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Socioeconomic inequality in health-related quality of life among Korean adults with chronic disease: an analysis of the Korean Community Health Survey

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OBJECTIVES: Health-related quality of life is crucial for people dealing with chronic illness. This study investigated the quality of life in individuals with 5 common chronic conditions in Korea. We also analyzed socioeconomic factors such as education, income, occupation, and urbanization to identify determinants of inequality. METHODS: Using 2016 Korea Community Health Survey data, we examined individuals aged 30 or older with chronic diseases (diabetes, hypertension, cardiovascular disease, hyperlipidemia, arthritis) using the EuroQol 5-Dimension 3 Level tool. We analyzed the associations between socioeconomic factors (education, income, occupation, urbanization) and quality of life using descriptive statistics and regression analysis. Inequality indices (relative inequality index, absolute inequality index) were used to measure inequality in quality of life. RESULTS: Individuals with higher income levels showed a 1.95-fold higher likelihood of a better quality of life than those with the lowest income. The lowest income group had higher odds of mobility (adjusted odds ratio [aOR], 2.2), self-care (aOR, 2.1), activity limitations (aOR, 2.4), pain/discomfort (aOR, 1.8), and anxiety/depression (aOR, 2.3). Educational disparities included a 3-fold increase in mobility and daily activity problems for those with elementary or lower education. Well-educated participants had a 1.94 times higher quality of life, with smaller differences in anxiety/depression and self-management. The income gap accounted for 14.1% of variance in quality-of-life disparities. CONCLUSIONS: Addressing socioeconomic disparities in the quality of life for individuals with chronic diseases necessitates tailored interventions and targeted health policies. This research informs policymakers in developing focused initiatives to alleviate health inequities. It emphasizes the importance of mental health support and ensuring affordable, accessible healthcare services.

Abstract

OBJECTIVES: Health-related quality of life is crucial for people dealing with chronic illness. This study investigated the quality of life in individuals with 5 common chronic conditions in Korea. We also analyzed socioeconomic factors such as education, income, occupation, and urbanization to identify determinants of inequality. METHODS: Using 2016 Korea Community Health Survey data, we examined individuals aged 30 or older with chronic diseases (diabetes, hypertension, cardiovascular disease, hyperlipidemia, arthritis) using the EuroQol 5-Dimension 3 Level tool. We analyzed the associations between socioeconomic factors (education, income, occupation, urbanization) and quality of life using descriptive statistics and regression analysis. Inequality indices (relative inequality index, absolute inequality index) were used to measure inequality in quality of life. RESULTS: Individuals with higher income levels showed a 1.95-fold higher likelihood of a better quality of life than those with the lowest income. The lowest income group had higher odds of mobility (adjusted odds ratio [aOR], 2.2), self-care (aOR, 2.1), activity limitations (aOR, 2.4), pain/discomfort (aOR, 1.8), and anxiety/depression (aOR, 2.3). Educational disparities included a 3-fold increase in mobility and daily activity problems for those with elementary or lower education. Well-educated participants had a 1.94 times higher quality of life, with smaller differences in anxiety/depression and self-management. The income gap accounted for 14.1% of variance in quality-of-life disparities. CONCLUSIONS: Addressing socioeconomic disparities in the quality of life for individuals with chronic diseases necessitates tailored interventions and targeted health policies. This research informs policymakers in developing focused initiatives to alleviate health inequities. It emphasizes the importance of mental health support and ensuring affordable, accessible healthcare services.

