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Qualities of life, educational level and human development: an international investigation of health

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Introduction and methods

This study investigated the relationship between health-related quality of life (QoL), educational level and culture, using a high quality cross-cultural generic measure (WHOQOL-BREF) containing 25 international dimensions organised in physical, psychological, social and environmental domains.

Results

Cross-cultural data from 9,404 sick and well adults in 13 countries showed that environmental QoL increased positively and sequentially from no education to tertiary education. The other three domains increased only up to secondary school level. These MANCOVA results were significantly influenced by health status, age, culture and economic development level. More positive feelings, less dependence on medication and treatment, better perceptions of financial resources, physical environment, and opportunities for information and skills, represent adult QoL advantages to those who received tertiary education compared with secondary schooling. Developing countries reported poorer environmental, psychological and physical QoL than developed countries, although social QoL was good, and no different for the two development bands. Only psychological QoL distinguished between every educational level, in developing countries. Increased positive feelings serve to link better mental health with more education. Across each domain, secondary and tertiary education was associated with better QoL in developing countries.

Conclusion

The results support a QoL case for universal secondary education on which better health and health care may be built.

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Acknowledgments

With grateful thanks to Norman Sartorius, David Clark, Laura Camfield, Ian Gough, and anonymous referees.

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Authors and Affiliations

  1. Department of Psychology, WHO Centre for the Study of Quality of Life, University of Bath, Bath, BA2 7AY, UK

    Suzanne M. Skevington

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  1. Suzanne M. Skevington
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Correspondence to Suzanne M. Skevington.

Additional information

For the WHOQOL Group See Appendix.

Appendix

Appendix

Footnote on Authorship

The WHOQOL Group comprises a co-ordinating group of collaborating investigators in each of the field sites and a panel of consultants. Dr Rex Billington directed this project that was initiated by Dr John Orley and Dr Norman Sartorius. The work reported here was carried out in 24 of the field sites: Prof. H. Herrman, St Vincent’s Hospital, Australia; Dr S. Bonicatto, FUNDONAR, Argentina; Dr M. Fleck, University of the State of Rio Grande do Sul, Brazil; Dr V. Petkov, National Centre for Interdisciplinary Human Studies, Bulgaria; Prof. S. Szabo, Prof Z. Metelko and Mrs M Pibernik-Okanovic, University of Zagreb, Croatia; Professor M.C. Angermeyer and Dr R Kilian, Department of Psychiatry, University of Leipzig, Leipzig, Germany; Dr L. Kullmann, National Institute for Medical Rehabilitation, Hungary; Dr S. Kumar, Chennai Medical College, Madras, India; Dr S. Saxena and Dr Rachna Bhargava, All India Institute of Medical Sciences, New Delhi, India; Dr M. Amir, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Dr G. de Girolamo, Instituto Superiore di Sanità, Rome, Italy; Dr M. Tazaki, Science University of Tokyo, Japan; Dr H. Che Ismail, University of Sains Malaysia, Kelantan, Malaysia; Dr M. Kalfoss, Oslo College, Norway; Dr A. Lomachenkov, V.M. Bekhterev Psychoneurological Research Institute, St Petersburg, Russian Federation; Dr R. Lucas Carrasco, Barcelona, Spain; Dr C. Fidaner, Izmir Cancer Registry Center, Turkey; Prof. S. Skevington and Dr K. O’Connell, University of Bath, Bath, United Kingdom; Prof. D. Patrick, Ms M. Martin and Dr D. Buesching, University of Washington, Seattle, United States. Some data was collected as part of the Longitudinal Investigation of Depression Outcomes (LIDO) study directed by Health Research Associates Inc., and in several field centres of the WHO Disability Assessment Schedule (WHODAS) validation study (ACE Group, WHO, Geneva). Further information on the WHOQOL can be obtained at http://www.who.ch\msa\mnh\mhp\ql.htm.

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Skevington, S.M. Qualities of life, educational level and human development: an international investigation of health. Soc Psychiat Epidemiol 45, 999–1009 (2010). https://doi.org/10.1007/s00127-009-0138-x

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  • DOI: https://doi.org/10.1007/s00127-009-0138-x

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