1. FEM 4203 ANALISIS KUALITI HIDUP Sem ester 2, 2011/12 Laily Bt. Hj Paim laily@putra.upm.edu.my

2. 1 Konsep & model kualiti hidup 1.Konsep dan pendekatan 2.Dimensi

3. What comes to mind when we think of QOL...

4. Level vs. Standard vs. QOL Level of livingStandard of livingQuality of life Real experience faced by individual or group. Quantity and quality of goods and services owned by individual (through purchasing or provided for them) Final output of the interaction between social, health, economy and environment which influence the social development

5. Level and standard of living Level of Living Real experience faced by individual or group. Formed by combinations of complex consumption, work environment, ownership, freedom, environment and many others (balanced and harmony). Related to fulfilling needs and wants.

6. Measurement of Level of Living Direct measure – consumption (resources that are actually used). Indirect measure (Proxy) – socio-economics variables. – income (wage from productive activity, transfer income, and other income)

7. Relationship between Consumption & WB More is better ?? Gap between level and standard of consumption Balanced consumption elements Goal achievement gap Social comparison gap Best previous experiences gap

8. Categories of Level of Living high ------ low superior ------ inferior expensive ------ thrifty elaborate ------ simple ample ------ restricted A well-balanced simple plane of living is much better as compared to an ill-balanced elaborate plane of living. The Amish: plain dress and resisting modern conveniences. Ghandi: using one's resources in the most minimal way so as not to deprive others." Islam: Prophet (PBUH) has not adopted the ways of the rich but embraced a simple way of life which is the mode of Fuqara' - poor people. Thus, he remained contented with simple food and had no relish for extravagant feasts.

9. Standard of living Standard of Living Level that family wants to achieve, achievement portrays success and failure causes frustration

10. Quality of life (QOL) Means a good life. A good life is the same as living a life with a high quality. All religions and philosophies have a notion of a good life. Notions about a good life are closely linked to the culture of which you are a part. The cultural conditioning makes us tend to include happiness, fulfillment of needs, functioning in a social context, etc.

11. Definition of QOL Is a product of interaction between various factors including social, health, economy, environment etc. Generally: QOL is what make individual/ family/ community happy. Can be defined from these aspects: – Physical: health, nutrition, basic needs and safety – Personal : work satisfaction, leisure, wealth, family and friends, availability of goods. – Community: fair government, freedom, equity, education for all.

12. Aspects of quality of life QOLASPECTS The subjective QOL  How good a life each individual feels he/she has.  Each individual personally evaluates how he/she views things and his/her feelings and notions.  Content with life and happy reflect the subjective QOL. The existential QOL  How good one’s life is at a deeper level.  live life in accordance with certain spiritual and religious ideals The objective QOL  How one’s life is perceived by the outside world.  This view is influenced by the culture in which people live.  The objective QOL = a person’s ability to adapt to the values of a culture (e.g. social status/the status symbols one should have to be a good member of that culture).

13. Approaches in Examining QOL Basic needs approach. Looking into minimum level of living, it is defined from the aspects of health status, eating habits and literacy. Elements in basic need approach are life expectancy, literacy rate and income per capita. Human development approach Humans are important to achieve development goals and are the main sources for economics growth. Capability approach. The capability of someone to do something meaningful to achieve well-being which leads to a better life.

14. 2 Indikator & pengukuran 1.Kekuatan dan kelemahan 2.Domain dan indikator kualiti hidup 3.Hubungan, kesejahteraan emosi, kesihatan, kesejahteraan 4.Kebendaan, pekerjaaan dan aktiviti produktif, komuniti, keselamatan, 5.Persekitaran dan sebagainya 6.Indeks Pembangunan Manusia (HDI, UNDP) 7.Indeks Fizikal Kualiti Hidup (PQLI) 8.Indeks Kesejahteraan Ekonomi (IEWB) 9.Lain-lain indeks

15. Measurement of Quality of Life Types of measurement Subjectively – “good” feeling and satisfaction; Objectively – fulfilling social and cultural demand from the aspect of material, social status and physical well-being. Perennial measurement Three aspects of quality of life for complete achievement is material, intellectual and spiritual. Conventional measurement In the form of material and quantity (example: GNP). There is cost/limit to over materialism including polluting the environment and human achievement, in real world it means material is not everything.

