Well-being measurement and the WHO health policy Health 2010: systematic review of measurement scales
Open accessAbstract
BACKGROUND: Subjective well-being (SWB) contributes to health and mental health. It is a major objective of the new World Health Organization health policy framework, 'Health 2020'. Various approaches to defining and measuring well-being exist. We aimed to identify, map and analyse the contents of self-reported well-being measurement scales for use with individuals more than 15 years of age to help researchers and politicians choose appropriate measurement tools. METHODS: We conducted a systematic literature search in PubMed for studies published between 2007 and 2012, with additional hand-searching, to identify empirical studies that investigated well-being using a measurement scale. For each eligible study, we identified the measurement tool and reviewed its components, number of items, administration time, validity, reliability, responsiveness and sensitivity. RESULTS: The literature review identified 60 unique measurement scales. Measurement scales were either multidimensional (n = 33) or unidimensional (n = 14) and assessed multiple domains. The most frequently encountered domains were affects (39 scales), social relations (17 scales), life satisfaction (13 scales), physical health (13 scales), meaning/achievement (9 scales) and spirituality (6 scales). The scales included between 1 and 100 items; the administration time varied from 1 to 15 min. CONCLUSIONS: Well-being is a higher order construct. Measures seldom reported testing for gender or cultural sensitivity. The content and format of scales varied considerably. Effective monitoring and comparison of SWB over time and across geographic regions will require further work to refine definitions of SWB. We recommend concurrent evaluation of at least three self-reported SWB measurement scales, including evaluation for gender or cultural sensitivity.
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The SLR identified two prior reviews of well-being scales (using a very broad definition of well-being that included quality of life, physical well-being, and health), which found 99 and 60 PROs respectively.
“In addition, the SLR identified two prior reviews of ‘well-being’ scales (using a very broad definition of well-being that included quality of life, physical well-being, and health), which found 99 and 60 PROs respectively [6, 7].”
From Patient-reported outcome measures for life engagement in mental health: a systematic review (2022) · cites this paper as [7]
Previous reviews have highlighted some available tools, but not all have used systematic methods for identifying measures.
“Previous reviews have highlighted some of the available tools.29–31 However, not all have used systematic methods for identifying measures.”
From Review of 99 self-report measures for assessing well-being in adults: exploring dimensions of well-being and developments over time (2016) · cites this paper as [31]
Previous reviews identified 60 or fewer well-being instruments.
“In previous reviews,30 31 60 or fewer instruments were identified; however, in our review 99 are reported.”
From Review of 99 self-report measures for assessing well-being in adults: exploring dimensions of well-being and developments over time (2016) · cites this paper as [31]
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“Subjective wellbeing refers to an individual’s satisfaction with material possessions, health, achievements, relationships, safety, social connectedness, and future security (28), which includes emotional, psychological, social, and spiritual aspects (29).”
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“Step 1: Collection of Domains and Subdomains From Existing Well-Being Scales Well-being and quality of life scales from six recent review studies were collected [5-8,31,47].”
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Well-being measures for younger children.
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Aznar, M. P. M., del Pino, M. J., Pérez, J. M. B., & Hernández-Lorenzo, D. E. (2022) · Applied Research in Quality of Life · doi:10.1007/s11482-022-10140-1 · Cited by 18 · see citing works
“There are various approaches to consider the definition and measuring of wellbeing (Cooke et al, 2016; Diener et al., 2017; Lindert et al., 2015; Linton et al., 2016).”
BackgroundYang, Y., Cui, M., Zhao, X., Wang, S., Wang, Y., & Wang, X. (2023) · BMC Nursing · doi:10.1186/s12912-023-01259-z · Cited by 18 · see citing works
“WHO advocated QoL beyond the physical, psychological and social dimensions, that is the fourth dimension that actively explored in persons with serious illness: spiritual well-being (SWB) [3].”
