Abstract
ObjectiveTo assess the relationship between socioeconomic deprivation and health-related quality of life in urban neighbourhoods, using a multilevel approach.MethodsOf the population-based cohort EPIPorto, 1154 georeferenced participants completed the 36-Item Short-Form Health Survey. Neighbourhood socioeconomic deprivation classes were estimated using latent-class analysis. Multilevel models measured clustering and contextual effects of neighbourhood deprivation on physical and mental HRQoL.ResultsResidents from the least deprived neighbourhoods had higher physical HRQoL. Neighbourhood socioeconomic deprivation together with individual-level variables (age, gender and education) and health-related factors (smoking, alcohol consumption, sedentariness and chronic diseases) explained 98% of the total between-neighbourhood variance. Neighbourhood socioeconomic deprivation was significantly associated with physical health when comparing least and most deprived neighbourhoods (class 2—beta coefficient: -0.60; 95% confidence interval:-1.76;-0.56; class 3 –beta coefficient: -2.28; 95% confidence interval:-3.96;-0.60), and as neighbourhood deprivation increases, a decrease in all values of physical health dimensions (physical functioning, role physical, bodily pain and general health) was also observed. Regarding the mental health dimension, no neighbourhood clustering or contextual effects were found. However, as neighbourhood deprivation increases, the values of vitality and role emotional dimensions significantly decreased.ConclusionNeighbourhood socioeconomic deprivation is associated with HRQoL, affecting particularly physical health. This study suggests that to improve HRQoL, people and places should be targeted simultaneously.
Highlights
Health-related quality of life (HRQoL) is a measure of perceived health status, and has become an important endpoint to monitor the population’s health, because it captures subjective assessments of both physical and mental health [1, 2]
Neighbourhood socioeconomic deprivation was significantly associated with physical health when comparing least and most deprived neighbourhoods, and as neighbourhood deprivation increases, a decrease in all values of physical health dimensions was observed
Neighbourhood socioeconomic deprivation is associated with HRQoL, affecting physical health
Summary
Health-related quality of life (HRQoL) is a measure of perceived health status, and has become an important endpoint to monitor the population’s health, because it captures subjective assessments of both physical and mental health [1, 2]. The socioeconomic factors, for example, education and occupation, have been associated with HRQoL over the life-course, and individuals from lower socioeconomic positions seem to experience worse quality of life than those at the top [3, 6]. Exploring HRQoL has the potential to provide a holistic perspective on health status, as HRQol includes several mental and physical aspects [1, 2]. Studying this relationship requires controlling for multiple variables that might confound the association between neighbourhood deprivation and HRQoL, for example health-related behaviours. Thereby, smoking, excessive alcohol consumption, and physical inactivity were more prevalent in the most deprived areas and were associated with higher levels of chronic diseases, which might influence HRQoL [7]
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