title: Qualities of life, educational level and human development: an international investigation of health.
abstract: METHODS
  This study investigated the relationship between health-related quality of life (QoL), educational level and culture, using a high quality cross-cultural generic measure (WHOQOL-BREF) containing 25 international dimensions organised in physical, psychological, social and environmental domains.
  
  
  RESULTS
  Cross-cultural data from 9,404 sick and well adults in 13 countries showed that environmental QoL increased positively and sequentially from no education to tertiary education. The other three domains increased only up to secondary school level. These MANCOVA results were significantly influenced by health status, age, culture and economic development level. More positive feelings, less dependence on medication and treatment, better perceptions of financial resources, physical environment, and opportunities for information and skills, represent adult QoL advantages to those who received tertiary education compared with secondary schooling. Developing countries reported poorer environmental, psychological and physical QoL than developed countries, although social QoL was good, and no different for the two development bands. Only psychological QoL distinguished between every educational level, in developing countries. Increased positive feelings serve to link better mental health with more education. Across each domain, secondary and tertiary education was associated with better QoL in developing countries.
  
  
  CONCLUSIONS
  The results support a QoL case for universal secondary education on which better health and health care may be built.
authors.affiliation: Department of Psychology, WHO Centre for the Study of Quality of Life, University of Bath, Bath, UK. s.m.skevington@bath.ac.uk
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Skevington
mesh_terms: D000328:Adult; D003431:Cross-Cultural Comparison; D003469:Culture; D003906:Developing Countries / Q000706:statistics & numerical data; D057217:Economic Development; D004522:Educational Status; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006803:Human Development; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012931:Social Environment; D011795:Surveys and Questionnaires; D014944:World Health Organization