BackgroundWhat is eating well? Capability approach and empirical exploration with the population in Japan
Ueda, H. (2021) · Appetite · doi:10.1016/j.appet.2021.105874 · Cited by 17 · see citing works
Govindasamy, D., Seeley, J., Olaru, I. D., Wiyeh, A. B., Mathews, C., & Ferrari, G. (2020) · Health and Quality of Life Outcomes · doi:10.1186/s12955-020-01352-w · Cited by 18 · see citing works
Creativity Policy, Partnerships and Practice in Education
Asquith, S., Wang, X., & Abraham, A. (2018) · Springer eBooks · doi:10.1007/978-3-319-96725-7 · Cited by 18 · see citing works
The Scientific Study of Life Satisfaction and Religion/Spirituality
Krumrei-Mancuso, E. J., & Lorona, R. T. (2022) · Springer eBooks · doi:10.1007/978-3-031-10274-5_19 · Cited by 18 · see citing works
Mejía-Lancheros, C., Lachaud, J., Aubry, T., Wiens, K., O'Campo, P. J., Stergiopoulos, V., & Hwang, S. W. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-021-02093-x · Cited by 17 · see citing works
“Psychological, self-perceived health, quality of life, spirituality, social relations, and life satisfaction are subjective aspects of well-being [3, 4].”
BackgroundRejikumar, G., Ajitha, A. A., Jose, A., & Mathew, S. (2021) · Journal of Service Theory and Practice · doi:10.1108/jstp-12-2020-0284 · Cited by 17 · see citing works
Environmental Displacement and Mental Well-Being in Banjarnegara, Indonesia
Burrows, K., Pelupessy, D. C., Khoshnood, K., & Bell, M. L. (2021) · Environmental Health Perspectives · doi:10.1289/ehp9391 · Cited by 15 · see citing works
“Economic factors are often included in over-arching well-being frameworks (Lindert et al. 2015) and are associated with mental health (Syrén et al. 2020), but they are not commonly incorporated as central components of mental well-being (Rose et al. 2017).”
Death education for Palliative care: a european project for University students
Testoni, I., Ronconi, L., Orkibi, H., Biancalani, G., Raccichini, M., Franchini, L., Keisari, S., Bucuță, M., Ciepliński, K., Wieser, M., et al. (2023) · BMC Palliative Care · doi:10.1186/s12904-023-01169-6 · Cited by 13 · see citing works
“In line with the conception of health of the World Health Organization (WHO) as a harmony between the somatic, psychological and social dimensions [4, 5], PC aims to relieve patients’ suffering and increase their quality of life as well as that of their families, thanks to the specific knowledge and skills of the heal…”
BackgroundPiumatti, G., Lietz, F., Aresi, G., & Bjegovic-Mikanovic, V. M. (2018) · Journal of Ethnicity in Substance Abuse · doi:10.1080/15332640.2017.1417186 · Cited by 15 · see citing works
“…from a multidimensional perspective assuming that although this is a complex construct comprehending several factors (Gallagher, Lopez, & Preacher, 2009), a synthesis of different personal fulfilment aspects in a unidimensional factor model of well-being is plausible (Lindert et al., 2015).”
BackgroundThe role of literary festival attendance in generating attendees' health and well-being
Rossetti, G. (2021) · International Journal of Event and Festival Management · doi:10.1108/ijefm-12-2020-0083 · Cited by 15 · see citing works
Du, J., Jiang, Y., Lloyd, C. E., Sartorius, N., Ren, J., Zhao, W., Wei, J., & Hong, X. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05381-9 · Cited by 13 · see citing works
“Thus, WHO-5 can be also used as a reliable screening tool for depression, as confirmed in various studies related to diabetes with good psychometric properties [20, 22].”
MethodToyoshima, K., Ichiki, M., Inoue, T., Masuya, J., Fujimura, Y., Higashi, S., & Kusumi, I. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s303751 · Cited by 13 · see citing works
“Hence, cognitive complaints may have more affinity to SIB, which had a stronger correlation with negative psychological factors than SWB, which correlates with positive psychological factors.(2,3) Furthermore, SWB is considered more stable than SIB, because personality traits have a stronger influence on SWB than SIB.”
BackgroundGreil, A. L., McQuillan, J., Burch, A., et al. (2019) · Journal of Marriage and the Family · doi:10.1111/jomf.12595 · Cited by 13 · see citing works
Binge drinking and well-being in European older adults: do gender and region matter?