참고문헌 (46)

  1. Saeedi P, "Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045 : results from the International Diabetes Federation Diabetes Atlas, 9th edition", Diabetes Res Clin Pract, 157, pp.107843~ (2019)
  2. Schutte AE, "Hypertension in low-and middle-income countries", Circ Res, 128, pp.808~826 (2021)[DOI]
  3. GBD 2019 Diseases and Injuries Collaborators, "Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019", Lancet, 396, pp.1204~1222 (2020)[DOI]
  4. "Population health: behavioral and social science insights" (2015)[URL]
  5. Alonso J, "Health-related quality of life associated with chronic conditions in eight countries : results from the International Quality of Life Assessment(IQOLA)Project", Qual Life Res, 13, pp.283~298 (2004)[DOI]
  6. Mielck A, "Health-related quality of life and socioeconomic status : inequalities among adults with a chronic disease", Health Qual Life Outcomes, 12, pp.58~ (2014)[DOI]
  7. Zhang P, "Health utility scores for people with type 2 diabetes in U. S. managed care health plans : results from Translating Research Into Action for Diabetes(TRIAD)", Diabetes Care, 35, pp.2250~2256 (2012)[DOI]
  8. Wang L, "Multimorbidity and health-related quality of life(HRQoL)in a nationally representative population sample : implications of count versus cluster method for defining multimorbidity on HRQoL", Health Qual Life Outcomes, 15, pp.7~ (2017)[DOI]
  9. Aschalew AY, "Health-related quality of life and associated factors among patients with diabetes mellitus at the University of Gondar referral hospital", Health Qual Life Outcomes, 18, pp.62~ (2020)[DOI]
  10. Höfelmann DA, "Chronic diseases and socioeconomic inequalities in quality of life among Brazilian adults : findings from a population-based study in Southern Brazil", Eur J Public Health, 28, pp.603~610 (2018)[DOI]
  11. Park B, "Multimorbidity and health-related quality of life in Koreans aged 50 or older using KNHANES 2013-2014", Health Qual Life Outcomes, 16, pp.186~ (2018)[DOI]
  12. Chung JY, "A study on the prevalence of chronic diseases, health-related habits and nutrients intakes according to the quality of life in Korean adults", Korean J Community Nutr, 15, pp.445~459 (2010)
  13. Kim H, "Quality of life in patients with diabetic nephropathy : findings from the KNOW-CKD(Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease)cohort", Kidney Res Clin Pract, 41, pp.43~57 (2022)[DOI]
  14. Kim HR, "Associations of socioeconomic status with depression and quality of life in patients with hypertension : an analysis of data from the 2019 Community Health Survey in Korea", J Prev Med Public Health, 55, pp.444~454 (2022)[DOI]
  15. Kim W, "Health-related quality of life among cancer patients and survivors and its relationship with current employment status", Support Care Cancer, 30, pp.4547~4555 (2022)[DOI]
  16. Kim SH, "Associations between health behaviors and health-related quality of life among breast cancer survivors", Asian Oncol Nurs, 12, pp.12~19 (2012)[DOI]
  17. Kang YW, "Korea Community Health Survey data profiles", Osong Public Health Res Perspect, 6, pp.211~217 (2015)[DOI]
  18. Rabin R, "EQ-5D : a measure of health status from the EuroQol Group", Ann Med, 33, pp.337~343 (2001)[DOI]
  19. Kim SH, "The EQ-5D-5L valuation study in Korea", Qual Life Res, 25, pp.1845~1852 (2016)[DOI]
  20. Gerlinger C, "Comparing the EQ-5D-5L utility index based on value sets of different countries : impact on the interpretation of clinical study results", BMC Res Notes, 12, pp.18~ (2019)[DOI]
  21. Kim I, "Income differences in smoking prevalences in 245 districts of South Korea : patterns by area deprivation and urbanity, 2008-2014", J Prev Med Public Health, 50, pp.100~126 (2017)[DOI]
  22. "Korean Standard Classification of Occupations" (2007)[URL]
  23. "International Standard Classification of Occupations" (2016)[URL]
