An empirical comparison of wellbeing measures used in UK

A number of different, yet related, measures of subjective well-being (SWB) and health are used across government departments. Under its Measuring National Well-being Programme, the Office of National Statistics (ONS) has adopted the use of the short Warwick Edinburgh Mental Well-being Scale (SWEMWBS) and the General Health Questionnaire (GHQ-12), which is a mental health screening measure, as well as four summary subjective (personal) well-being questions which ask about life satisfaction, happiness and anxiety yesterday, and worthwhileness (the ONS-4). In addition to the measures used within the ONS framework, the National Institute for Health and Care Excellence (NICE) currently prefer the EQ-5D, a measure of health-related quality of life (HRQoL), in the assessment of medical technologies and public health interventions,[NICE, 2013a] while social care guidance includes measures of capability and need: the Investigating Choice Experiments Capability Measures for Older people/ Adults (ICECAP-A and ICECAP-O) and the Adult Social Care Outcomes Toolkit (ASCOT).[NICE, 2013b] There is limited evidence on how these measures relate to each other, which causes difficulty in the comparison of results across datasets and evaluations containing different measures, as well as for informing decisions across sectors. Given that these measures are used to inform policy making throughout Government, it is important to better understand how these measures compare.

The Department of Health has asked the Policy Research Unit in Economic Evaluation of Health and Care Interventions (EEPRU) to undertake a conceptual and empirical comparison of the following six commonly used measures of health and well-being: SWEMWBS, GHQ-12, ONS-4, ICECAP, ASCOT and EQ-5D. This report summarises psychometric analysis including factor analysis which sought to compare the ONS-4, the SWEMWBS/WEMWBS, the GHQ-12, the ICECAP-A or ICECAP-O, ASCOT, the EQ-5D and the SF-6D. The report also takes into consideration additional measures of SWB found within the datasets to shed further light on these comparisons and the concepts behind the measures. It addresses three related questions: 1) whether the well-being measures measure the same or different constructs related to the underlying theoretical foundations;[see Peasgood et al, 2014] 2) whether or not separate positive and negative well-being measures are required; and 3) what the potential impact of using well-being measures in the evaluation of health-care interventions would be. The questions relate to the more specific question of whether there is redundancy if both the GHQ-12 and the S-WEMWBS are measured. GHQ-12 has both negative and positive items while the S-WEMWBS focuses only on positive well-being questions. The key question is whether the negative questions provide additional, policy relevant, information to the positive well-being questions.