Fuentes, S., Bilal, U., Galán, I., Villalbí, J. R., Espelt, A., Bosque‐Prous, M., Franco, M., & Lazo, M. (2016) · European Journal of Public Health · doi:10.1093/eurpub/ckw246 · Cited by 13 · see citing works
Happiness, health, and mortality
Kubzansky, L. D., Kim, E. S., Salinas, J., Huffman, J. C., & Kawachi, I. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30896-0 · Cited by 14 · see citing works
Self-citationRodrigues, R., Nicholson, K., Guaiana, G., Wilk, P., Stranges, S., & Anderson, K. K. (2022) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980822000368 · Cited by 12 · see citing works
The influence of perceived stress and income on mental health in China and Germany
Li, R., Liu, S., Huang, C., Darabi, D., Zhao, M., & Heinzel, S. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e17344 · Cited by 12 · see citing works
“Future studies could investigate other indicators of mental health and stress, such as well-being and life events stressors [72,73].”
BackgroundDefining well-being in psoriasis: A Delphi consensus among healthcare professionals and patients
Daudén, E., Belinchón, I., Colominas-González, E., Coto, P., de la Cueva, P., Gallardo, F., Poveda, J. L., Herráiz, E. R., Ros, S., Ruíz‐Villaverde, R., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-64738-6 · Cited by 12 · see citing works
“Nevertheless, despite no agreed definition 27 there is broad agreement that well-being encompasses: mental health, functional status, life satisfaction, personal development, positive social relationships, positive emotions, and the absence of negative emotions 22,23 .”
BackgroundArslan, G., & Coşkun, M. (2025) · Journal of Personality Assessment · doi:10.1080/00223891.2025.2569671 · Cited by 11 · see citing works
“One of the most pressing concerns in this regard is the absence of cultural sensitivity in wellbeing assessments (Lindert et al., 2015).”
PIUMATTI, G., Magistro, D., Zecca, M., & Esliger, D. (2017) · Ageing and Society · doi:10.1017/s0144686x1700071x · Cited by 11 · see citing works
“measures as health indicators and cost-benefit analysis tools to evaluate public health policies (Lindert et al. 2015; O’Donnell et al. 2014).”
BackgroundThe Handbook of Wellness Medicine
Snellings, J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182 · Cited by 11 · see citing works
Mininni, G. M., Foxon, T. J., Copeland, C., Martinez, B. A., Brown, D., Brisbois, M. C., Contreras, G. A. T., Stack-Maddox, S., Lacey‐Barnacle, M., & Jaccarini, C. (2024) · Energy Research & Social Science · doi:10.1016/j.erss.2024.103799 · Cited by 10 · see citing works
The Use of Public Health Indicators to Assess Individual Happiness in Post-Disaster Recovery
Sun, Y., & Yan, T. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16214101 · Cited by 10 · see citing works
“Regarding neighborhood connectedness, its positive impacts on happiness have been verified by numerous studies [12,18,35,41].”
BackgroundMahamid, F., Veronese, G., & Bdier, D. (2023) · Middle East Current Psychiatry · doi:10.1186/s43045-023-00282-9 · Cited by 9 · see citing works
“Due to the importance of having tools to measure wellbeing and because definitions and approaches of WB are heterogeneous [16], PERMA-Profiler scale was developed by Butler and Kern [6].”
MethodEvaluating flourishing: a comparative analysis of four measures using item pool visualization
Ploke, V., Batinic, B., & Stieger, S. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1458946 · Cited by 12 · see citing works
“The surge in interest in promoting wellbeing has led to many definitions of this concept and a plethora of questionnaires that claim to capture it (Cooke et al., 2016; Lindert et al., 2015; Linton et al., 2016).”
Noordzij, G., van Dam, A., & Born, M. P. (2024) · Journal of Happiness Studies · doi:10.1007/s10902-024-00828-6 · Cited by 11 · see citing works
“…to measure and define well-being ranging from the positive aspects of well-being to the absence of diseases, from global life-satisfaction to domain specific well-being, from one dimension to multiple dimensions, and from objective to subjective components of well-being (Lindert et al., 2015 ).”
