DISTINGUISHING COST OF LIVING FROM QUALITY OF LIFE: A CONCEPTUAL FRAMEWORK USING SINGAPORE AS AN ILLUSTRATIVE CASE
Author(s)
Nikita Khoo, PhD Candidate.
College of Integrative Studies, Singapore Management University, Singapore, Singapore.
College of Integrative Studies, Singapore Management University, Singapore, Singapore.
OBJECTIVES: Cost of living and quality of life are often discussed together in policy debates, yet they measure different dimensions of household experience. Cost-of-living indicators capture rices, expenditure, and affordability pressure, while quality-of-life measures capture wellbeing health, security, functioning, and social participations. This conceptual paper compares these two concepts and examines why they should not be used interchangeably in health policy and outcomes research, using Singapore as an illustrative high-cost urban case.
METHODS: A conceptual comparison approach was used to distinguished cost-of-living measures from quality-of-life construct relevant to health economics and outcome research. The framework maps cost pressures, including housing, food, transport, healthcare, and caregiving, against quality-of-life domains such as health status, perceived wellbeing, financial security, access to services, autonomy, and social participation. Singapore is used as an illustrative case to examine how high living cost may interact with healthcare financing, public infrastructure, and household support system.
RESULTS: The framework identifies three key distinctions. First cost of living reflects material affordability, whereas quality of life reflects experienced wellbeing. Second, higher living cost may reduce quality of life through financial stress, delated care, or constrained choices, but this relationship may be moderated by subsidies, insurance, savings, public services, and family support. Third, quality-of-life measures may mask hidden affordability strain when household maintain wellbeing by reducing saving, relying on caregivers, or postponing non-urgent needs.
CONCLUSIONS: Cost of living and quality of life should be treated as related but distinct concepts in HEOR and health policy evaluation. Differentiating material affordability from lived wellbeing can help policymaker identify hidden financial strain and design more equity-sensitive measures of access, affordability, and population wellbeing.
METHODS: A conceptual comparison approach was used to distinguished cost-of-living measures from quality-of-life construct relevant to health economics and outcome research. The framework maps cost pressures, including housing, food, transport, healthcare, and caregiving, against quality-of-life domains such as health status, perceived wellbeing, financial security, access to services, autonomy, and social participation. Singapore is used as an illustrative case to examine how high living cost may interact with healthcare financing, public infrastructure, and household support system.
RESULTS: The framework identifies three key distinctions. First cost of living reflects material affordability, whereas quality of life reflects experienced wellbeing. Second, higher living cost may reduce quality of life through financial stress, delated care, or constrained choices, but this relationship may be moderated by subsidies, insurance, savings, public services, and family support. Third, quality-of-life measures may mask hidden affordability strain when household maintain wellbeing by reducing saving, relying on caregivers, or postponing non-urgent needs.
CONCLUSIONS: Cost of living and quality of life should be treated as related but distinct concepts in HEOR and health policy evaluation. Differentiating material affordability from lived wellbeing can help policymaker identify hidden financial strain and design more equity-sensitive measures of access, affordability, and population wellbeing.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
PCR12
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas