Association of experienced and evaluative well-being with health in nine countries with different income levels: a cross-sectional study

Marta Miret, Francisco Félix Caballero, Beatriz Olaya, Seppo Koskinen, Nirmala Naidoo, Beata Tobiasz-Adamczyk, Matilde Leonardi, Josep Maria Haro, Somnath Chatterji, José Luis Ayuso-Mateos, Marta Miret, Francisco Félix Caballero, Beatriz Olaya, Seppo Koskinen, Nirmala Naidoo, Beata Tobiasz-Adamczyk, Matilde Leonardi, Josep Maria Haro, Somnath Chatterji, José Luis Ayuso-Mateos

Abstract

Background: It is important to know whether the relationships between experienced and evaluative well-being and health are consistent across countries with different income levels. This would allow to confirm whether the evidence found in high income countries is the same as in low- and middle-income countries and to suggest policy recommendations that are generalisable across countries. We assessed the association of well-being with health status; analysed the differential relationship that positive affect, negative affect, and evaluative well-being have with health status; and examined whether these relationships are similar across countries.

Methods: In this cross-sectional study, interviews were conducted amongst 53,269 adults from nine countries in Africa, Asia, Europe, and Latin America. Evaluative well-being was measured with a short version of the World Health Organization (WHO) Quality of Life instrument, and experienced well-being was measured with the Day Reconstruction Method. Decrements in health were assessed with the 12-item version of WHO Disability Assessment Schedule 2.0. Block-wise linear regression and structural equation models were employed.

Results: Considering the overall sample, evaluative well-being was more strongly associated with health (β = -0.35) than experienced well-being (β = -0.14), and negative affect was more strongly associated with health (β = 0.10) than positive affect (β = -0.02). The relationship between health and well-being was similar across countries. Lower scores in evaluative well-being and a higher age were the factors more strongly related with a worse health.

Conclusions: The different patterns observed across countries may be related to differences in the countries' gross domestic product, social protection system, economic situation, health care provision, lifestyle behaviours, or living conditions. The fact that evaluative well-being is more predictive of health than experienced well-being suggests that our level of satisfaction with our lives might be more important for our health than the actual emotions than we experience in our day-to-day lives and points out the need of interventions that improve the way people evaluate their lives.

Keywords: Evaluative well-being; Experienced well-being; Health status.

Conflict of interest statement

Ethics approval and consent to participate

Ethical approvals from the following institutions were obtained: Ethics Review Committee, World Health Organization; Ethics Review Committee, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Ethics Review Committee, La Princesa University Hospital, Madrid, Spain; Bioethical Committee, Jagiellonian University, Krakow, Poland; Ethics Review Committee, National Public Health Institute, Helsinki, Finland; Ethical Committee, Ghana Medical School, Accra, Ghana; Ethics Committee, School of Preventive and Social Medicine, Russian Academy of Medical Sciences, Moscow, Russia; Ethics Committee, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China; Institutional Review Board, International Institute of Population Sciences, Mumbai, India; Research Ethics Committee, Human Sciences Research Council, Pretoria, South Africa; and Ethics Committee, National Institute of Public Health, Cuernavaca, Mexico. Written informed consent from each participant was also obtained.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests. The views expressed in this paper are those of the authors and do not necessarily represent the views or policies of the World Health Organization.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
SEM estimates of the association of experienced and evaluative well-being with WHODAS score. Weighted data β=Standardised coefficients; all the coefficients had associated p < 0.001. Analyses were controlled by country

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