Dr. Jim Randall shares his thoughts on Quality of Life with PEI Standing Committee on Health and Wellness

 
March 15, 2016 | J. Angus MacLean Building, Charlottetown, PEI


SPEAKING NOTES
I am currently the Chair of the Executive Committee of the Institute of Island Studies and the Coordinator of the Master of Arts Island Studies program at UPEI. I was trained as an economic and urban geographer and have a particular passion and appreciation for interdisciplinarity and for the importance of place and context.

Jim Randall low-resSome of my research has been spent looking at quality-of-life indicators. I was part of a team at the U. of Saskatchewan that assessed neighbourhood level quality of life of residents. This team included geographers, epidemiologists, sociologists and business management professors from university as well as City Councilors and representatives of the health district and community-based organizations in the Saskatoon region. This research was carried out several times so we were able to fine tune an instrument that we were comfortable was fairly accurate in assessing how individuals felt about their own quality of life (degree of “happiness,” sense of belonging). It also was used to help direct public policy (neighbourhood inequality, health determinants and perceptions of personal health and security). As I will talk about shortly, this is only one kind of instrument that can be used to assess quality of life.

Since coming to UPEI I have maintained my working relationship with this group. We carried out another version of this quality of life project several years ago, comparing perceptions of quality of life among residents in Charlottetown, Hamilton and Saskatoon. We employed a survey research company to carry out a telephone survey for this work and then followed up with focus groups, especially focusing on newcomers to each of these urban places.

The origins of “alternate” indicators

Since the 1960s, concern has been raised about the overreliance on a narrow range of indicators that are supposed to measure success of a society, particularly Gross Domestic Product, or standardized for population: GDP/capita. Although it may have been useful to better understand the development path taken by the USA, Canada, Europe after WW2, it said nothing about the level and character of social development, political development or environmental development. So, for example, if you have a corrupt government that was oppressing free speech and democracy, that would not show up in a GDP/capita measure. Also, as we have seen in some of the largest cities in China recently, economic production might have devastating impacts on the long-term air quality and health of citizens and ironically adversely affect the long-term economic capacity of the country. These kinds of indicators also do not measure the degree of inequality within a society. So, for example, a country like Saudi Arabia always comes out at the high end in relative comparisons of GDP/capita. However, most of that wealth is generated and accrues to a small segment of the citizenship of that society, while most of the population lives in abject poverty. Finally, since GDP/capita is based only on the formal economy, it undervalues the contributions that are made by women and by those living in more rural areas, where informal networks of sharing and support are more common and welcomed.

So, starting in the early 1970s, a number of international academics and practitioners called on international bodies to broaden the way that we measure development. Look at the work by Dudley Seers, Denis Goulet and Amartya Sen. United Nations Development Program definition of development, “the three essentials of development include the ability to lead a long and healthy life, to acquire knowledge and to have a decent standard of life.”

International bodies started using the Human Development Index (a composite indicator).

It is multidimensional, including an economic dimension but not only the economy, but also health outcomes (life expectancy at birth) and education (adult literacy rate and combined gross enrolment ratio in primary, secondary and post-secondary schools). It is still not very sophisticated, but is at least broader than just the GDP/capita.

You needed to keep it simple because if you were going to measure it across all countries of the world, you need to have the data to compare countries and to measure it longitudinally (so you could determine if a place was progressing or not).

Another improvement includes measures of inequality (Gini Coefficient) and graphical equivalent (Lorenz Curve). It is a simple mathematical tool to measure the degree of inequality in a society and could be used for any indicator (but primarily for income distribution).

Which brings us to the present. Many different jurisdictions are searching for ways to best measure what we value as a society. As you can imagine, societies value different things so our measures will also differ.

I think you have already been exposed to some of these: the Genuine Progress Indicator, Canadian Index of Well-being, European Accounts of Well-being, for example.

In all of these, there are two basic groups: those that measure the perceptions or attitudes of individuals towards their own life and the world around them and those that use secondary surrogate indicators across a range of societal dimensions. The Quality of Life project in which I participated in Saskatoon, and that we used with the telephone survey in Charlottetown, was an example of the former type.  So, we asked a series of 50-60 questions about a person’s attitudes towards various aspects of their neighbourhood and social relationships and brought those together. Among the questions were the following:

  • In general, would you say your health is: Excellent, Very Good, Good, Fair, Poor, Don’t Know
  • There are people in my neighbourhood who I think of as close friends. Strongly Agree, Agree, Neutral, Disagree, Strongly Disagree
  • Can you get help from friends when you need it? On a scale of 1 to 4 where 1 = No, not at all and 4 = Yes, definitely.

This is a very rich source of opinions and links very closely to what people feel, especially about the world in which they live. It can also be conducted on a very small scale. Unfortunately, as you can imagine, it is also expensive to carry out and it is difficult to compare to different jurisdictions (especially if the questions are slightly different) or to replicate over successive time periods.

The second kinds are the ones that are really more sophisticated versions of the Human Development Index. In other words they use secondary data (they are not measuring phenomena directly) and then try to tell you something about that society on the basis of the responses. But they use a much more comprehensive set of indicators than the HDI in order to try to capture all of the dimensions that a society might value.

