The collection of microdata on well-being is a central objective. Following Eurostat`s proposal to collect microdata on well-being under the 2013 SILC module, data for subjective indicators will be collected regularly as European statistics in the relatively near future (planned from 2022). While in the long term data for several of the required indicators are readily available from other sources (e.g. LFS for the productive dimension or the main activity dimension), the EU-SILC should be further developed to serve as a central EU instrument linking the different dimensions of quality of life at the individual level and reflecting their dynamic interdependencies. In order to make the indicator system less complex and to allow an analysis of the 8+1 dimensions of quality of life, a very limited number of key indicators were selected for each dimension, while synthetic indicators for highly correlated variables could be developed. A scoreboard of uncorrelated primary indicators should complete the table. Health is an essential element of citizens` quality of life and can also be seen as a form of human capital. Poor health can affect the overall progress of society. Physical and/or mental problems also have a very detrimental effect on subjective well-being.
The health situation in the European Union in the context of quality of life is mainly measured on the basis of three sub-dimensions: health indicators such as life expectancy (based on life tables), number of years of healthy life (combination of information on life expectancy with a survey variable on self-reported activity restrictions) and subjective assessments of one`s own health, chronic diseases and activity limitations (data based on EU-SILC); Determinants of health (healthy and unhealthy behaviours such as smoking, alcohol consumption and fruit and vegetables, data from the European Health Survey (EHIS); and access to healthcare (data based on EU-SILC). In 2019, life expectancy at birth in the EU averaged 81.3 years. A child born in Spain in 2019 could expect to live longer than a child born in one of the other EU Member States, as life expectancy at birth in that country was 84 years. In contrast, Bulgaria recorded the lowest life expectancy at birth – 75.1 years. The modified indices used in the NSHAP tended to have good internal reliability and good validity at the same time. These measures can be used with confidence in research on quality of life and mental health later in life and its many correlates. Overall, life expectancy in the EU has steadily improved over the last century due to a number of factors, including: reduced infant mortality, rising living standards, improved lifestyles, improved education, and advances in health and medicine. Between 2010 and 2019, life expectancy at birth in the EU increased from 79.8 years to 81.3 years (see Figure 2). Seven QoL and mental health indicators were included in the NSHAP. Four of them – anxiety, depression, stress and loneliness – reflect the more negative aspect of QoL, while the other three – emotional health, happiness and self-esteem – highlight its positive side. While the NSHAP framework includes established measures of happiness, self-esteem, loneliness, and depression, some changes have been made to measures of anxiety, stress, and emotional health.
The central objective of this paper was therefore to present the changes to the NSHAP and to provide empirical evidence of the relevance of the modified measures. Within NSHAP, feelings of anxiety are conceptually integrated into the broader concept of QoL and mental health. As mentioned above, other indicators of quality of life include depression (as measured by the CES-D), stress (Perceived Stress Scale [PSS]-4), loneliness, self-esteem, emotional health, and happiness. The simultaneous validity of HADS-A can be determined by examining the correlation between these constructs. As can be seen in Table 3, the correlations are moving in the expected direction, with the strongest association found between depression and anxiety (.63, p < .001). Positive associations have been found between anxiety, stress and loneliness. In addition, three negative correlations have been found between the positive aspects of QoL: good emotional health, high self-esteem, and overall happiness. Since each of these correlations went in the expected direction, the simultaneous validity of HADS-A was demonstrated. Material standard of living is measured on the basis of three sub-dimensions: income, consumption and material conditions (deprivation and housing).
Income is an important indicator because it affects most of the other indicators in the framework. Within this sub-dimension, there are various indicators drawn from both national accounts and household surveys (national net income, household disposable income based on EU-SILC). The same applies to consumption, where some aggregated indicators are taken from the national accounts (real individual consumption per capita of households), and other indicators of household consumption will in future be developed from the Household Budget Survey. Common indicators of income, consumption and wealth are also evolving and have the potential to examine the situation of households in the most comprehensive way. Nevertheless, the prosperity aspect is currently covered in this context under the sub-dimension of economic security. Material conditions (deprivation and housing) provide important additional information on these monetary approaches, and the indicators selected for this sub-dimension are also based on EU-SILC. Improving the quality of life requires action not only by NGOs, but also by governments. Global health has the potential to achieve greater political presence if governments included aspects of human security in foreign policy. The focus on people`s human rights to health, food, shelter and freedom addresses important cross-cutting issues that can negatively impact today`s society and lead to more action and resources. The integration of global health concerns into foreign policy can be hampered by approaches shaped by the primary roles of defence and diplomacy.  Since self-reported emotional health contributes to a positive quality of life, we assumed that this measure would positively correlate with the rest of the positive quality of life indicators.