Social determinants of health-related quality of life

Social Indicators Research, 2014

Purpose: Identify predictors and normative data for quality of life (QOL) in a sample of Portuguese adults from general population Methods: A cross-sectional correlational study was undertaken with two hundred and fifty-five (N=255) individuals from Portuguese general population (mean age 43yrs, range 25-84yrs; 148 females, 107 males). Participants completed the European Portuguese version of the World Health Organization Quality of Life short-form instrument (WHOQOL-Bref) and the European Portuguese version of the Center for Epidemiologic Studies Depression Scale (CES-D). Demographic information was also collected. Results: Portuguese adults reported their QOL as good. The physical, psychological and environmental domains predicted 44% of the variance of QOL. The strongest predictor was the physical domain and the weakest was social relationships. Age, educational level, socioeconomic status and emotional status were significantly correlated with QOL and explained 25% of the variance of QOL. The strongest predictor of QOL was emotional status followed by education and age. QOL was significantly different according to: marital status; living place (mainland or islands); type of cohabitants; occupation; health. Conclusions: The sample of adults from general Portuguese population reported high levels of QOL. The life domain that better explained QOL was the physical domain. Among other variables, emotional status best predicted QOL. Further variables influenced overall QOL. These findings inform our understanding on adults from Portuguese general population QOL 2 and can be helpful for researchers and practitioners using this assessment tool to compare their results with normative data.

Materia socio-medica, 2014

Studying self-reported health is considered an indicator for morbidity and mortality that may be used in primary health care to detect poor health in certain population groups that predicts health care utilization. The goal of the survey is to assess the socioeconomic self-rated health gradient and to describe contribution of behavioral risk factors to this gradient among population in Republic of Macedonia. Data is collected through a "nested case-control study", conducted in the period March - December, 2013. "Cases" are households with TB patient(s) registered in the period July, 2012 - June, 2013 and "controls" are households randomly chosen in cases' immediate vicinity. The total study population is 562 households with total of 2720 respondents. Self-rated health was reported as excellent or good by only half of the respondents, with slightly less positive answers among cases compared to controls and evident differences in responses for poor or...

International Journal of Environmental Research and Public Health, 2013

Studies show that the association between socioeconomic status (SES) and self-rated health (SRH) varies in different countries, however there are not many country-comparisons that examine this relationship over time. The objective of the present study is to determine the effect of three SES measures on SRH in 29 countries according to findings in European Social Surveys (2002-2008), in order to study how socioeconomic inequalities can vary our subjective state of health. In line with previous studies, income inequalities seem to be greater not only in Anglo-Saxon and Scandinavian countries, but especially in Eastern European countries. The impact of education is greater in Southern countries, and this effect is similar in Eastern and Scandinavian countries, although occupational status does not produce significant differences in southern countries. This study shows the general relevance of socio-educational factors on SRH. Individual economic conditions are obviously a basic factor contributing to a good state of health, but education could be even more relevant to preserve it. In this sense, policies should not only

Quality of Life Research, 2013

Purpose To investigate time trends in health-related quality of life (HRQoL) in France and to report existing and changing demographic, socioeconomic, and geographic disparities. Methods Data were drawn from two independent national cross-sectional surveys conducted in 1995 and 2003, including 3,243 individuals aged 18-84 in 1995 and 22,743 in 2003. HRQoL was measured with the 8 subscales of the French version of the SF-36. Results After multiple linear regression, a significant decrease was observed between 1995 and 2003 in all scales scores, from -0.11 adjusted standard deviations for Social Functioning (95% CI: -0.15 to -0.08) to -0.23 for Vitality (-0.26 to -0.19). Increasing age, female gender, divorce/widowhood, lowest educational levels, chronic conditions, and living in the Northern region were identified as independent predictors of lower HRQoL scores. Testing interactions showed significantly greater differences between 1995 and 2003 for subjects aged 75-84 and for least educated subjects (Physical Functioning, General Health). The Gini index increased for all scales. Conclusions We report evidence of worsening trends and possibly increasing demographic, socioeconomic, and regional disparities in HRQoL between 1995 and 2003 in France. Monitoring HRQoL in populations can provide unique and sensitive data, complementary to classical indicators based on mortality and morbidity.

