Mapping eu member states' quality of life during COVID-19 pandemic crisis

De ma is, Zacha ias; Kalligos y is, Cha alampos; Kalama a, Eleni; Anas asiou,
A hanasios
A icle
Mapping eu membe s a es' quali y o li e du ing
COVID-19 pandemic c isis
Economies
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MDPI – Mul idisciplina y Digi al Publishing Ins i u e, Basel
Sugges ed Ci a ion: De ma is, Zacha ias; Kalligos y is, Cha alampos; Kalama a, Eleni; Anas asiou,
A hanasios (2024) : Mapping eu membe s a es' quali y o li e du ing COVID-19 pandemic c isis,
Economies, ISSN 2227-7099, MDPI, Basel, Vol. 12, Iss. 7, pp. 1-18,
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Ci a ion: De ma is, Zacha ias,
Cha alampos Kalligos y is, Eleni
Kalama a, and A hanasios Anas asiou.
2024. Mapping EU Membe S a es’
Quali y o Li e du ing COVID-19
Pandemic C isis. Economies 12: 158.
h ps://doi.o g/10.3390/
economies12070158
Academic Edi o : Se gio Scicchi ano
Recei ed: 27 Ma ch 2024
Re ised: 4 June 2024
Accep ed: 11 June 2024
Published: 24 June 2024
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economies
A icle
Mapping EU Membe S a es’ Quali y o Li e du ing COVID-19
Pandemic C isis
Zacha ias De ma is 1, Cha alampos Kalligos y is 1,2, Eleni Kalama a 2,3 and A hanasios Anas asiou 1,*
1Depa men o Managemen Science and Technology, Uni e si y o Peloponnese, 221 00 T ipoli, G eece;
[email p o ec ed] (Z.D.); [email p o ec ed] (C.K.)
2G eek Independen Au ho i y o Public Re enue, 101 84 A hens, G eece; [email p o ec ed]
3Depa men o Economics, Uni e si y o Peloponnese, 221 00 T ipoli, G eece
*Co espondence: [email p o ec ed]
Abs ac : This s udy p oposes an in eg a ed me hodology o he assessmen and mapping o quali y
o li e (QoL) among Eu opean Union membe s a es in he pe iod be o e and a e he pandemic
c isis o COVID-19. The assessmen o quali y o li e was based on he de elopmen o composi e
c i e ia and Geog aphical In o ma ion Sys ems o GIS echnology, using a iables ha assess quali y
o li e. The composi e c i e ia ela e o he socioeconomic en i onmen , employmen condi ions,
economic condi ions and heal h se ices. Each c i e ion was e alua ed by a se o a iables, and each
a iable was weigh ed based on ele an esea ch by G eek expe s. C i e ia we e also weigh ed
and combined o assess o e all quali y o li e. The me hodology was applied in 27 EU membe
coun ies, and mapping led o he iden i ica ion o coun ies wi h low and high quali y o li e. The
esul s showed a change in he le el o o e all quali y o li e in he EU coun ies be o e and a e he
pandemic pe iod, al hough on a limi ed scale, since he e is a sligh eclassi ica ion o he coun ies’
posi ions. The analysis also e ealed he highes le el o quali y o li e in ou EU coun ies [Sweden,
Denma k, he Ne he lands and Luxembou g] ha show an inc eased GDP pe capi a, combining a
low le el o a ea s and a low le el o inabili y o make ends mee , whe eas ou coun ies showed
he lowes le el o quali y o li e [G eece, Bulga ia, Romania and C oa ia] in bo h pe iods.
Keywo ds: quali y o li e; Geog aphical In o ma ion Sys ems; COVID-19; socioeconomic
1. In oduc ion
In he las qua e o 2019, an unknown i us ha o igina ed in Wuhan, China de el-
oped in o a pandemic ha became a dange no only o li es bu also o he economies
o e e y coun y. I did no ake long o all coun ies a ound he wo ld o ealize ha
he e is an u gen need o ind a solu ion o his unp eceden ed h ea o he 21s cen u y.
Un il he end o he i s qua e o 2020, in o de o slow he sp ead o he co ona i us
and p o ec he heal h and well-being o all Eu opeans, some social es ic ions had o be
pu in place. P epa a ion ime a ied om coun y o coun y, wi h some go e nmen s
ac ing immedia ely, whe eas o he s needed ime o ake ac ion and decide wha s a egy o
pu sue. Among he i s measu es aken we e he es ablishmen o co ona i us hospi als,
he pu chase o sa e equipmen o hospi al s a and con ac acing p ocedu es o he i s
cases. In addi ion, ga he ings we e banned, and dining and en e ainmen ou le s we e
closed. The use o public anspo was p ohibi ed, wi h he excep ion o ca ying ou he
p o essional ac i i y o ci izens. Res ic ions on he mo emen o ci izens be ween coun ies
we e also es ablished. A e he li ing o he qua an ine, he bo de s we e opened only on
he indica ion o a nega i e disease es esul and a 12-day qua an ine o a ele s. E en
hose a ec ed by he pandemic we e s eng hened wi h s a e inancial aid. The consequence
o all his was ha many coun ies had o eadjus hei annual s a e budge s, esul ing in
he c ea ion o he i s iscal de ici s. The go e nmen s o all coun ies had o choose which
o he abo e s a egies o ollow o deal wi h he double c isis [pandemic and iscal] in o de
Economies 2024,12, 158. h ps://doi.o g/10.3390/economies12070158 h ps://www.mdpi.com/jou nal/economies
Economies 2024,12, 158 2 o 18
o achie e he bes esul s wi h he leas iscal cos . The p e ailing s a egy among coun ies
was he implemen a ion o a balanced policy be ween he p o ec ion o public heal h and
he main enance o iscal balance, wi h he absolu e p o ec ion o public heal h coming
second and chosen mainly by eas e n coun ies. Wi h his da a, he COVID-19 pandemic
has had a signi ican impac on he quali y o li e (QoL), daily li es yle, well-being and
heal h o he ci izens o he Eu opean Union.
