Introduction

Quality of life (QoL) is a dynamic concept, changing in time and in context. A number of quality of life definitions exists however in general we can state that it is an interdisciplinary term, defining the sense of human satisfaction that arises as a result of satisfying a number of his or her needs. The great majority of authors recognize QoL on the basis of a set of objective (social indicators) and subjective components (sense of satisfaction, individual satisfaction), distinguishing in each of them the economic, spatial, social, and psychological aspects. From the psychological perspective, QoL means the sense of well-being and happiness of a person. In economics, it refers to the level of income, and material resources [1]. In sociology and social policy, QoL is perceived through the prism of various indicators, such as social norms, social relations, value systems, and a sense of belonging to the community. According to the Quality of Life Group (operating under the WHO), `quality of life` is an individual's perception of life position in the context of culture and systems of values accepted by the society in which he or she lives and in relation to his or her life goals, expectations, and interests [1]. The research on quality of life shows that the different life dimensions are the most often considered as analytical indicators that should be taken into account, such as: emotional well-being, health, family and social relationships, material well-being, work or other forms of professional activity, sense of security, independence and control, social position, and self-esteem [2,3]. It should be emphasized that the quality of life is a different concept than just the standard of living. Quality of life is the complex subject of well-being and welfare (experiences, feelings) of individuals. In other words, the standard of living is a term related to the objective and material zone, while the quality of life still includes the sphere of personal experiences and quality of life assessment [4,5].

              Quality of life encompasses a number of different areas of life and it is influenced by the condition of the natural environment, material possessions, access to education and culture, a sense of security (e.g. finances, health, crime, violence, aggression), a sense of belonging to a family and to the local community, interpersonal relations, and empowering, impacting decisions regarding individual and collective life.

As a result of the identified need in relation to the teaching process and exploring the subject of quality of life, we decided to approach the issue of quality of life indicators in a comprehensive manner, gathering in one place, on the basis of the available literature, information on QoL indicators, focusing it from various perspectives, presenting the types of indicators followed by some examples.

In this manuscript we share in a structured way the information related to quality of life indicators which was found as a result of a search of the available literature aiming to identify the indicators which are affecting the quality of life of an individual and the society.

Materials and Methods

The chosen approach was to search broadly both internet publications and libraries for book publications. The aim of the performed search was determined based on the needs reported by students in relation to the teaching process and exploring the subject of quality of life during academic discussions. The agreed objective was to provide an overview of the quality of life indicators from individual and societal perspective in a structured way, based on the available published data and discuss them taking into account different perspectives. Once the main concept for the search was agreed, the key words and search databases were identified. In order to identify the published information the internet searches were performed. The sources were the online resources, available libraries and databases as well as printed materials, e.g. books. We searched Google, Google Scholar, IBUK Libra and EBSCOhost.  The research concerned the period January 2002 - August 2022. The search in English was based on the following key words: indicators, quality of life, QoL, society, individuals, impact. Additionally, there was performed a search in Polish for the same key words. Since the approach was broad and we searched for quality of life indicators as general term we have not used any specific exclusion criteria and we accepted the results as a basis to group the indicators by perspectives. After finalising the search and completing the review the obtained results were checked for consistency and completeness, compared, verified for duplications and unified.  The duplications were not included and the indicators classification to a specific perspective was checked.

Results

Based on the identified publications the indicators determining the quality of life can be divided into internal and external as shown on fig. 1 [6].

Fig.1 Quality of life indicators by conditions

Internal indicators are considered at the individual level and as presented in table 1 two groups of conditions may be identified: the individual’s own characteristics and situational factors [4]. The most important internal conditions include: the state of health and the psychophysical condition of a human being, his or her aspirations and temperament, personality, level of education and intelligence, the will to make changes within his or her own behaviour and consciousness, defence and motivational mechanisms, cognitive, identity, and world-view structures, social status, life experiences, shaped social and professional competences, habits and behavioural patterns, as well as the degree of internalization of culture and language competences [7,8,9,10].