16. Comprehensive Model of QOL Quality of Life BeingPhysical Psycholog ical SpiritualBelongingPhysicalSocial Communi ty BecomingPracticalLeisureGrowth

17. Quality of Life Research Unit, University of Toronto B E I N G Physical Being  Being physically able to get around.  My nutrition and the food I eat. Psychological Being  Being free of worry and stress.  The mood I am usually in. Spiritual Being  Having hope for the future.  My own ideas of right and wrong. BE L O N GI N G Physical Belonging  The house or apartment I live in.  The neighborhood I live in. Social Belonging  Being close to people in my family.  Having a spouse or special person. Community Belonging  Being able to get professional services (medical, social, etc.)  Having enough money. Practical Becoming  Doing things around my house.  Working at a job or going to school. BE C O M I N G Leisure Becoming  Outdoor activities (walks, cycling, etc.)  Indoor activities (TV, cycling, etc.) Growth Becoming  Improving my physical health and fitness.  Being able to cope with changes in my life.

18. QOL: A System Model Family and friends Work Neighborhood/ shelter Neighborhood/ shelter Community Health Education Spiritual Quality of Life/ sense of wellbeing Culture Socio-economic condition Demographic characteristics Input Perception/opinion Output Feedback

19. Index and elements in measuring QOL ElemenIndeks Human dev (UNDP) Physical QOL (Morris) Econom ic WB American Demograph ic Dasgupta & Wales (1992) WHO (1993) Cummins (1997) Hagerty et al. (2001) Schalock (2000) Felce (1996) Relationship with family & friends √√√ Emotional Well-being √√√√√ Health√√√√√√ Material Well-being √√√√√√√ Work & Productivity √√√√ Feeling of belonging to the local society √√√√√√ Personal security/ safety √√√√√ Quality of Environment √

20. Malaysian Quality of Life “Encompassing personal advancements, a healthy life style, access and freedom to pursue knowledge and a standard of living which surpasses the fulfillment of the basic needs of individuals and their psychological needs, to achieve a level of social well being compatible with nation’s aspiration” Malaysian Quality of Life 1999.

21. Malaysian QOL Index

22. Area and indicator of MQOL Index AreaIndicator Income & Distribution  Real Per Capita Income  Gini Coefficient  Incidence of Poverty Working Life  Unemployment Rate  Trade Disputes  Man Days Lost due to Industrial Actions  Industrial Accident Rate Transports & Communications  Private Motorcars & Motorcycles  Commercial Vehicles  Road Development Index  Telephones  Internet Subscribers  Average Daily Newspaper Circulation

23. AreaIndicator Health  Male Life Expectancy at Birth  Female Life Expectancy at Birth  Infant Mortality Rate  Doctor-Population Ratio Education  Literacy Rate  Pre-School Participation Rate  Secondary School Participation Rate  University Participation Rate  Primary School Teacher-Student Ratio  Secondary School Teacher-Student Ratio Housing  Average Price of Low-Medium-Cost House  Low-Cost Housing Units  Housing Units with Piped Water  Housing Units with Electricity Area and indicator of MQOL Index

24. AreaIndicator Environment  Air Quality  Water Quality  Forested Land Family Life  Divorces  Crude Birth Rate  Household Size  Juvenile Crimes Social Participation  Registered Voters  Membership in Registered Non-Profit Organizations  Registered Residents’ Associations Public Safety  Crimes  Road Accidents Culture & Leisure  Membership in Public Libraries  Television Viewers  Domestic Hotel Guests Area and indicator of MQOL Index

25. Physical Quality of Life Index(Morris) Encompassing literacy, infant mortality rate and life expectancy.

26. Quality of life indicators, Life During Growth, (World bank). Individual rights and democracy Political stability and war Education Health Transportation and Communication Class and gender inequality “BAD” Easterly, W. (March 1999).

