Quality of Life

Why this is important: There is more to a population’s health than the absence of disease; health is defined as a complete state of physical, emotional and social well-being.1 Population health assessments must therefore move beyond traditional, death- and disease-focused measures to also incorporate measures of social and emotional well-being. Quality of life (QoL) tells us how well people are living, not just how long. As such, it is an important indicator of population health and societal progress. Measuring and monitoring a community’s collective QoL helps public health agencies and community partners to identify strengths, areas of concern and disparities. An understanding of communities’ strengths and areas of concern helps inform the development of programs and public policy decisions that can improve lives.

Definition: Quality of life (QoL)—defined by the World Health Organization (WHO) as people’s “perceptions 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”2,3—moves beyond narrow measures of health. Although physical health is an important part of QoL, there are several other areas to consider. These include social, behavioral, emotional and environmental indicators.                      

In SRHD’s Quality of Life (QoL) Survey, QoL is assessed with two measures: self-rated QoL and a composite QoL score.

1. Self-rated QoL refers to responses to the single survey question, “How would you rate the quality of life in Spokane?” Response options included Poor, Fair, Good, Very good, or Excellent.

2. A composite QoL score is also calculated by scoring the responses to 42 survey questions. These questions align with six areas of interest that capture different aspects of people’s daily lives that contribute to their quality of life. These areas include the following:

      • Community vitality
      • Financial stability
      • Physical and mental health
      • Lived experience
      • Social relationships
      • Time use

Across these areas, there are various types of survey questions, including questions about people’s behaviors (e.g., number of hours worked in a typical week), questions about people’s social environments (e.g., number and quality of close relationships) and questions about their thoughts and emotions (e.g., stress, feelings of belonging and security). A formula is used to assign composite QoL scores, which range between 0 and 1; higher scores close to 1 reflect better quality of life.

Key Findings: QoL 2019 Fact Sheet

Consistent findings emerged across the QoL Survey assessment years (2015, 2017, and 2019). Spokane County residents’ age, race, income level, employment status and general health were associated with their quality of life. Specifically, Spokane County residents who were younger than 65 years-old, Black, Indigenous, and other People of Color (BIPOC), living in lower-income households, unemployed (either out of work or unable to work) or in poor health had the lowest self-rated quality of life.

Data Source: 1 Constitution of the World Health Organization. In: World Health Organization. Handbook of basic documents. 5th ed. Geneva: Palais des Nations, 1952:3-20.2 WHOQOL Group. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403-9. 3 The WHOQOL Group. The World Health Organization Quality of Life Assessment (WHOQOL). Development and psychometric properties. Soc Sci Med. 1998;46(12):1569-1585.