Physical Environment Social Environment Health Environment Natural Environment The authors next compared their factor list with similar lists generated by other research groups, and the result of this comparison is shown in Exhibit A.

There are a number of specific points to note about this exhibit. First, the horizontal structure is designed to match items in the ten other factor lists with the six principal component headings given above. It is evident that, despite the apparent differences in the various lists, there is some underlying structure that is common to essentially all of them.

Furthermore, when we study the words and phrases used to denote specific factors, we find that the same concepts are emphasized repeatedly, albeit in different language. There are, however, some exceptions to this uniformity trend, and they are listed outside the double-line boundaries on the chart. The most striking exception to the overall trend is found in the factor list developed by Dalkey and Rourke Exhibit A gives only a few representative examples from their psychologically oriented list.

Because of. Instead of relying on the "armchair" method of list generation, these authors made use of a sample population of college students and conducted a three-step survey program based on Delphi techniques: The subjects were asked to list from five to ten items that they considered to be most important in determining their QOL biological factors were to be excluded and then to rank those items. From this initial survey some 48 categories of similar items were generated by a panel of researchers.

This factor list is shown in Exhibit B. In the second session, the subjects participated in an exercise to reduce the number of distinct items on the factor list by rating the similarity between labels on the initial list of The result of this exercise was a component list, with each component containing a number of related factors.

Fear, anxiety 2. Aggression, violence, hostility 3. Ambition 4. Competition, competitiveness 5. Opportunity, social mobility, luck 6. Dominance, superiority 7. Money, acquisitiveness, material greed 8. Comfort, economic well-being 9. Novelty, change, newness, variety, surprise Honesty, sincerity, truthfulness Tolerance, acceptance of others Status, reputation, recognition, prestige Flattery, positive feedback, reinforcement Spontaneity, impulsive, uninhibited Freedom Communication, interpersonal understanding Loneliness, impersonality Dependence, impotence, helplessness Power, control, independence Good health Failure, defeat, losing Involvement, participation There are even more guitar heroes than ever before.

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