Quali y o li e (QoL) is a subjec o s udy ha has a ac ed pa icula in e es in he
humani ies, social sciences and economics. A he same ime, i is di icul o de ine as
a widely accep ed concep due o i s complex and mul idimensional na u e (Fa quha
1995;Si gy e al. 2006;Anas asiou e al. 2023). The concep o QoL gene ally e e s o he
condi ions o he en i onmen in which people li e, he quali ies o he en i onmen , he
cha ac e is ics o a p ospe ous socie y and e en he elemen s ha make people eel sa is ied
and happy in li e (Pacione 2003;Rose e al. 2009). Conside ing ha he condi ions o he
en i onmen (physical and li ing), people’s needs and hei impo ance a e cons an ly
changing o e ime, he s udy o quali y o li e and he assessmen o i s le el in a coun y o
egion is a subjec o cons an esea ch in e es (Faka 2020).The Wo ld Heal h O ganiza ion
(WHO) de ines QOL as “indi iduals’ pe cep ions o hei posi ion in li e in he con ex o
he cul u e and alues sys ems in which hey li e and in ela ion o hei goals, expec a ions,
s anda ds and conce ns” (Kim and Kim 2020). Mo eo e , he s udy o quali y o li e equi es
a clea e e ence o he domains ha de ine he concep o quali y o li e. Consequen ly, he
s udy o he places whe e people li e and wo k allows o he co ela ion o each domain
in ol ed in he de ini ion o quali y o li e wi h speci ic cha ac e is ics o li ing condi ions,
such as economic condi ions, he na u al en i onmen , wo king and educa ional condi ions,
housing needs, e c. (Lina es e al. 2016;Mizgajski e al. 2014;Massam 2002;K emas io i
e al. 2018;Kopsidas e al. 2018;Komninos e al. 2020;Lia go as e al. 2020;De ma is and
Anas asiou 2020). Wi h hese da a, he assessmen o he quali y o li e consis s o s udying
hese cha ac e is ics h ough he de elopmen o composi e indica o s (UN-Habi a 2016),
so ha di e en indica o s can be in eg a ed and linked o each o he in o de o achie e
he assessmen o each sec o and, consequen ly, he o e all quali y o li e in a place (Faka 2020).
Fu he mo e, he de ini ion o he concep o quali y o li e is a undamen al elemen
in he p ocess o s udying quali y o li e, because o he subjec i e and objec i e c i e ia
ha a e aken in o accoun . The subjec i e dimension o he concep o quali y o li e e e s
o he pe cep ion o he sa is ac ion ha indi iduals de i e om hei li es and he sense
o well-being ha hey enjoy (Campbell 1976). On he o he hand, objec i e assessmen
akes in o accoun objec i e indica o s (census da a, seconda y su ey da a, s a is ical da a,
geospa ial da a, e c.) ha objec i ely measu e he li ing condi ions and en i onmen in
which people li e, ega dless o hei pe cep ions o hei s anda d o li ing (Pacione 1982).
Ne e heless, he use o bo h me hods is widely ad oca ed in he li e a u e, as he e is
no clea and conclusi e e idence ha one me hod is supe io o he o he (Pacione 2003;
Eu o ound 2017). The su ey conduc ed by he OECD (2013) on measu ing well-being
and assessing quali y o li e add esses he issue by collec ing da a on 11 dimensions. The
amewo k de eloped by he OECD [Be e Li es Ini ia i e] o measu ing well-being
dis inguishes be ween cu en and u u e well-being. Cu en p ospe i y is measu ed
in bo h ma e ial condi ions and quali y o li e. The s a is ics p esen ed in he espec i e
OECD epo s suppo he exis ence o signi ican p og ess in ce ain a eas, such as income
and weal h, educa ion, he en i onmen and subjec i e well-being. This p og ess mus be
sus ained while s a is ical challenges emain in o he a eas o well-being.
Geog aphical In o ma ion Sys ems (GIS) a e a use ul ool o assessing a ious quali y-
o -li e indica o s. GIS is a compu e p og am ha uses spa ial da a o s o e, analyze
and isualize in o ma ion globally. I is widely used ac oss a ious disciplines including
en i onmen al managemen , u ban planning, public heal h, anspo a ion and he social
sciences o collec , manage, analyze and in e p e da a (Ca uso and Reyes 2016). The
applica ion o GIS in quali y-o -li e analysis is pa icula ly ad an ageous, since i pe mi s
he in es iga ion o spa ial pa e ns be ween dis inc ac o s, which can help gene a e an
Economies 2024,12, 158 3 o 18
unde s anding o how di e en aspec s de e mine human well-being. Consequen ly, GIS
echnologies can be employed o analyze di e se dimensions o quali y-o -li e in o ma ion
h ough he mapping and isualiza ion o spa ial da a.
