The relationship between individual-level deprivation and health-related quality of life.
OBJECTIVE
To examine the association between individual-level deprivation and health-related quality of life (HRQL) in the general population.


METHODS
Data from a population-based survey in the Canadian province of Alberta were used. Individual-level deprivation was assessed using the Canadian Deprivation Index (CDI) and the Ontario Deprivation Index (ODI). HRQL was assessed using the EQ-5D-5 L. Differences in problems in the EQ-5D-5 L dimensions, index and visual analogue scale (VAS) scores across levels of deprivation were examined. Multivariate logistic and linear regression models adjusted for socio-demographic and other characteristics were used to examine the independent association between deprivation and HRQL.


RESULTS
Of the 6314 respondents, 39% were aged between 18 and 44 years and 38% between 45 and 64 years; 60% were female. Mean EQ-5D-5 L index and VAS scores were 0.85 (standard deviation [SD] 0.14) and 79.6 (SD 17.7), respectively. Almost one-third (30.6%) of respondents reported no problems on all EQ-5D-5 L dimensions. Few participants reported some problems with mobility (23.8%), self-care (6.2%) and usual activities (25.2%), while 59.3 and 35.5% reported some levels of pain/discomfort and anxiety/depression, respectively. Differences between the most and least deprived in reporting problems in EQ-5D-5 L dimensions, index and VAS scores were statistically significant and clinically important. In adjusted regression models for both deprivation indices, the least well-off, compared to the most well-off, had higher likelihood of reporting problems in all EQ-5D-5 L dimensions. Compared to the most well-off, the least well-off had an EQ-5D-5 L index score decrement of 0.18 (p < 0.01) and 0.17 (p < 0.01) for the CDI and ODI, respectively. Similarly, an inverse association was found between the VAS score and the CDI (β = - 17.3, p < 0.01) as well as the ODI (β = - 13.3, p < 0.01).


CONCLUSION
Individual-level deprivation is associated with worse HRQL. Poverty reduction strategies should consider the effects of not only neighbourhood-level deprivation, but also that of individual-level deprivation to improve overall health.
['Kashem|Tahmid|T|', 'Al Sayah|Fatima|F|', 'Tawiah|Andrews|A|', 'Ohinmaa|Arto|A|', 'Johnson|Jeffery A|JA|']
D000293:Adolescent D000328:Adult D000368:Aged D000416:Alberta D001007:Anxiety D003863:Depression D005260:Female D006304:Health Status D006801:Humans D008297:Male D008875:Middle Aged D010146:Pain D011788:Quality of Life D012648:Self Care D012959:Socioeconomic Factors D011795:Surveys and Questionnaires D055815:Young Adult
Deprivation HRQL CDI ODI EQ-5D-5 L EuroQol