  24. Lohr S, "Sampling: design and analysis", pp.24~328 (2010), Cengage Learning
  25. Mackenbach JP, "Measuring the magnitude of socio-economic inequalities in health : an overview of available measures illustrated with two examples from Europe", Soc Sci Med, 44, pp.757~771 (1997)[DOI]
  26. Mielck A, "Impact of educational level on health-related quality of life(HRQL) : results from Germany based on the EuroQol 5D(EQ-5D)", Eur J Public Health, 23, pp.45~49 (2013)[DOI]
  27. Mielck A, "Health-related quality of life and socioeconomic status : inequalities among adults with a chronic disease", Health Qual Life Outcomes, 12, pp.58~ (2014)[DOI]
  28. Wexler DJ, "Correlates of health-related quality of life in type 2 diabetes", Diabetologia, 49, pp.1489~1497 (2006)[DOI]
  29. JieAnNaMu, "Inequalities in health-related quality of life and the contribution from socioeconomic status : evidence from Tibet, China", BMC Public Health, 20, pp.630~ (2020)[DOI]
  30. Jang BN, "Association between community deprivation and practising health behaviours among South Korean adults : a survey-based cross-sectional study", BMJ Open, 11, pp.e047244~ (2021)[DOI]
  31. Abegunde DO, "The burden and costs of chronic diseases in low-income and middle-income countries", Lancet, 370, pp.1929~1938 (2007)[DOI]
  32. Cherepanov D, "Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US : evidence from four US nationally representative data sets", Qual Life Res, 19, pp.1115~1124 (2010)[DOI]
  33. Shah V, "Inequalities in health-related quality of life : repeated cross-sectional study of trends in general practice survey data", Br J Gen Pract, 71, pp.e178~e184 (2021)[DOI]
  34. Marmot M, "Health equity in England : the Marmot review 10 years on", BMJ, 368, pp.m693~ (2020)[DOI]
  35. Krawczyk-Suszek M, "Health-related quality of life(HRQoL)of people over 65 years of age", Int J Environ Res Public Health, 19, pp.625~ (2022)[DOI]
  36. Kang JH, "Correlation of unmet health care needs and employment status for a population over 65 years of age", J Korean Gerontol Soc, 37, pp.281~291 (2017)
  37. Eren I, "The effect of depression on quality of life of patients with type II diabetes mellitus", Depress Anxiety, 25, pp.98~106 (2008)[DOI]
  38. Kashem T, "The relationship between individual-level deprivation and health-related quality of life", Health Qual Life Outcomes, 17, pp.176~ (2019)[DOI]
  39. Tao Y, "How does urban form influence PM2. 5 concentrations : insights from 350 different-sized cities in the rapidly urbanizing Yangtze River Delta region of China, 1998-2015", Cities, 98, pp.102581~ (2015)[DOI]
  40. Aletta F, "Associations between positive health-related effects and soundscapes perceptual constructs : a systematic review", Int J Environ Res Public Health, 15, pp.2392~ (2018)[DOI]
  41. Cosby AG, "Growth and persistence of place-based mortality in the United States : the rural mortality penalty", Am J Public Health, 109, pp.155~162 (2019)[DOI]
  42. Mouratidis K, "Urban planning and quality of life : a review of pathways linking the built environment to subjective well-being", Cities, 115, pp.103229~ (2021)[DOI]
  43. Lee HJ, "Unmet health care needs and impact of type of household among the elderly in Korea", Korean J Health Econ Policy, 23, pp.85~108 (2017)
  44. Lee SE, "Neighborhood deprivation and unmet health care needs : a multilevel analysis of older individuals in South Korea", Osong Public Health Res Perspect, 10, pp.295~306 (2019)[DOI]
  45. Dray-Spira R, "Chronic diseases and employment: impact on social health inequalities", Rev Epidemiol Sante Publique, 61(Suppl 3), pp.S146~S151 (2013)[DOI]
  46. Sapkota T, "Vicious cycle of chronic disease and poverty : a qualitative study in present day Nepal", Int Health, 13, pp.30~38 (2021)[DOI]

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