27. Quality of life indicators Easterly, W. (March 1999). Life During Growth, World Bank. 1.1: Individual Rights and Democracy Freedom from expropriation Government does not break contracts Bureaucratic quality Rule of law Freedom from corruption Civil liberties Human rights rating % Of children (age 10-14 ) working (-) Political rights Index of independence of politics from military

28. Quality of life indicators Easterly, W. (March 1999). Life During Growth, World Bank. 1.2: Political instability and war Cabinet changes (-) Deaths from political violence, per capita (-) General strikes (-) Government crises (-) Number of assassinations per million per year (-) Number of coups per year (-) Number of revolutions per year (-) Purges (-) Riots (-) War deaths per capita (-) Freedom from external conflict risk Freedom from civil war risk Absence of racial tensions % Involved in separatist movements (-)

29. Quality of life indicators Easterly, W. (March 1999). Life During Growth, World Bank. 1.3: Education schooling years for adult population (25+) % literate % "no schooling" in population (-) gross enrollment ratio for higher education gross enrollment ratio for secondary education gross enrollment ratio for primary education museums per capita Book titles published per capita

30. Quality of life indicators Easterly, W. (March 1999). Life During Growth, World Bank. 1.4: Health Life Expectancy at age zero Mortality - infant (-) Mortality -under-5 (-) Daily calorie intake Daily protein intake Hospital beds per capita Physicians per capita Nurses per capita % With access to safe water % Rural with access to safe water % Urban with access to safe water Access to sanitation Access to sanitation (rural) Access to sanitation (urban)

31. Quality of life indicators Easterly, W. (March 1999). Life During Growth, World Bank. 1.5: Transport and Communications Paved Roads as share of all Roads Road length per car Railroad Mileage per square mile Telephones per capita International telexes, minutes per capita telegrams per capita Radios per capita TVs per capita Mail Per capita Fax machines per capita

32. Quality of life indicators Easterly, W. (March 1999). Life During Growth, World Bank. 1.6: Inequality across class and gender Gini coefficient (-) Share of income of bottom 20% Share of income held by middle 60% Share of income of top 20% (-) Female to male schooling years (age 26+) Ratio of Women's Literacy to Men's Female to male primary enrollment Female to male secondary enrollment Female to male higher enrollment

33. Quality of life indicators Easterly, W. (March 1999). Life During Growth, World Bank. 1.7: "Bads" Fraud Rate per capita (-) Freedom from political terrorism (-) Homicide rate per capita (-) Manslaughter per capita (-) Robbery rate per capita (-) Rapes per capita (-) Drug crimes per capita (-) Carbon dioxide emissions per capita (-) Industry CO2 emissions per capita (-) Sulfur dioxide emissions per capita (-) Nitrogen oxides emissions per capita (-) Suspended particulate matter (-) Annual forest area change (%) Waste paper production per capita (-) Injuries at work (per 1000 workers) (-) Suicides per capita (-)

34. The World Health Organization QOL Instruments DomainFacets incorporated within domains Overall Quality of Life and General Health 1. Physical healthEnergy and fatigue Pain and discomfort Sleep and rest 2. PsychologicalBodily image and appearance 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

35. The World Health Organization QOL Instruments DomainFacets incorporated within domains Overall Quality of Life and General Health 4. Social relationshipsPersonal relationships Social support Sexual activity 5. EnvironmentFinancial 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

36. Factors and Indicators of QOL FactorIndicatorSource 1.Material wellbeingGDP per personEconomist Intelligence Unit 1.HealthLife expectancy at birth, years.US Census Bureau 1.Political stability and security Political stability and security ratings.Economist Intelligence Unit 1.Family lifeDivorce rate (per 1,000 population), converted into index of 1 (lowest divorce rate) to 5 (highest). UN; Euromonitor 1.Community lifeDummy variable taking value of 1 if country has either high rate of church attendance or trade-union membership; zero otherwise. ILO; World Values Survey 1.Climate and geographyLatitude, to distinguish between warmer and colder climates. CIA World Factbook 1.Job securityUnemployment rate, %.Economist Intelligence Unit; ILO. 1.Political freedomAverage of indices of political and civil liberties. Scale of 1 (completely free) to 7 (unfree). Freedom House 1.Gender equalityRatio of average male and female earnings, latest available data. UNDP Human Development Report

37. Characteristics of ideal measurement for QOL (1)Dynamic, which means measurement that can show potential development as compared to only showing the current development status, (2)Measurement according to changes in human’s perception of development, (3)Taking into consideration the changes in main motivating power such as information technology.