              Situational factors include: living conditions and economic situation, social environment and received support, the number and quality of contacts maintained within and outside its own group, the scope and depth of life changes caused by a random situation, and life-long and professional challenges [11,12,13,14]. The interaction of individual and situational factors, shapes the adaptive behaviour of the individual, affects the subjective assessment of its life situation.

              External factors include socio-economic variables that consist of social, cultural, religious, political, and economic factors, such as the specificity of axionormative systems, ideologies, political systems, religious belief systems, hierarchy and rules of social life and management, the model of personality and behaviour patterns, ways of fulfilling roles and social relations, interpretative systems, cognitive and communication scripts, images of the world and school competence framework, life and social competences [15,16,17].

According to the report published by EUROSTAT, people quality of life might be affected by those risks having impact either on the individual level or national or global one. The individuals’ related  risks might be due to material conditions and safety, e.g. in connection to the job, health or ageing. A recent example of a global event leading to a deterioration of economic conditions in Europe and affecting individual’s quality of life could be the global financial and economic crisis or the Covid19 pandemic. The individual’s safety may be also significantly impacted by the non-economic risks, such as violence and/or crime which potentially can be influencing quality of life. It is important to notice that there is not only the materialised risk what influences individuals quality of life. Equally important is the subjective perception of a threat. Such perception may result in feeling insecure and ultimately in quality of life deterioration [18].

An example of a study related to quality of life indicators is a study performed in 2021/2022 in Bristol, UK assessed a total of 184 QoL indicators. However the focus was on 50 priority indicators and authors compared the results with previous assessments by analysing a three years trend. The topics of interest included health, lifestyles, community, local services and living in Bristol [19].

Table 1. Internal quality of life indicators – some examples

Discussion

According to many authors a good quality of life should guarantee human development in all its dimensions by shaping the right proportions in generating, satisfying, and implementing economic, social, cognitive, and emotional needs [20,21,22]. Quality of life plays crucial role to the sustainable development and should be supported by all those who somehow have an impact on another human being, e.g. parents/guardians, peers/friends/employers/colleagues at work, ruling authorities/politicians/officials/decision makers, corporations/producers/bankers [23,24,25].

              According to many interpretations of quality of life, the point of valuing element is the separation of objective and subjective evaluation. Objective quality of life is defined as living conditions, while the level of contentment, satisfaction with life determines the subjective quality. Usually, objective measurement is made using economic indicators (GDP, AIC, social minimum, the Gini coefficient, and others). On the other hand, the level of satisfaction is connected with a sense of happiness, mental well-being, level of trust, emotional intelligence, ability to face adversity, motivation to take on new challenges, and self-realization. Taking into account these indicators, we can state that for the majority of the inhabitants of our globe, the quality of life assessment is low. Many studies indicate that the discussed indicators affecting the quality of life and the subjective impression of every human being, despite the unprecedented high level of economic and technological development (enrichment of societies) did not affect the progress in improving the general condition of society [26, 27,28,29,30,31].

              In each stage of the world’s development, there are different problems emerging, therefore causing variety of challenges. The progress of civilization, apart from improvements and facilities, is also accompanied by various negative consequences. The development of modern civilization has contributed to the growth of global issues, such as environmental degradation, social inequality, violence, aggression, prejudices, mental disorders (addictions). In addition to those existing from long time ago there has also been a huge number of new ones, such as: terrorism, ethnic and national conflicts, and mass migrations. Many researchers emphasize that the major problems that our world is facing today are a consequence of the poor promotion of humanistic content in the development of modern civilization. In recent decades, emphasis has been placed on economic and individual development, without taking into account the wider context of development of the human community as a whole integrated with the environment. It was not until the end of the twentieth century that the negative effects of this approach were noticed, which was reflected, among others, in the United Nations Document of 1993 which recommended countries an education in a spirit of democracy, tolerance, respect for human rights, a sense of solidarity between people, strengthening friendships, respect and recognition among peoples, and strengthening peace and international cooperation [32].

