The relationship of neighbourhood-level material and social deprivation with health-related quality of life.

Abstract

To examine the relationship of neighbourhood-level material and social deprivation with health-related quality of life, measured by the EQ-5D-5L, in the general adult population. A sample of 11,835 adults living in Alberta, Canada was drawn from three combined annual Health Quality Council of Alberta Satisfaction and Experiences with Health Care Services surveys from 2012 to 2016. Neighbourhood-level material and social deprivation indices were derived using the Pampalon index and the 2006 Canadian census. The EQ-5D-5L dimensions, index and VAS scores were compared across the deprivation indices quintiles in the overall sample and by participants' sub-groups. Differences were tested using ANOVA or Chi-square test as appropriate. Multivariate linear regression models were conducted to examine the independent association of material and social deprivation with the EQ-5D-5L index and VAS scores, and multinomial logistic regression models with each of the EQ-5D-5L dimensions. Respondents in higher material or social deprivation categories had lower EQ-5D-5L index and VAS scores than those in the least deprived categories. Additionally, respondents with higher material deprivation were more likely to report problems on mobility, usual activities, and pain/discomfort; those with higher social deprivation were more likely to report problems on mobility, self-care, usual activities, and anxiety/depression. Higher neighbourhood-level material and social deprivation is significantly associated with lower health-related quality of life in the general adult population. Examining the factors leading to this inequity in health between individuals living in the least and most deprived neighbourhoods is imperative to mitigating these inequities.