The Genuine Progress Indicator is a good example of this type of measure. It is most commonly identified with the GPI Atlantic and the work of Ron Colman. But it is also carried out in other jurisdictions.  A report in the “other Guardian” (from the United Kingdom) in 2014 states that the GPI had been adopted by 20 US states. It has been used in Alberta, in Australia, and in many other jurisdictions. In the States of Maryland and Vermont it has been approved in their respective legislatures.

It incorporates a series of domains (in the case of the Nova Scotia GPI they used the domains of Time Use, Living Standards,  Human and Social Capital, Natural Capital, Human Impact on the Environment). Under each one of these there are more specific phenomena being measured, so, for example, under Human Impact on the Environment you will find Solid Waste, Ecological Footprint, Greenhouse Gas Emissions, and Transportation.

And then you need to find something to measure each of these. So, for example, under Solid Waste, there are indicators such as “solid waste disposed per capita” and “residential recycling and composting rates.”

This also incorporates things like the Gini Index to measure the level of inequality in a society.

The value, as you can imagine, is that it reflects the whole basket of things that we value as a society (not just economic change) and should be adaptable to different societies. So, different jurisdictions can choose different baskets of indicators and they can weight them differently to reflect their values. You can imagine that in PEI, where we value the strength of social relationships (pulling together to overcome crises, or in the academic literature, a strong social bonding capital) then this can be given prominence and we can try to measure how this is changing over time. In fact, I would go further and say that this is an essential component of this process: the dialogue with the population to determine what best reflects the values of that community as a group.

In that Guardian article, one of the advocates is quoted as saying that one of the values of the GPI over more traditional measures like the GDP (or GPP) for policy is that it forces agencies (government and community-based) to start working together, because the measures cut across agency goals. So, instead of having separate outcomes for development, you end up working together on collaborative measures.

At the very least, we value what we measure. If we only measure our society on the basis of economic indicators, then that is what we value and that is what drives policy. If we measure other features, and do so in a consistent societally accepted way, then this becomes a vehicle to stimulate discussion and drive public policy. It allows people to understand the trade-offs that are made in society and the differences between short-term gain and long-term gain. In fact, we are doing this right now on a global basis by recognizing that the short-term  gains from burning more fossil fuels and contributing to greenhouse gas emissions will have much greater long-term environmental and economic costs for our grandchildren.

One of the challenges is finding data that measures the kinds of indicators that might be part of the GPI. So, for example, when it was applied in Nova Scotia in 2008, one of the indicators under Solid Waste was “hazardous and toxic wastes.” In the report, it notes that the disposal of hazardous and toxic wastes is not tracked in the province.

Geography of Application

One of the other features I want to bring to your attention is what I call the “geography of application.”

Every measure (whether it is an economic measure like the GDP or GPP or the indicators used in a GPI) has a territory or geography associated with it. So, for example, the GDP is an average of the value of all production in the country and we know that this varies across the country, just as the GPP measures economic activity across the province.

So, what do you do if the measure you are using is too aggregate and does not adequately measure a more locally based aspect of well-being. For example, do you feel safe or secure, or do you believe you can count on your neighbours for help in a crisis. These are very much neighbourhood-based, or at best community-based, and it doesn’t matter very much what some kind of average of the number of break-ins/1,000 population over the county, province or country might be.

It is also true that it is often easier to find measures at this large geography but when you want to drill down to an individual community (the place where they are really meaningful) you can’t get them because there are privacy and confidentiality concerns or there are too few observations or, as with the QOL perceptual/attitudinal measures, it becomes too expensive to collect them consistently over time.

So what scale do you use; is it the neighbourhood, is it the city, is it the county or is it the province? Different measures apply best at different scales. For example:

  • Volunteerism – town or city
  • Water pollution – watershed
  • Rely on Neighbours – family or neighbourhood scale

“National Accounts of Well-being”

The one I like is one that has been used in Europe: “The National Accounts of Well-being.”

Like the QOL measure I talked about earlier, this falls into the category of the subjective/perceptual/attitudinal kind of measure. It consists of 50 questions that are related to self-reflection (domains of Emotional, Satisfying Life, Vitality, Resilience and Self-Esteem) and the social (supportive relationships, trust & belonging).

They did an initial survey of a random number of individuals in each of the EU countries, and reported the result, but then they opened it up online so that you could take the “test” yourself and see how you compared to the “average” in your country or community. So it becomes a way to engage people on an ongoing basis rather than just snapshots at various points in time.

I think ultimately a society needs both kinds of indicators: those that use secondary sources and those that measure the attitudes and perceptions of individuals. They complement one another and help to provide a more robust set of measures on what is taking place in our society and how we feel about those changes.

I’d like to close my presentation with a quote that I found in an online article in the New Republic magazine (February 3, 2014), quoting Robert Kennedy in a speech he gave almost 50 years ago. Although this quote was with respect to our American neighbours to the south of us, it could as easily apply to us. He said that the Gross National Product “measures neither our wit nor our courage, neither our wisdom nor our learning, neither our compassion nor our devotion to our country, it measures everything, in short, except that which makes life worthwhile. And it can tell us everything about America except why we are proud that we are Americans.”

I should also say that, as you may already know, the Institute of Island Studies has been involved in measuring QOL on PEI in the past. We hope to reengage in this activity as one of our signature projects in the future. We would be happy to continue to provide advice to the government as it proceeds with this important initiative.


If you wish to comment on this, please contact iis@upei.ca.

 

 

 

 

 

 

 

 

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