              Despite the actions taken to strengthen humanism, understood as the conviction that the moral duty of every human being is an honest and friendly attitude to people and cooperation for the common good, modern European societies still have to work to better implement social practices of nurturing neighbourly bonds, solidarity, social co-responsibility for the environment and the ability to cooperate based on open-ness and tolerance.

              According to the Council of Europe and the UN in the modern world, regardless of the social, technological, and economic development, the phenomenon of social exclusion of individuals and groups is still an issue. Indicators of poverty, unemployment, homelessness, economic uncertainty, or social pathologies are constantly growing. Intensive civilization development enables many people to live at a high level of economic development, but it also impacts human relations by worsening them. Those people who experience exclusion or worse treatment, have a sense of harm and threat. Most often, they withdraw from social life. Many researchers have been warning about the potential threats for years. It is related to the mechanisms that make people vulnerable to existing inequalities, the increase of fear and the intensity of rebellion on the part of marginalized and discriminated groups; deprived of the opportunity to earn income in a dignified way, use of public goods, and social infrastructure [33, 34].

              The contrast between material success and social failures of many highly developed countries has become the subject of interest for researchers who are increasingly emphasizing that reducing inequalities would increase the quality of life of every human being. Despite the increase in the standard of living in those highly developed countries, the occurrence of drug abuse and depression is systematically increasing [35].

              The studies on sources of stress in contemporary societies show that they are associated primarily with low social status, lack of friends, and insecurity in early life [36]. In the case of children, the risk of a sense of security occurs when there is no strong emotional involvement; the parents do not show their affection and tenderness to the child, they do not show interest in his or her feelings and emotions. Under such conditions, the child’s development is disturbed in all spheres (physical, mental, emotional), and often there is a risk of neuroses. In the situation of not meeting the needs or rejection of the child by the parents  fear, anxiety, and anger arise in his or her mind. Such children are convinced that the world is hostile and unjust, people cannot be trusted, he or she must watch himself/herself, and when it will be necessary they have to fight for their rights with cunning and strength. The lack of interest, love, and care may also be the reason for depression and apathy and the child becomes submissive, insecure, and fearful. When feeling unwanted children sometimes feel a resigned acceptance of defeat, and is torn two ways. Many psychologists indicate the haste, instability, and disorganization of family and social life as the reason for this state of affairs, these indicators are becoming a more common phenomenon in all social circles, including well-educated and very wealthy ones. The unemployment, poverty, and bad family relationships, often leading to family breakdown, have a particularly devastating effect on the functioning of the family. As a result, millions of children are deprived of emotional support and moral support in development process, which results in the phenomenon of constant decline of emotional capabilities in a significant part of contemporary youth. Studies show that no child, poor or rich, can free himself from the risk of falling into depression [37, 38, 39]. These are universal problems occurring in all ethnic and racial groups, and in all classes and social categories, regardless of the income differences that separate them [40].

              The latest studies also show that regardless of individuals age and social status, due to the permanent need to confirm their high self-esteem and positive image in the eyes of others they sense a constant threat to perform well in society [41]. One of the reasons is the current consumeristic and materialistic approach to life. Pride and shame are the quintessence of social emotions. Shame is associated with emotions experienced when people perceive themselves as stupid, infirm, incompetent, vulnerable, and insecure. This feeling causes stress and suffering. The opposite of shame is pride, associated with pleasure. From early childhood, pride and shame are information for each child about the social evaluation of him or her as a person, often emphasized by parents and educators [42]. Especially vulnerable are young people, when the sense of their own self-esteem is the most fragile, and the pressure forces many teenagers to hate their appearance, origin, status, which leads to depression and destructive behaviours.