The aim o his s udy is he de elopmen o a me hodological app oach ha allows
o he e alua ion, compa a i e analysis and, by ex ension, he mapping o he quali y o
li e in he EU membe coun ies du ing he pe iod be o e and a e he pandemic c isis,
in o de o in es iga e he indi idual cha ac e is ics and li ing condi ions ha ep esen
he deg ee o well-being o indi iduals. The me hodology consis ed o es ablishing a
composi e index o quali y o li e (QoL) ha allowed o de e mining EU membe s a es by
he s anda d o li ing hei inhabi an s can enjoy. Then, he esul s we e geog aphically
mapped using Geog aphical In o ma ion Sys ems (GIS). The panel subjec i ely e alua ed
each indica o wi h he expe s’ opinion o assess he o e all weigh ed objec i e indica o s
o he de elopmen o composi e QoL. The mapping o quali y o li e will hus be an
impo an decision-making ool o iden i ying he ac o s ha will con ibu e o imp o ing
he s anda d o li ing. The use o GIS will con ibu e o he assessmen o quali y o li e
by linking speci ic explana o y a iables wi h spa ial da a, allowing o spa ial analysis
and he c ea ion o da a isualiza ions (Rinne 2007;Longley e al. 2005;Appa icio e al.
2008;B e e on e al. 2008;Haslaue e al. 2015;Li and Weng 2007;Malczewski and Liu 2014;
Ma inez 2019;Ram Mohan Rao e al. 2012;Shyy e al. 2007;Vizza i 2011;De ma is e al.
2017,2019a,2019b,2021).
2. Li e a u e Re iew
The COVID-19 pandemic c isis and o he ela ed con ol measu es ha e been he
subjec o nume ous empi ical s udies ocusing on how hey may a ec quali y o li e,
li es yle and public heal h, p o iding aluable insigh s in o well-being a di e en socie al
le els. Fo example, he s udy o how dispa a e social g oups a e a ec ed by he pandemic
c isis and he pe cep ions o med is o pa icula esea ch in e es . The e olu ion o quali y
o li e du ing he pandemic has also been he subjec o esea ch, in o de o e eal he
ac o s in luencing his e olu ion. Gene ally speaking, s udies conduc ed in his a ea can
p o ide a sou ce o in o ma ion ha allows o a be e unde s anding o he e ec s and
ac ions o he COVID-19 pandemic c isis.
Mo e speci ically, Himmle e al. (2023) s udied Eu opean wel a e pa e ns a he
le el o socioeconomic subg oups du ing he pandemic. Simila ly, Coh des e al. (2024)
in es iga ed ac o s a ec ing quali y o li e in pandemics and hei associa ions wi h
sociodemog aphic aspec s. The aim o he esea ch was o gain new knowledge abou he
cha ac e is ics o ce ain g oups and hei di e ences in subjec i e well-being esponse
pa e ns o e ime. Quali y-o -li e (QoL) cou se was also explo ed as an index o subjec i e
well-being g ouped by he iden i ied la en classes om July 2020 o July 2021 based on
mon hly and pandemic phase ollow-up da a. The su ey showed ha wo ou o i e
people showed esilience (i.e., ela i e s abili y) o eco e y (i.e., app oaching p e-pandemic
le els) o e ime. Also, Schilin (2023) examined a ious deg ees o in eg a ion wi hin he
Economic and Mone a y Union and how hese a ec ed a i udes owa ds he c isis among
di e en g oups. This analysis a gues ha he COVID-19 c isis has had di e en impac s
on people’s li es yles, ac ions and beha io . Fu he mo e, i highligh s he impo ance o
con inued esea ch in his a ea, as da a moni o ing and ool de elopmen can p o ide mo e
e ec i e s a egies o di ec ly add ess hese issues. The esul s challenge de e minis ic
assump ions abou he sel - ein o cing na u e o di e en ia ed DI in eg a ion in economic
and mone a y union and es ablish DI as a concep ha s uc u es eli e pe cep ions.
In Eu ope, he s udy conduc ed by Eas e lin and O’Conno (2023) ied o analyze
how he COVID-19 pandemic a ec ed he le el o li e sa is ac ion. The analysis ound ha
he luc ua ions o he pandemic c isis [ la es and ecessions] co esponded o changes in
li e sa is ac ion ac oss Eu ope. This inding con as s wi h p e ious esea ch, which was
conduc ed in smalle a eas and ound a small decline on a e age in li e sa is ac ion. The
s udy by Polinesi e al. (2023) ocused on he e ec s o COVID-19 on mul i-dimensional
Economies 2024,12, 158 4 o 18
well-being among people aged 50 and o e in Eu ope, measu ing changes in indi idual
well-being be o e and a e he ou b eak o he pandemic. The mul i-dimensional na u e o
well-being was exp essed h ough he dimensions o economic well-being, heal h s a us,
social connec ions and employmen s a us. The esul s showed ha wo ke s and he
weal hies indi iduals su e ed he la ges losses in wel a e, and di e ences by gende
and educa ion a y om coun y o coun y. I also eme ged ha in he i s yea o he
pandemic, he main d i e o changes in well-being was economics, and in he second yea ,
he heal h dimension domina ed he upwa d and downwa d changes in well-being.