Frontiers in Public Health, 2023

Background: Generic health-related quality of life instruments, such as the EQ-D, are increasingly used by countries to monitor population health via general population health surveys. Our aim was to demonstrate analytic options to measure socio-demographic di erences in self-reported health using the EuroQol Group's archive of EQ-D-L population surveys that accumulated over the past two decades. Methods: Analyses captured self-reported EQ-D-L data on over , individuals from countries with nationally representative population surveys. Socio-demographic indicators employed were age, sex, educational level and income. Logistic regression odds ratios and the health concentration index methodology were used in the socio-demographic analysis of EQ-D-L data. Results: Statistically significant socio-demographic di erences existed in all countries (p < .) with the EQ VAS based health concentration index varying from. to. across countries. Age had generally the largest contributing share, while educational level also had a consistent role in explaining lower levels of self-reported health. Further analysis in a subset of countries with income data showed that, beyond educational level, income itself had an additional significant impact on self-reported health. Among the dimensions of the EQ-D-L descriptive system, problems with usual activities and pain/discomfort had the largest contribution to the concentration of overall self-assessed health measured on the EQ VAS in most countries. Conclusion: The EQ-D-L was shown to be a powerful multi-dimensional instrument in the analyses of socio-demographic di erences in self-reported health using various analytic methods. It o ered a unique insight of inequalities by health dimensions.

Revista de Saúde Pública, 2014

OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36); health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD), Games-Howell and Conover were used in the statistical analysis. RESULTS Health related quali...

Value in Health Regional Issues, 2015

To explore reporting differences related to sociodemographic characteristics affecting different health status indicators to assess their impact on the measurement of self-reported health status among the Tunisian population using the Tunisian version of the 12item Short-Form Health Survey (SF-12). Methods: Psychometric properties of the SF-12 were validated for a random sample of individuals (N ¼ 3864) aged 18 years and older. The SF-12 summary scores were derived using the standard US algorithm. The principal-component analysis was used to confirm the hypothesized component structure of the SF-12 items. Results: "Known-subgroup" comparisons showed that the SF-12 discriminated well between groups of respondents on the basis of sex, age, education, and socioeconomic status, providing evidence of construct validity. The results suggest the existence of reporting differences related to the sociodemographic characteristics affecting the health status indicators. For a given latent health status, women and oldest people are more likely to report physical activity limitations and chronic diseases. Mental health problems are overreported by divorced people and underreported by the oldest people. In addition, highly educated and socially advantaged people more often report social activities limitations due to the problems of physical and mental health. Conclusions: The findings showed that the Tunisian version of the SF-12 is a reliable and valid measure, and suggest its potential for measuring health-related quality of life in largescale studies, specifically when overall physical and mental health are the outcomes of interest instead of the typical eight-scale profile.

The European Journal of Public Health, 2007

Background: Socioeconomic conditions and lifestyle factors have been found to be related to self-rated health, which is an established predictor of morbidity and mortality. Few studies, however, have investigated the independent effect of material and psychosocial conditions as well as lifestyle factors on self-rated health. Methods: The association between socioeconomic conditions, lifestyle factors, and self-rated health was investigated using a postal survey questionnaire sent to a random population sample of men and women aged 18-79 years during March-May 2000. The overall response rate was 65%. The area investigated covers 58 municipalities in the central part of Sweden. Multivariate odds ratios for poor self-rated health were calculated for a range of variables. A total of 36 048 subjects with full data were included in the analysis. Similar analyses of the influence of working conditions were conducted among those employed aged 18-64 years (17 820 subjects). Results: The overall prevalence of poor self-rated health was 7% among men and 9% among women. Poor self-rated health was most common among persons who had been belittled, who had experienced economic hardship, who lacked social support, or who had retired early. A low educational level was independently associated with poor self-rated health among men, but not among women. Physically inactive as well as underweight and obese subjects were more likely to have poor self-rated health than other subjects. Working conditions associated with poor self-rated health were dissatisfaction with work, low job control and worry about losing one's job. Conclusion: While a cross-sectional study does not allow definite conclusions as to which factors are determinants and which are consequences of poor self-rated, the present findings support the notion that both psychosocial and material conditions as well as lifestyle factors are independently related with poor self-rated health.

Journal of Clinical Epidemiology, 2001

The metric properties of health-related quality of life measures are typically evaluated on selected samples and assumed to hold across different population groups. We assessed the extent to which the measurement properties of the Spanish version of the Nottingham Health Profile (NHP) were stable across sociodemographic, clinical and geographical characteristics. We collected information from all available studies using the NHP in Spain (1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995), and obtained data from 9419 individuals. We examined data completeness and distribution, as well as reliability and construct validity. The percentage of missing dimensions was lower than 5%, but increased with age and poor health status. Large ceiling effects in scores were observed for social isolation and energy dimensions, being largest for younger ages and individuals reporting "very good/good" health. Reliability was higher than 0.7 in all population groups considered, except for social isolation and energy dimensions in some subgroups. Mean NHP scores correlated with self-rated overall health ( r ϭ 0.48), but they varied substantially by age among those rating their health as "very good/good." We conclude that NHP is adequate for all Spanish populations. Nevertheless, some caution is needed because the reliability of dimension scores is not sufficient for individual purposes. And also, because a non-negligible high ceiling effect renders the instrument inefficient to measure changes over time among healthy populations.

Cadernos de Saúde Pública, 2005

Self-rated health has been used extensively in epidemiologic studies, not only due to its importance per se but also due to the validity established by its association with clinical conditions and with greater risk of subsequent morbidity and mortality. In this study, the socio-demographic determinants of good self-rated health are analyzed using data from the World Health Survey, adapted and carried out in Brazil in 2003. Logistic regression models were used, with age and sex as covariables, and educational level, a household assets index, and work-related indicators as measures of socioeconomic status. Besides the effects of sex and age, with consistently worst health perception among females and among the eldest, the results showed pronounced socioeconomic inequalities. After adjusting for age, among females the factors that contributed most to deterioration of health perception were incomplete education and material hardship; among males, besides material hardship, work related ...

Background: Social inequalities in health threaten social cohesion and their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies.Methods: A cross-sectional survey using primary data was applied. The study investigated the size and the extent of social inequalities in quality of life and health behaviours in Limassol, Cyprus. Data collection was done door-to-door in the form of survey interviews. The sample consisted of 450 residents aged 45-64 across 45 randomly selected neighbourhoods, that met the selection criteria. The tools used were: Demographic questionnaire, SF 36 Questionnaire, IPAQ- International Physical Activity Questionnaire short form.Results: The social gradient appears in all social indicators. Physical dimension of health has a strong relationship between health-related quality of life with the educat...

Anthropological Review, 2000

Self-rated health is an important measure of health status and outcomes and plays a significant role in the quality of life. The main purpose of the study was to estimate selected demographic and socio-economic factors associated with perceived health status among middle-aged Polish people. The sample being studied consisted of 5,776 women and 2,191 men aged 35-65 years, participants of two nation-wide cross-sectional surveys: the survey on middle-aged women's health and quality of life (WOMID) and the survey on men's health and quality of life, both conducted in 2000-2004. Participants were administered a gender-specific questionnaire on demographic, socio-economic status, lifestyle behaviours and self-rated health. The subjectively evaluated health status was then correlated with sex, age, marital status, place of residence, education level, financial situation, types of leisure time and the tobacco use. Data were processed using uni-and multivariate statistical procedures including the logistic regression models LOGITs and multiple correspondence analysis (MCA). It was found that the perceived health status was associated with women's and men's age, and in women with their menopausal status. Women were likely to evaluate their health significantly worse than men. It was found that marital status, educational attainment and financial well-off were the factors significantly associated with perceived health status in both women and men. In concluding remarks it should be stated that the health perception of women and men in mid-life is significantly related to their socio-economic status.

Sanamed

Introduction: Self-reported health status is considered one of the highly significant indicators of general health and overall quality of life. Aim: to examine whether there are gender differences in self-reported health status among the older population depending on the socioeconomic determinants. Methods: The analysis was carried out based on the data collected from the fourth National Health Survey of the population of Serbia, which was designed as a cross-sectional study. The research was conducted in accordance with the methodological guidelines and research instruments of the European Health Interview Survey. Results: A statistically significant correlation was observed between gender and the self-reported health status of the respondents. Women were significantly more likely to report poor self-rated health (27.8%), whereas men reported better self-rated health (21.3%). The results of the multivariate logistic regression analysis showed that poor self-rated health status amon...

2015

Inequalities in health are a major problem worldwide. Most of these inequalities are strongly related to the social stratification of our societies, which makes them unfair. This study aims to investigate the inequalities in self-assessed health in Romania according to personal socio-economic characteristics such as gender, age, employment status, education and income level.

BMJ Open

ObjectiveThe general aim was to meet the need for empirical comparative studies of health-related quality of life (HRQoL) assessment instruments, by evaluating and comparing the psychometric properties and results of three different, widely used, generic HRQoL instruments in a population sample. The specific aims were to evaluate the subscales of the different instruments that measure the same domain and to assess the association between the HRQoL measures and a single-item self-rated health scale.DesignAn observational cross-sectional study.SettingA population-based sample from Gothenburg, Sweden, was studied in 2008 in the WHO MONItoring of trends and determinants for CArdiovascular disease.ParticipantsA total of 414 subjects were included, 77% women, age range 39–78 years.InterventionsThe Nottingham Health Profile (NHP), the Short Form-36 questionnaire (SF-36), the Psychological General Well-Being Index (PGWB) and a self-rated health scale were used.Outcome measuresScores were an...