Miret Marta, Caballero Francisco Félix, Olaya Beatriz, Koskinen Seppo, Naidoo Nirmala, Tobiasz-Adamczyk Beata, Leonardi Matilde, Haro Josep Maria, Chatterji Somnath, Ayuso-Mateos José Luis
Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo 4, 28029, Madrid, Spain.
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.
Global Health. 2017 Aug 23;13(1):65. doi: 10.1186/s12992-017-0290-0.
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.
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.
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.
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.
了解不同收入水平国家中体验到的幸福感与评价性幸福感和健康之间的关系是否一致很重要。这将有助于确认在高收入国家发现的证据是否与低收入和中等收入国家相同，并提出可在各国推广的政策建议。我们评估了幸福感与健康状况之间的关联；分析了积极情绪、消极情绪和评价性幸福感与健康状况之间的差异关系；并研究了这些关系在各国是否相似。
在这项横断面研究中，对来自非洲、亚洲、欧洲和拉丁美洲九个国家的53269名成年人进行了访谈。评价性幸福感采用世界卫生组织（WHO）生活质量量表简版进行测量，体验到的幸福感采用日重建法进行测量。健康状况的下降采用WHO残疾评定量表2.0的12项版本进行评估。采用逐块线性回归和结构方程模型。
考虑总体样本，评价性幸福感与健康的关联更强（β = -0.35），而体验到的幸福感与健康的关联较弱（β = -0.14），消极情绪与健康的关联更强（β = 0.10），而积极情绪与健康的关联较弱（β = -0.02）。各国健康与幸福感之间的关系相似。评价性幸福感得分较低和年龄较大是与健康状况较差更密切相关的因素。
各国观察到的不同模式可能与各国的国内生产总值、社会保护体系、经济状况、医疗保健提供、生活方式行为或生活条件的差异有关。评价性幸福感比体验到的幸福感更能预测健康这一事实表明，我们对生活的满意度水平可能比我们在日常生活中实际体验到的情绪对健康更重要，并指出需要采取干预措施来改善人们评价自己生活的方式。