Rega ding he pandemic c isis o COVID-19, Mousazadeh e al. (2023) in es iga ed
how immig an s’ a i udes and beha io owa ds hei sense o place (SOP) a ec ed hei
le el o quali y o li e. In his analysis, he esea che s examined 120 I anian na ionals li ing
in Budapes , Hunga y ega ding he impac o hei sense o place a i ude on hei le el o
quali y o li e du ing he pandemic. The indings o his s udy e ealed ha e idence o
SOP, such as loca ion linkage, loca ion iden i ica ion and loca ion dependency, was subjec
o change and based on quali y o li e du ing he pandemic. Viola o e al. (2023) p esen ed a
combined app oach wi h desc ip i e and eg ession analyses o in es iga e he associa ion
be ween he pandemic and changes in heal h- ela ed quali y o li e (HRQoL) in he gene al
popula ion in 13 di e en coun ies. A composi e measu e o gene al heal h de e io a ion
was ob ained om he EQ-5D-5L ins umen and i s domains, such as mobili y, sel -ca e,
usual ac i i ies, pain o discom o and anxie y o dep ession. In addi ion o indi idual-
le el ac o s (socioeconomic s a us, clinical backg ound and expe ience o COVID-19),
na ional-le el ac o s such as pandemic se e i y, go e nmen esponse and e ec i eness
we e also examined o hei associa ion wi h heal h de e io a ion. The esul s showed
ha o e all heal h wo sened on a e age ac oss coun ies o mo e han a hi d o he
15,480 pa icipan s, mos ly in he heal h domain o anxie y/dep ession, especially o
younge ci izens.
The esea ch o Unge e al. (2023) analyzed public opinion owa ds EU edis ibu i e
policies in Aus ia, Ge many and I aly du ing he heal h and economic c isis. Speci ically,
hey in es iga ed whe he ci izens o he Eu opean Union suppo a common aid package,
common deb and edis ibu ion o hose coun ies in g ea es economic need. Th ough he
s udy o h ee explana o y concep s—sel -in e es , jus ice a i udes and gene al suppo o
Eu opean in eg a ion—i was ound ha all h ee explana o y concep s ha e p edic i e
powe . Howe e , he s onges e ec was obse ed o suppo o EU-le el edis ibu ion
o ci izens’ ins umen al calcula ions o whe he hei coun y bene i s om EU aid and
gene al suppo o EU in eg a ion, a he han o jus ice a i udes. In ano he s udy
published by B ooks e al. (2022), neo- unc ionalism was used as a heo e ical amewo k o
examine how he COVID-19 pandemic a ec ed heal h policy and led o deepe in eg a ion
in EU membe s a es. As neo unc ionalism migh p edic , membe s a es ha e sol ed
p oblems bo n o in eg a ion wi h mo e in eg a ion: main aining he in e nal ma ke ,
insu ing agains disas e s, p e en ing bo de closu es and s eng hening he EU’s powe o
de elop and supply accines. On he o he hand, Xiong e al. (2020) sough o in es iga e
he e ec s o COVID-19 on psychological ou comes in he gene al popula ion and associa ed
isk ac o s. The esul s showed ela i ely high a es o symp oms o anxie y, dep ession,
pos - auma ic s ess diso de , psychological dis ess and s ess in he gene al popula ion
du ing he COVID-19 pandemic in China, Spain, I aly, I an, he USA, Tu key, Nepal and
Denma k. Risk ac o s associa ed wi h dis ess measu es include emale gende , younge
age g oup (
≤
40 yea s), he p esence o ch onic/psychia ic condi ions, unemploymen ,
s uden s a us and equen exposu e o social media/news abou COVID-19. In addi ion,
T ipoli e al. (2024) in es iga ed he e ec s o he ex ension o he COVID-19 eme gency
on quali y o li e and li es yle in a sample o 100 ou pa ien s a he psychia ic uni a he
Uni e si y Hospi al o Pale mo, I aly. Quali y o li e was measu ed by a 12-i em sho - o m
su ey on he impac o COVID-19 on quali y o li e. The majo i y o pa icipan s epo ed
a majo impac o COVID-19 on quali y o li e, and almos hal epo ed a de e io a ion in

Economies 2024,12, 158 5 o 18
li es yle. Wo se li es yle was p edic i e o bo h poo men al and physical heal h- ela ed
quali y o li e.
In hei esea ch, Himmle e al. (2023) in es iga ed pa e ns o well-being du ing he
pandemic ac oss Eu ope, wi h pa icula emphasis on ele an socioeconomic subg oups,
using da a om a epea ed, c oss-sec ional, ep esen a i e popula ion su ey wi h nine
wa es o da a om se en Eu opean coun ies om Ap il 2020 o Janua y 2022, wi h he
aim o unde s anding changes in well-being du ing he pe iod o COVID-19 in Eu ope.