              Impact on QoL can be also caused by poverty and poor education. Affected people are focused on passive satisfaction of basic physiological needs, are susceptible to social diseases and pathologies, have limited opportunities for active participation in society, which can lead to isolation, marginalization, a sense of life defeat, withdrawal, but also hostile attitude towards those who succeeded [43,44].

              It has also been proven that the greater the income gap in a given society, the less trust in other people. `Inequality leads to lower levels of trust` [45]. Lack of trust is not conducive to cooperation, and what is worse affects the social bonds, dysfunctional relationships and isolation of individuals and social groups for fear of harm, because other people are treated as rivals and enemies rather than as partners to the joint actions. High level of trust in others impacts people QoL, they feel safer, have less worries, are more open and more easily accept dissimilarities [45].

              Research shows also that living in conditions of inequality is not good for either the poor or the rich. According to Wilkinson and Picket the well-being and happiness of people have stopped growing with economic growth, affluent societies are still getting more and more afflicted with drug, depression, and other problems [46].

              There is evidence that for thousands of years, the best way to improve the quality of life was to raise the material standard of living. However improvement of the average standard of living is less and less affecting the health of the society and the sense of happiness. The curve of the sense of happiness grows steeply in the initial stages of economic growth, and at a certain level becomes a horizontal line. Richard Layard, an economist in his book about happiness, drew attention to this fact at the beginning of the twenty-first century [47, 48]. This has also been observed earlier, following changes in the level of happiness for many years using a different indicator of welfare (Measure of Economic Welfare, MEW). It turned out that although the real income of the population doubled, the perceptible level of happiness did not increase.

              The economic growth and raising average income do not affect the quality of life as much as the differences in the size of income inequalities in individual countries. If inequalities are relatively small, the health and well-being of individual members of society are much better [49].

              Focusing on children, the gap between the rich and the poor, the quality of the family environment and the related difference in cultural and social capital have a big impact on school performance. Children of less well-off families statistically achieve worse educational results. This is due not only to the psycho-social factors (different family aspirations regarding children's learning, adopted norms and value systems, and limitations of cognitive abilities of children), but there is evidence that the performance and behaviour of the child during implementation of educational tasks depend on how he or she is perceived and assessed by others (e.g. teachers, peers). New discoveries within the neurology field explain the impact of feelings on the learning process. If the child learns in a stimulating environment and is sure that he or she is able to achieve success, what the child feels is happiness. The young person is self-confident so in his/her brain there are processes that strengthen the memory, concentration, and problem-solving ability. However, when the child feels threatened and/or stressed then in his/her body a hormone is released that impacts negatively the process of thinking and the memory. Research indicates the relationship between existing inequalities in the society and the school, which affect the feelings and self-esteem of children from poorer families, affecting their learning outcomes.

There was also observed an increase in mental health problems among people with lower incomes. That is connected with the desire to achieve goods and trying to gain material wealth, often at the expense of family relationships and quality of life [50,51].

              The health condition is also affected by social relations. Many researchers argue that a sense of belonging, friendships, marriage, having a group of supporting people protect health [52]. An important determinant of health is also the socioeconomic status of the family and the degree of social integration.

              It is recognized that the stress of early childhood reflects on the child’s emotional, social, and cognitive development. In general, the trajectory of health and human development depends on the called as `psychosocial factors`, which include social status, networks of interpersonal bonds and stress in early childhood, which in modern societies they become more and more important determinants of the individual’s quality of life and well-being. Life is often shortened in particularly stressful conditions [53]. Studies help to understand how stress increases the risk of illness, and the sense of acceptance, pleasure, and happiness promote health. It is known that the acute stress caused by a threat that passes in a few minutes is a natural phenomenon, but when stress continues for a very long time, then it turns into a chronic state and leads to dysfunctions of the body. As a result it can be observed a weakening of the immune system and a whole range of effects such as digestive disorders (nausea, overeating, obesity), sleeping disorders, worse memory, worsening of cognitive functions, limitations of strength in life or serious cardiovascular diseases.

