BOX 1. HEALTH-RELATED QUALITY OF LIFE

Some of the impacts of shale development that are most salient to local communities are those in the area of health-related quality of life (HRQOL or, for the purposes of this guidebook, “quality of life”). The World Health Organization (WHO) defines health as “a state of complete physical, mental, and social well-being, not merely the absence of disease . . .”[ref]Programme on Mental Health, World Health Organization Division of Mental Health and Prevention of Substance Abuse, WHOQOL Measuring Quality of Life (WHO/MSA/MNH/PSF/97.4, 1997)[/ref] Well-being and quality of life must therefore be considered in a discussion of individual and community health. According to the U.S. Centers for Disease Control and Prevention (CDC), HRQOL is “an individual’s or group’s perceived physical and mental health over time.” This multidimensional concept has been shown to be an important predictor of health outcomes. HRQOL data can be used to determine health needs and guide interventions.[ref]Centers for Disease Control and Prevention, “Health-Related Quality of Life:  HRQOL Concepts,” last modified March 17, 2011.[/ref] In order to measure quality of life, the WHO has identified the six domains in Table 1 below as important to assess.[ref]Programme on Mental Health, World Health Organization Division of Mental Health and Prevention of Substance Abuse, WHOQOL Measuring Quality of Life (WHO/MSA/MNH/PSF/97.4, 1997), pp. 3-4[/ref]

Table 1. Domains of Health-Related Quality of Life 

Shale development projects have the potential to affect many, if not all, of these domains. Given the potential impacts on the economy, infrastructure, and physical environment of a community, these projects can influence the “environment” domain in particular. The aspects of HRQOL that we have focused on in this guidebook are social relationships; financial resources and opportunities for acquiring new information and skills (economic impacts); and the physical environment, including pollution, noise, traffic, lighting, and viewshed alterations. In this guidebook,the HRQOL concept is used as a framework for organizing these types of positive and negative community impacts and considering their potential relation to health.