Well-being is measu ed using he ICECAP-A, a mul i-dimensional ins umen o app oach
well-being capabili ies. The s udy mainly ocused on di e en socioeconomic subg oups,
which p o ided a weal h o use ul in o ma ion. The esul s showed ha Denma k, he
Ne he lands and F ance showed a U-shaped pa e n in well-being, whe eas well-being
in he UK, Ge many, Po ugal and I aly ollowed an M-shape, wi h inc eases a e Ap il
2020 and a d op in he win e o 2020, ebounding in he summe o 2021 and alling in he
win e o 2021. Howe e , he obse ed a e age wel a e declines we e gene ally small. The
la ges declines we e ound in he a achmen and enjoymen dimensions o well-being
and among people wi h younge age, inancial ins abili y and poo e heal h. Mo ali y
om COVID-19 was consis en ly nega i ely associa ed wi h compe ence well-being and
i s subdimensions, whe eas se e i y and incidence a e we e gene ally no signi ican ly
associa ed wi h well-being. König e al. (2023) examined he condi ions su ounding he
de elopmen o long- e m heal h de e io a ion [“ ail y”] in olde adul s as a esul o
COVID-19 and he unde lying mechanisms and ac o s con ibu ing o his de elopmen . A
na a i e e iew o he mos ele an a icles published on he associa ion be ween COVID-
19 and ail y was he e o e unde aken up o Janua y 2023. The esul s suppo he no ion
ha he e was indeed an inc ease in ail y in he elde ly as a esul o COVID-19. Rega ding
he unde lying mechanisms, a mul icausal genesis can be hypo hesized, including bo h
di ec i al and indi ec e ec s, pa icula ly om imposed lockdowns wi h de as a ing
consequences o he elde ly: educed physical ac i i y, die a y change, sa copenia, a igue,
social isola ion, neu ological p oblems. Bock e al. (2021), on he o he hand, e alua ed he
eaching o e ed in o al and maxillo acial su ge y a he uni e si y du ing he pandemic and
in es iga ed he s uden s’ pe cep ions o he cu en si ua ion. The esul s showed ha he
pandemic had a a he posi i e e ec on he acquisi ion o heo e ical skills and a nega i e
e ec on he acquisi ion o p ac ical skills (p< 0.0001). S uden s decla ed high accep ance
o digi al lea ning o ms and showed inc eased mo i a ion o lea n due o e-lea ning. The
in luence o he pandemic on he educa ion o s uden s was assessed ambi alen ly.
Ano he esea ch s udy conduc ed by Ande sen and Rocabado (2021) on a global scale
sough o de e mine how COVID-19 had changed no only he du a ion bu also he quali y
o li e in 124 coun ies du ing he i s yea o he pandemic c isis. Changes in he quan i y
o li e a e measu ed as yea s o li e los due o COVID-19, including excess dea hs no
o icially epo ed as dea hs om COVID-19. Changes in quali y o li e co espond o he
mean change in daily mobili y, compa ed o he p e-COVID baseline. F om he esea ch
esul s, i was ound ha he e was a s ong and nega i e ela ionship be ween he wo,
meaning ha he coun ies wi h he g ea es educ ions in mobili y a e also he coun ies
wi h he g ea es loss o li e yea s. I was es ima ed ha a ound 48 million yea s o li e we e
los du ing he i s yea o he pandemic, which co esponds o 0.018% o all expec ed
li e yea s.
In addi ion, a popula ion su ey conduc ed by an Ballegooijen e al. (2021) du ing
he ini ial pe iod o he COVID-19 lockdown analyzed s ess le els, wo ies, quali y o
li e, access o heal hca e and p oduc i i y, among o he ac o s, du ing he i s 8 weeks
o he co ona i us lockdown in he gene al popula ion in Belgium and he Ne he lands.
The esul s highligh he bu den on socie y due o s ess, los medical esou ces and
los p oduc i i y. Dane (2021) also assessed he psychological impac among heal hca e
wo ke s on he on lines o he SARS-CoV-2 c isis and compa ed i wi h o he heal hca e
p o essionals h ough a sys ema ic e iew o Wes e n publica ions. Eu opean and Ame ican
quan i a i e s udies epo ed mode a e and high le els o s ess, anxie y, dep ession, sleep
Economies 2024,12, 158 6 o 18
dis u bances and bu nou , wi h di e en coping s a egies and mo e equen and se e e
symp oms among women and nu ses, wi hou de ini i e esul s by age. On he on line,
he psychological impac was g ea e han among he es o heal h p o essionals and in
he Asian coun ies.
Ano he g oup is desc ibed by Jabakhanji e al. (2022), who conduc ed a s udy be ween
Ap il 2020 and June 2021 in i e Eu opean coun ies: F ance, Ge many, I aly, Spain and
Sweden. Thei esea ch aimed o unde s and he ela ionship be ween he e olu ion o
he COVID-19 pandemic and sleep quali y. The esul s suppo an inc eased impac on
women, pa en s and young adul s. In addi ion, hey show ha a ound hal o he decline in
sleep quali y caused by he e olu ion o he pandemic can be a ibu ed o li es yle changes,
wo sening men al heal h and nega i e a i udes agains COVID-19 and i s managemen .
In con as , changes in SARS-CoV-2 in ec ion s a us o sleep du a ion we e no signi ican
de e minan s o he ela ionship be ween COVID-19- ela ed dea hs and sleep quali y.
Aslan and Zengin (2022) in es iga ed he quali y o li e du ing he COVID-19 pan-
demic in Hunga y, Slo akia, La ia, Poland and Es onia, compa ing i wi h Tu key. Thei
s udy also p o ided ecommenda ions o policymake s. The esul s o he s udy indica e
ha he ac o s a ec ing he quali y o li e o he people du ing he pandemic di e be ween
coun ies. In he s udy, i was de e mined ha he coun ies wi h a high a e age o us in
go e nmen ins i u ions and heal h sys ems also ha e high a e age sco es o sa is ac ion
and happiness. I is impo an o policymake s o ha e in o ma ion abou he ac o s a ec -
ing he quali y o li e o socie y o be p epa ed o pandemics. In addi ion, Sánchez (2022)
conduc ed an analysis on he economic changes ha ook place in he Eu opean Union
as a esul o he global inancial c isis (GFC) and he COVID-19 pandemic. The ocus o
he s udy was on changes in a es o po e y, ex eme po e y and income inequali y. The
au ho a gues ha he pandemic has shown ha bo h he pe sonal and p o essional ca e
in as uc u e o socie ies is undamen al o economic, poli ical, cul u al and en i onmen al
li e. He emphasized how a basic dimension o social jus ice is emo ional equali y, ha is,
equali y in gi ing and ecei ing lo e, ca e and solida i y. In an impo an s udy, Jin (2022)
in es iga ed he impac o he COVID-19 pandemic on he heal h sys ems o each coun y
in he Eu opean Union. The s udy also looked a he co ela ion be ween he pandemic
and key indica o s o economic con e gence o he yea 2020.
