Exploring the capability approach to quality of life in disadvantaged population groups.

The capability approach argues that having effective choices and fair opportunities are essential to maintain and promote one's own health and quality of life (QoL). This study examines the determinants of QoL in four disadvantaged population groups (young people not in education, employment, or training; long-term unemployed; refugees; older people living alone) within the framework of the capabilities by tracking the direct and indirect effects of individual and structural factors and capabilities on their QoL. Cross-sectional data (N = 866) with validated scales of quality of life (physical, social, psychological, and environmental QoL) and self-reported capabilities were utilized. Individual factors included age and gender and structural factors education and income. Descriptive statistics and structural equation modelling with latent variables were used for statistical analyses. Our results suggest that capabilities have crucial direct and mediating roles in achieving good QoL in the disadvantaged population groups. Individual factors had only small effects whereas especially the structural factors affected QoL through capabilities. Our results suggest that to reduce health inequalities and to promote wellbeing, policies should focus on improving both the structural factors and the individual capabilities of people in disadvantaged positions.