              Naomi Eisenberger’s experiments have shown that suffering from social group rejection involves the same areas of the brain that are stimulated when experiencing physical pain. Other experiments also showed how the impression of cooperation is stimulated by brain reward centers. Researchers underline the importance of the impact of `mirror neurons` on processes occurring in contact with other people, stating that the sense of community, gratitude, joy, and empathy reduce the level of cortisol, a stress hormone that is released when we complain. They point out that the `attitude of gratitude` affects mood and energy, and then our brain programs itself for positive thinking [54].

              According to Richard Wilkinson and Kate Picket a strong influence of exclusion or inclusion demonstrates the fundamental need for social integration and undoubtedly partly explains why friendship and involvement in social life are so beneficial to individual’s health and social functioning [55,56].

              Robert Putnam points to the relationship between inequality and `social capital` which he defines as the involvement of people in social life [57,58]. Putnam emphasizes that the increase in inequality leads to the erosion of social capital. With large inequalities in society in the macrostructural context, group monopolies are divided and formed, i.e. the privileged groups strive to protect and maintain their dominant position, at the expense of others. Representatives of individual social groups have different awareness of their status and may adopt different attitudes towards them (either rebellion or acceptance). As a result, they experience deprivation, frustration, alienation, blaming society and/or themselves for a failed life, lack of faith in their own abilities, pessimism, and fear of the future. These feelings may be accompanied by behaviours like: apathy, non-alignment, passivity, hedonism, and consumerism, distrust of others, withdrawal, individualism, escapism (escape from reality), drug abuse, extremism, violence [59].

              Danesh’s assumptions are reflected in the results of research, which confirm that political and social forms of inequality are the most important factors in the outbreak of violence [60]. Research over the course of several decades has shown that excluded groups with a sense of unequal treatment, suffering from their want and humiliation, can rebel and unite in the fight against injustice.

              According sociologists there is a strong relationship between social exclusion and crime. Loss or lack of regular income can cause conflicts and violence in the family [61,62].

              In recent years, we observe economic, ethnic, and religious conflicts in the countries of North Africa and the Middle East, resulting in revolutions, genocides, and mass migrations of civilians. Samuel Huntington would say that a new order is now emerging as a result of the collapse of order and failure of a civil society that is not economically sustainable [63]. This creates a space in which fundamentalist groupings enter, making use of the dissatisfaction of individuals with a sense of alienation, which results in degradation, lack of self-satisfaction and self-fulfilment, isolation, loneliness.

Based on the finding in the reviewed literature we can assume that environmental and personal sources of satisfaction are interdependent determinants, however not everyone is cognizant of how inequalities and incorrect interpersonal relationships affect the well-being of an individual. Being aware of all the dependencies, as a society, through our collective actions at the level of social organizations, we can create conditions contributing to the improvement of social relations and the individuals’ quality of life. Overcoming strong differences, increased trust and better cooperation between members of local, national, European and international communities can be a crucial factor in creating favourable conditions for reducing harmful stereotypes. In addition, it contributes to an effective organization and mitigating the dynamic course of social processes. The adults mediate between the rapidly changing world and the young generation that is entering this world. Adult behaviour pattern and particular skills or competences can impact creating own paths to succeed in society. It can be accomplished through building a good relationships and maintaining those adult behaviour patterns which contributes in increasing social ties and self-esteem of each person.

Limitations

We are confident that we have conducted a sensitive search to identify the key evidence publicly available, however since we have not performed a systematic literature review there exist the chance that we may have missed relevant information.

Conclusions

Considering social indicators, we can state that the achieved economic growth has contributed to extend the average life expectancy, however a positive correlation occurs only to a certain level.

Available data shows that in many developed countries, further quality of life improvement does not depend only on economic growth, but there is also impact of interpersonal relations and involvement in social life. The social inequalities issue requires an action in order to avoid worsening and an increase of conflicts, or cases related to mental disorders, crime, and other problems which young generations are facing.

Authors disclose no conflict of interest.