3. Me hodology
A composi e quali y-o -li e indica o ha is able o p o ide a ue pic u e o he li ing
condi ions in a gi en a ea o coun y is a g ea ad an age. On he whole, e en hough he
mos common o m o a summa y o economic ac i i y includes p ice, unemploymen and
ou pu indica o s, composi e indices o quali y o li e can also be used o his pu pose. The
conside a ion o wha should o m pa o an economic index should no only be limi ed
o a ious aspec s bu also o he peculia i ies o each pa icula e i o y co e ed by a
composi e quali y-o -li e index. In u n, he me hodological ounda ion o such an index is
based on a ious s a is ical and spa ial da a sou ces (Giannias e al. 1999). The e o e, wi h
espec o he measu emen aspec , we conside ha he ope a ionaliza ion o quali y-o -li e
measu es akes place as ollows:
QoL =∑N
k=1(wkaki)
∑N
k=1wkj
o i= 1, 2, 3, ..., m,
whe e
aki is he kindex o coun y i;
wkis he weigh ing coe icien o he indica o k;
Nis he numbe o indica o s;
m: he numbe o coun ies conside ed.
Economies 2024,12, 158 7 o 18
Li e quali y e alua ions ha e come up wi h a se o indica o s, including he social
en i onmen , wo king condi ions, educa ion, housing, economy, heal h and li espan (Si gy
e al. 2006;B e e on e al. 2008;Hage y e al. 2001;Naja pou e al. 2014;Faka 2020). These
a eas ha e been iden i ied by he Eu opean Union coun ies as he domains whe e quali y
o li e is o be measu ed. Each c i e ion is measu ed h ough pa icula a iables ha
explo e indi iduals’ di e en dimensions o li ing s anda ds. Among o he ea u es, he
social en i onmen is shaped by he s uc u e o age dis ibu ion and ci izen incomes—da a
ypically ep esen ed in he o m o unemploymen le els, le els o educa ion and so
o h. Con inuous educa ion and aining ha e a signi ican in luence on an indi idual’s
quali y o li e h ough inc easing ea nings and boos ing employabili y, which consequen ly
esul s in be e li ing condi ions (OECD 2013). The social en i onmen is e alua ed based
on a numbe o ac o s, including he le els o unemploymen , he numbe o people in
low-wo k-in ensi y households, he le el o he inac i e popula ion, he pa icipa ion a e
o educa ion and aining and he employmen gap. I is also impo an o no e ha
economic s a us is used o de e mine he deg ee o well-being among indi iduals, since
he inabili y o mee basic equi emen s and eeling he pinch o ma e ial dep i a ion
nega i ely impac s li e (Rose e al. 2009). The Eu o ound s udy (Eu o ound 2013) ound
ha low income le els as well as poo le els o educa ional achie emen we e signi ican ly
co ela ed wi h heigh ened a es o ma e ial dep i a ion. The s udy on he economic le el
o indi iduals akes in o accoun he GDP pe capi a, unemploymen a e, inabili y o mee
basic needs, inabili y o handle unexpec ed expenses and he absence o deb ela ed o
inancial companies and go e nmen o ganiza ions. In addi ion o his da a, li e expec ancy
will also a ec he quali y o li ing, and es ic ed access o heal hca e acili ies ad e sely
a ec s he o e all heal h, sa e y and well-being o people. The well-being o indi iduals can
be assessed by conside ing indica o s such as li e expec ancy and epo s on unadd essed
medical equi emen s.
Quali y o li e as an indica o o composi e QoL in he abo e equa ion does no ha e
he same weigh ing coe icien s w
k
in all coun ies, because he pe cep ion o people on he
ac o s desc ibing hese indica o s may a y. As a esul , he quali y-o -li e index o any
coun y will be based on he weigh s ha a e used o compu e i . Fo ins ance, using he
weigh s se by a consume li ing in I aly, he alue p oduced by he o mula is how much
ha hypo he ical I alian consume would say ep esen s he quali y o li e o coun y i.
The weigh s, gene ally speaking, can be o any alue. One o he common p ac ices is o
make hem all 1/N, bu one can also de ine he weigh s based on p incipal componen s o
su ey ou comes.
In his case, o he calcula ion o he quali y-o -li e indica o s o he Eu opean coun-
ies, he weigh s de ined by 30 G eek expe s (heal h p o essionals, en i onmen alis s,
economic analys s, s a is ical analys s) who pa icipa ed in a su ey conduc ed be ween
No embe and Decembe 2022 we e used. Mo e speci ically, we asked 30 G eek expe s o
ank he impo ance o each o he 11 a iables o hei quali y o li e and/o how well
each o hese 11 a iables desc ibes i . The a e age o he weigh s o each a iable was
used o calcula e he weigh ed a e age. All expe s we e G eek and pa icipa ed in esea ch
p og ams in en i onmen al economics o o he ela ed sciences. Fo he calcula ion o he
quali y-o -li e indica o s o he Eu opean coun ies, he weigh s o he G eek expe s we e
used. As a esul , Table 1 e eals he p e e ences o G eek li e and, in pa icula , shows how
G eek consume s see he quali y o li e in o he Eu opean coun ies.