38. 3 Aktiviti ekonomi dan kemiskinan 1.Konsep 2.Pengukuran 3.Aktiviti ekonomi pasaran dan bukan pasaran 4.Insiden kemiskinan di Malaysia dan negara lain 5.Unsur rintangan dan sokongan ke arah meningkatkan kesejahteraan hidup keluarga

39. Household production The production of goods and services by the members of a household; – For their own consumption – Using their own capital – Their own unpaid labor. Goods and services produced by households for their own use include; – Accommodation – Meals – Clean clothes – Child care

40. The transformation of purchased intermediate commodities (supermarket groceries and power-utility electricity) into final consumption commodities (meals and clean clothes). Households use their own capital (kitchen equipment, tables and chairs, kitchen and dining room space) and their own labor (hours spent in shopping, cooking, laundry and ironing). Process of household production

41. Production/Consumption Model Production Human Capital Good and services for sale/ gift/ exchange Input CommodityConsumptionWell-being

42. The who, what, where, when, why and how of a measure of consumption poverty What: What resource measure is going to be used? Who: Whose standard of living is being measured? When: What time period is used? Where: Do the measures differ by geographic location? Why: What is the purpose of these measures? How: Which measure and thresholds are used?

43. Measurement issues Ruang &konteks Universaliti Multidime nsionaliti Unit diukur Perspektif masa Sebab kemiskinan Sumber vs utiliti? Apa yang boleh dicapai vs apa yang sebenarnya dicapai? Aspek apa yang patut di ambilkira? Material, sosial, budaya, politik? Bagaimana tentukan garis kemiskinan Mutlak vs relatif? Boleh diguna pakai pada masyarakat lain Objektif vs subjektif value judgement mempengaruhi definisi &pengukuran Siapa yang patut menentukan Perbezaan sistem ekonomi eg. Sosialis &kapitalis? Boleh guna satu indeks? Bagaimana memilih dimesi? Bagaimana menggabungkan dimensi? Individu vs keluarga vs sempadan geografi Jangka pendek vs jangka panjang Patut ambilkira sebab kemiskinan

44. What difference a measure makes Using consumption-based measures, in comparison with income-based measures – The levels of poverty and inequality tend to decrease – The WB of the elderly tends to increase relative to other groups (mainly due to the inclusion of a value for owner-occupied housing in the measure of consumption). Consumption and income definitions have somewhat different implications for who is counted as poor. – A consumption resource definition will include the people who are income-rich but consumption-poor (people who choose to spend at levels below the poverty threshold when they actually have incomes that would support consumption above that level). exclude people who are income-poor (e.g., because they lost a job), but who sustain their consumption at a level above the poverty threshold (by spending from savings, borrowing from relatives, or charging to their credit cards). – An income resource definition will exclude people who have adequate income during the measurement period, whether they spend it or not.

45. Masalah mengukur pendapatan PENDAPATAN Perbelanjaan lebih stabil berbanding pendapatan Perbelanjaan lebih mudah diingat drpd pendapatan Perbelanjaan kurang silap berbanding pendapatan Tak suka soalan pendapatan Perbelanjaan > pendapatan kalangan berpendapatan rendah Under-reported -- Anggaran simpanan yang jauh lebih rendah

46. Poverty Line Income RuralUrbanRuralUrban Johor711647Perlis667621 Kedah683636Selangor760677 Kelantan618572Tganu664662 Melaka710653Sabah821802 N.Semb684680Swak779756 Pahang703651KL880 P.Pinang751704Labuan821802 Perak666630 Model household: One male and one female (aged 18-29), two boys aged 3 and 9, and a girl aged 5.