Abstract
BackgroundThe current international interest in well-being indicators among governmental agencies means that many quality of life scales are potential components of such national indicator sets. Measuring well-being in minority groups is complex and challenging. Scales are available that have been validated in specific parts of the population, such as older people. However, validation among combinations of minority groups, such as older adults of ethnic minority backgrounds, is lacking.FindingsWe pooled data from two surveys of older adults in Great Britain: one conducted among White British people, and one among four ethnic minority groups. Quality of life was measured by the Older People's Quality of Life (OPQOL); Control, Autonomy, Self-realisation, Pleasure (CASP-19); and World Health Organization Quality of Life scale for older people (WHOQOL-OLD). We found differences, some significant, between groups in terms of self-reported importance of various aspects of quality of life. A regression model of each total quality of life scale revealed greater unexplained variability in the White British group than the others. Principal components analysis within each ethnic group's data showed considerable differences in the correlation structures.ConclusionsThere are differences between ethnic groups that are consistent across the three scales and are not explained by a battery of predictor variables. If scales such as these are used to compare quality of life between ethnic groups, or equivalently between geographical regions, the different results in each group are liable to bias any comparison which could lead to inequitable policy decisions.
Highlights
Policy makers world-wide are increasingly interested in promoting and measuring societal well-being, which is a dynamic, multi-faceted concept with social and psychological dimensions, overlapping with measures of quality of life (QOL) [1,2,3]
If scales such as these are used to compare quality of life between ethnic groups, or equivalently between geographical regions, the different results in each group are liable to bias any comparison which could lead to inequitable policy decisions
Using mixed-effects logistic regression, adjusting for age and household size, we found that ethnic groups differed in the reported importance [Figure 1]
Summary
We have seen that our data do not provide simple solutions to the problem of making fair comparisons between ethnic groups. Importance of leisure aspects and ethnicity had significant interactions predicting OPQOL and CASP. Importance of social aspects and ethnicity had significant interactions predicting CASP and WHOQOL-OLD.). The WHOQOL-OLD scale was developed by modifying a generic QOL scale for adults and tested by a series of convenience samples internationally, which may explain its detection of fewer differences between ethnic groups compared to OPQOL. Any QOL scale can be used as a well-being measure, it would need to be developed or tested in a variety of socio-cultural groups in the population, not analysed by groups to assess differences. Authors’ contributions Both authors contributed to writing, RG carried out secondary data analysis and AB was responsible for data collection and processing. Competing interests The authors declare that they have no competing interests
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