In his analysis, we assume ha he anking based on quali y o li e is equi alen
o a anking based on he maximum u ili y ha a ep esen a i e consume can enjoy in
each o he coun ies conside ed. Consequen ly, he wo ankings will no be equi alen
i each coun y’s quali y o li e is calcula ed using he weigh s o i s own ep esen a i e
consume — o example, he quali y o li e o Spain is calcula ed using he weigh s o a
ep esen a i e Spanish consume , he quali y o li e o Ge many is calcula ed using wi h
he bu dens o a ep esen a i e Ge man consume , e c. The e o e, o he pu poses o he
s udy, i is assumed ha consume s in well-de ined homogeneous egions [such as EU
Economies 2024,12, 158 8 o 18
coun ies] ha e iden ical p e e ences and skills, a e ully mobile wi hin hei egion and
choose op imal loca ions so ha hey canno imp o e hei posi ion by mo ing o ano he
coun y. Ano he impo an poin is ha he weigh s a e no necessa ily ime-in a ian .
Howe e , o he same eason ha we use he same weigh s o calcula e quali y-o -li e
indices o all coun ies, we mus use he same weigh s o calcula e quali y-o -li e indices
o all ime pe iods conside ed. Ou analysis and esul s he e o e show how a speci ic
g oup o (G eek) consume s [expe s] iew quali y-o -li e issues be ween coun ies in he
EU o he pe iod be o e and a e he COVID-19 pandemic c isis. The abo e assump ions
cons i u e he limi a ions o he analysis.
Table 1. Weigh ing coe icien s.
Quali y-o -Li e Fac o Weigh ing Fac o
GDP pe capi a 67.5
Inabili y o make ends mee 68.0
Unemploymen a es 58.7
Pe sons li ing in households wi h e y low wo k in ensi y 46.2
Inac i e popula ion as a pe cen age o he o al popula ion 36.0
Li e expec ancy 71.0
Sel - epo ed unme needs o medical examina ion 48.7
Pa icipa ion a e in educa ion and aining (las 4 weeks) 72.0
Inabili y o ace unexpec ed inancial expenses 69.0
A ea s (mo gage o en , u ili y bills o hi e pu chase) 52.0
Gende employmen gap 41.0
Sou ce: Au ho s’ calcula ions.
The p e e ed amewo k o e alua ing he quali y o li e in he EU coun ies based
on he abo e a iables elies on ac o s ha ha e been ex ensi ely used in simila s udies
p esen ed in he li e a u e e iew (Polinesi e al. 2023;Viola o e al. 2023;Unge e al. 2023;
Himmle e al. 2023; an Ballegooijen e al. 2021;Sánchez 2022).
Wi h his da a, he quali y-o -li e index in a coun y is de ined as he weigh ed a e age
o he scale a iables. The scale alue, X*, o a a iable Xis calcula ed as ollows:
X∗=X−Xmax
Xmin −Xmax
whe e
Xis he alue o he a iable;
Xmin and Xmax a e he minimum and maximum alues, espec i ely;
X* is he scaled alue o he a iable;
The ange o he scaled alue X* o a a iable is 0–100.
The a iables conside ed o de e mine quali y o li e in ou analysis include he
ollowing: GDP pe capi a, inabili y o make ends mee , unemploymen a es, pe sons
li ing in households wi h e y low wo k in ensi y, inac i e popula ion as a pe cen age o
he o al popula ion, li e expec ancy, sel - epo ed unme needs o medical examina ion,
pa icipa ion a e in educa ion and aining (las 4 weeks), inabili y o ace unexpec ed
inancial expenses, a ea s (mo gage o en , u ili y bills o hi e pu chase) and gende
employmen gap. Un o una ely, due o a lack o da a, en i onmen al quali y, c ime and
public se ices, as well as measu es o income dis ibu ion, a e no included in ou index
and analysis. The su ey da a a e o he ime pe iods 2019 and 2021, i.e., be o e and a e
he COVID-19 c isis, and hey a e de i ed om seconda y public sou ces (OECD, IMF,
Wo ld Bank).
Economies 2024,12, 158 15 o 18
Economies2024,12,xFORPEERREVIEW15o 18


Figu eA2.Valueso  hescale a iables(2021).
Re e ences
(Anas asioue al.2023)Anas asiou,A hanasios,NicholasApe gis,andA hinaZe oyianni.2023.Pandemic,sen imen so e 
COVID-19,andEUcon e gence.Empi icalEconomics66:1683–707.h ps://doi.o g/10.1007/s00181-023-02504-9.
(Ande senandRocabado2021)Ande sen,LykkeE.,andAlejand aGonzalesRocabado.2021.Li eandDea hDu ing heFi s Yea 
o  heCOVID-19Pandemic:Ananalysiso c oss-coun ydi e encesinchangesinquan i yandquali yo li e.Re is a
La inoame icanadeDesa olloEconómico19:9–57.h ps://doi.o g/10.35319/lajed.202135438.
(Appa icioe al.2008)Appa icio,Philippe,Anne-Ma ieSéguin,andDanielNaud.2008.Thequali yo  heu banen i onmen a ound
publichousingbuildingsinMon éal:Anobjec i eapp oachbasedonGISandmul i a ia es a is icalanalysis.SocialIndica o s
Resea ch86:355–80.