Huang, Y., Li, Z., Wu, X., et al. (2025) · Applied Geography · doi:10.1016/j.apgeog.2025.103713 · Cited by 8 · see citing works
Sathe, N. C., Carney, P. A., & Furnari, M. (2022) · Medical Education Online · doi:10.1080/10872981.2022.2153781 · Cited by 8 · see citing works
Assessing the well-being of residents in nursing facilities
Schott, N., Johnen, B., & Klotzbier, T. J. (2021) · German Journal of Exercise and Sport Research · doi:10.1007/s12662-021-00776-w · Cited by 8 · see citing works
Tng, G. Y. Q., & Yang, H. (2022) · Social Media + Society · doi:10.1177/20563051221094768 · Cited by 8 · see citing works
“These include global evaluations of life (i.e., life satisfaction; Myers & Diener, 1995) and domain-specific evaluations of an individual’s social relations with others (e.g., loneliness) and mental health (e.g., depressive symptoms; Hyde et al., 2003; Lindert et al., 2015; Meadow et al., 1992).”
BackgroundEmerson, E. J., Ford, R. C., & Simsek, K. D. (2022) · International Journal of Hospitality Management · doi:10.1016/j.ijhm.2022.103295 · Cited by 8 · see citing works
Kelly-Hedrick, M., Lhaksampa, T. C., Chisolm, M. S., & Miller, L. (2022) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045221143898 · Cited by 8 · see citing works
“Although numerous well-being measures exist, few have been modi fi ed for adolescents and young adults using a method that ensures acceptability and appropriateness for this population (Lindert et al., 2015; Lippman et al., 2014; Pustilnik, 2019).”
MethodTesting multidimensional well-being among university community samples in Italy and Serbia
Lietz, F., Piumatti, G., Mosso, C., Marinkovic, J., & Bjegovic-Mikanovic, V. (2016) · Health Promotion International · doi:10.1093/heapro/daw082 · Cited by 10 · see citing works
“A very recent review of self-reported well-being measurement scales by Lindert et al. (2015) listed 60 unique tools, the majority of which are multidimensional but do not pay enough attention to cultural sensitivity.”
BackgroundMethodInfluentialResponse to “Advancing the Science of Well-Being: A Dissenting View on Measurement Recommendations”
VanderWeele, T. J., Trudel‐Fitzgerald, C., & Kubzansky, L. D. (2021) · doi:10.1093/oso/9780197512531.003.0020 · Cited by 8 · see citing works
Self-citationHlynsson, J. I., Sjöberg, A., Ström, L., & Carlbring, P. (2024) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2024.2402992 · Cited by 9 · see citing works
“Numerous instruments have been produced that reliably assess SWB (for a review, see Lindert et al., 2015).”
Koh, Z. H., Serbetci, D., Skues, J., & Murray, G. (2025) · JMIR Mental Health · doi:10.2196/59351 · Cited by 7 · see citing works
“Most instruments measuring mental well-being and HRQoL found in the present review were also identified in an earlier review by Lindert et al [61] of well-being measurement scales.”
InfluentialLin, T.-F., Zhao, Z.-Y., Yuan, C.-Z., Huang, Y., Liu, D., Li, F.-X., Jiang, Y.-W., Li, B., Wei, C., Sha, F., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.148 · Cited by 7 · see citing works
Mercer, J., Davies, E. W., Cook, M., & Bowes, N. (2022) · Journal of Forensic Practice · doi:10.1108/jfp-11-2021-0057 · Cited by 7 · see citing works
Duncan, A. R., Bell, S. B., & Hellman, C. M. (2022) · Journal of Social Distress and the Homeless · doi:10.1080/10530789.2022.2107336 · Cited by 7 · see citing works
“” The Cantril Ladder scale has been used for years by Gallup for wellbeing surveys and has been validated in various populations across the world (Cantril, 1965; Lindert et al., 2015).”
MethodKoh, Z. H., Skues, J., & Murray, G. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-065162 · Cited by 7 · see citing works
Cappelen, H., Ivarsson, A., & Jormfeldt, H. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2022.2158408 · Cited by 6 · see citing works
“It is generally known that well-being is contributing to healthy aging, mental health, and health in general (Lindert et al., 2015).”
BackgroundMethodSusanto, H., Wedyaswari, M., & Dalimunthe, K. L. (2023) · Frontiers in Education · doi:10.3389/feduc.2023.1132031 · Cited by 6 · see citing works
Sequeira, C., Carvalho, J. C., Roldán-Merino, J. F., Moreno‐Poyato, A. R., Teixeira, S. M. A., David, B., Costa, P., Llobet, M. P., & Lluch‐Canut, T. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1375378 · Cited by 6 · see citing works
“There are many instruments to measure well-being or mental health (22), but only fewer addressing a specific area of mental health - positive mental health.”
Liu, F., & Chong, E. S. K. (2024) · Family Process · doi:10.1111/famp.13012 · Cited by 7 · see citing works
Burke, E. (2017) · Landscape Research · doi:10.1080/01426397.2017.1353069 · Cited by 7 · see citing works
Eccles, F. J. R., Garner, I. W., Murray, C. D., Doyle, C., & Simpson, J. (2023) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2023.120768 · Cited by 6 · see citing works
Liu, F., Wang, Y., Wang, N., Ye, Z., & Fang, S. (2023) · Mindfulness · doi:10.1007/s12671-023-02213-5 · Cited by 6 · see citing works
“Its significance as an overall well-being indicator for the general population is underscored by its utilization in the World Health Organization (WHO; Lindert et al., 2015).”
BackgroundToyoshima, K., Ichiki, M., Inoue, T., Shimura, A., Masuya, J., Fujimura, Y., Higashi, S., & Kusumi, I. (2022) · BMC Public Health · doi:10.1186/s12889-022-12936-0 · Cited by 7 · see citing works
Childs, A. (2018) · Multicultural Education Review · doi:10.1080/2005615x.2018.1460893 · Cited by 5 · see citing works
Research on Physician Burnout and Wellbeing: A Solution-Oriented Perspective
Bogue, R. J., & Downing, N. R. (2019) · Springer eBooks · doi:10.1007/978-3-030-15250-5_2 · Cited by 5 · see citing works
Tamura, N., Park, S., Sato, Y., Takita, Y., Morishita, J., Ninomiya, A., Kosugi, T., Sado, M., Mimura, M., & Fujisawa, D. (2020) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000022 · Cited by 5 · see citing works
Pacheco-Jaramillo, W. A., & Zaldumbide-Peralvo, D. A. (2025) · Sustainability · doi:10.3390/su17104555 · Cited by 4 · see citing works
Chen, X., Hoek, G., Frijters, P., Dyer, G. M. C., Gössling, S., Khomenko, S., Khreis, H., Kolb, E., Mueller, N., Staatsen, B. A. M., et al. (2026) · Environment International · doi:10.1016/j.envint.2026.110067 · Cited by 4 · see citing works
Urban Regeneration between Well-Being, Social Determinants and Sustainable Development Goals
Battisti, A. (2023) · Green energy and technology · doi:10.1007/978-3-031-16182-7_1 · Cited by 4 · see citing works
- Authors
- Lindert, J., Bain, P. A., Kubzansky, L. D., & Stein, C.
- Affiliations
- Brandeis University (US)
- Harvard University (US)
- Venue
- The European Journal of Public Health
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-01-22
- Volume
- 25
- Issue
- 4
- Pages
- 731-740
- ISSN
- 1101-1262 (ISSN-L)
- 1464-360X
- OpenAlex
- W2160933378
- Cited by
- 246
- References
- 35
- Citations by year
- 2026: 14 · 2025: 22 · 2024: 18 · 2023: 23 · 2022: 25 · 2021: 34 · 2020: 76 · 2019: 14 · 2018: 8 · 2017: 5 · 2016: 5 · 2015: 2
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Public Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Topics
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Keywords
- subjective well-being, self-report measures, health policy, life satisfaction, affect, interpersonal relationships, spirituality, scale reliability and validity, intercultural sensitivity, gender sensitivity
- MeSH terms
- Female, Health Status, Humans, Interpersonal Relations, Male, Mental Health, Personal Satisfaction, Surveys and Questionnaires, World Health Organization, Reproducibility of Results, Spirituality
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