(AslanandZengin2022)Aslan,Yasemin,andO hanZengin.2022.COVID-19PandemiDönemindeTü kiye eDoğuA upa
Ülkele ininYaşamKali ele ineDai KapsamlıBi Değe lendi me.ODÜSosyalBilimle A aş ı mala ıDe gisi13:763–84.
h ps://doi.o g/10.48146/odusobiad.1140891.
(Bocke al.2021)Bock,Anna,Flo ianPe e s,PhilippWinnand,K is ianKniha,Ma iusHei ze ,Ma inLemos,F ankHölzle,andAli
Modabbe .2021.Oneyea o COVID-19pandemic:Ac osssec ionals udyon eachingo alandmaxillo acialsu ge y.Head&
FaceMedicine17:51.
(B e e one al.2008)B e e on,Finba ,J.Pe e Clinch,andSusanaFe ei a.2008.Happiness,geog aphyand heen i onmen .
EcologicalEconomics65:386–96.
MainGDP
agg ega e
spe 
capi a
Inabili y
omake
ends
mee ‐EU
‐
SILC
su ey
Unemplo
ymen 
a esby
sex,age
and
educa ion
al
a ainme
n le el
Pe sons
li ingin
househol
dswi h
e ylow
wo k
in ensi y
byage
andsex
popula io
nasa
pe cen ag
eo  he
o al
popula io
n,bysex
andage
(%)
Li e
expec an
cybyage
andsex
Sel ‐
epo ed
unme 
needs o 
medical
examina i
onbysex,
age,main
eason
Pa icipa
ion a e
in
educa ion
and
aining
(las 4
weeks)by
sex,age
Inabili y
o ace
unexpec
ed
inancial
expenses‐
EU‐SILC
su ey
A ea s
(mo gag
eo  en ,
u ili ybills
o hi e
pu chase)
om
2003
onwa ds‐
Gende 
employm
en gap
Belgium
54,06329 12,43243 27,5 86,66667 71,5 90,83333 46,66667 31,93548 22,8125 6,470588 35,26316
Bulga ia
0,001736 31,62162 19,16667 47,77778 60 3,333333 20 ‐0,32258 66,875 54,11765 38,94737
Czechia
19,51341 3,243243 ‐1,66667 15,55556 37 53,33333 0 11,93548 9,6875 1,176471 0,757895
Denma k
62,27841 2,162162 ‐1,66667 63,33333 22 86,66667 13,33333 66,12903 14,0625 12,64706 31,05263
Ge many
52,07527 0 5 64,44444 26,5 82,5 3,333333 20 52,8125 12,05882 33,15789
Es onia
19,45308 0 26,66667 10 24,5 49,16667 6,666667 48,3871 37,8125 10,88235 14,21053
I eland
42,71291 11,08108 26,66667 100 47 98,3333 3,333333 40,64516 45,9375 34,11765 47,36842
G eece
14,87282 100 97,5 100 83,5 77,5 93,33333 7,096774 97,8125 101,1765 98,94737
Spain
25,91761 18,37838 98,33333 85,55556 51,5 102,5 3,333333 40,32258 57,8125 36,17647 50,52632
F ance
45,76005 9,72973 40,83333 77,77778 55 95,83333 60 31,29032 39,375 23,82353 27,36842
C oa ia
12,2502 15,67568 38,33333 52,22222 76,5 48,33333 10 9,354839 98,4375 42,94118 50
I aly
37,86266 19,18919 54,16667 85,55556 97,5 99,16667 33,33333 22,90323 55,3125 16,76471 95,78947
Cyp us
34,39187 25,40541 37,5 24,44444 36,5 90 3,333333 17,74194 88,75 45 58,94737
La ia
13,34838 8,918919 38,33333 27,77778 41 20 56,66667 19,03226 83,4375 15,29412 20
Li huania
31,67159 1,891892 34,16667 47,77778 29 29,16667 3,333333 19,03226 66,875 13,52941 2,105263
Luxembou g
99,99913 4,864865 19,16667 26,66667 54 98,33333 23,33333 51,29032 19,6875 13,52941 33,68421
Hunga y
6,006164 21,08108 9,166667 17,77778 39 29,16667 6,666667 10,96774 61,875 27,05882 50,52632
Mal a
23,239 5,135135 3,333333 13,33333 29 99,16667 3,333333 32,90323 2,1875 17,05882 81,05263
Ne he lands
54,29985 ‐1,08108 10 54,44444 1,5 87,5 3,333333 82,25806 0,3125 1,764706 37,89474
Aus ia
55,49093 5,405405 26,66667 50 34 85,83333 6,666667 36,12903 11,25 8,235294 40
Poland
17,14645 3,513514 3,333333 3,333333 56 38,33333 13,33333 10,32258 29,6875 14,70588 68,42105
Po ugal
23,12267 25,13514 30 17,77778 44 85 50 37,41935 50,625 14,11765 25,78947
Romania
17,95859 24,59459 21,66667 10 92 15,83333 73,33333 7,419355 100,9375 21,76471 100,5263
Slo enia
25,63634 2,162162 15 4,444444 45 82,5 3,333333 56,45161 30 20,58824 30
Slo akia
10,46141 10,27027 31,66667 11,11111 47 31,66667 16,66667 9,354839 46,875 24,11765 39,47368
Finland
50,95625 0,27027 39,16667 61,11111 26 91,66667 0 86,12903 26,5625 18,23529 5,263158
Sweden
53,01241 3,243243 48,33333 58,88889 5,5 101,6667 0 99,67742 10,625 9,411765 22,63158
Figu e A2. Values o he scale a iables (2021).
Re e ences
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