Skip to main content

Advertisement

Log in

Relationship Among Sociodemographic Factors, Clinical Conditions, and Health-related Quality of Life: Examining the EQ-5D in the U.S. General Population

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Introduction: Health-related quality of life (HRQL) measures are used increasingly in evaluations of clinical and population-based outcomes and in economic analyses. We investigate the influence of demographic, socioeconomic, and chronic disease factors on the HRQL of a representative U.S. sample. Methods: We examined data from 13,646 adults in the 2000 Medical Expenditure Panel Survey, a nationally representative sample of the U.S. general population, who completed a self-administered questionnaire containing the EQ-5D, a preference-based measure. We assessed the relationships between EQ-5D scores and sociodemographic variables, including age, sex, race/ethnicity, income and education, and six common chronic conditions. Results: In fully adjusted models, EQ-5D scores decreased with increasing category of age and were lower for persons with a lower income and educational attainment as well as each of the six conditions. Although the EQ-5D scores were lower for females and Whites compared with Blacks such differences were not of a magnitude considered to be clinically important. Conclusions: In the U.S., sociodemographic factors and clinical conditions are strongly associated with scores on the EQ-5D. Population health studies and risk-adjustment models should account and adjust for these factors when assessing the performance of health programs and clinical care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. JK Cooper T Kohlmann JA Michael et al. (2001) ArticleTitleHealth outcomes. New quality measure for Medicare Int J Qual Health Care 13 9–16 Occurrence Handle10.1093/intqhc/13.1.9 Occurrence Handle11330450 Occurrence Handle1:STN:280:DC%2BD3MvhtVSltg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. Institute of Medicine. Summarizing Population Health: Directions for the Development and Application of Population Metrics. Field MJ, Gold MR, eds. Washington, D.C.: National Academy Press 1998.

  3. Murray CJL, Lopez AD, Mathers CD, et al. (2001) The Global Burden of Disease 2000 project: Aims, methods, and data sources. Global Programme on Evidence for Health Policy Discussion Paper No. 36. World Health Organization. November 2001.

  4. MR Gold P Muennig (2002) ArticleTitleMeasure-dependent variation in burden of diseases estimates: Implications for policy Med Care 40 260–266 Occurrence Handle10.1097/00005650-200203000-00009 Occurrence Handle11880798

    Article  PubMed  Google Scholar 

  5. MR Gold JE Siegel LB Russell (Eds) et al. (1996) Cost-effectiveness in Health and Medicine Oxford University Press New York

    Google Scholar 

  6. JA Johnson SJ Coons (1998) ArticleTitleComparison of the EQ-5D and SF-12 in an adult US sample Qual Life Res 7 155–166 Occurrence Handle10.1023/A:1008809610703 Occurrence Handle9523497 Occurrence Handle1:CAS:528:DyaK1cXlt1aktro%3D

    Article  PubMed  CAS  Google Scholar 

  7. SJ Borowsky DB Nelson JC Fortney et al. (2002) ArticleTitleVA community-based outpatient clinics: performance measures based on patient perceptions of care Med Care 40 578–586 Occurrence Handle10.1097/00005650-200207000-00004 Occurrence Handle12142773

    Article  PubMed  Google Scholar 

  8. MM Zack DG Moriarty DF Stroup ES Ford AH Mokdad (2004) ArticleTitleWorsening trends in adult health-related quality of life and self-rated health – United States, 1993–2001 Public Health Rep 119 493–505 Occurrence Handle10.1016/j.phr.2004.07.007 Occurrence Handle15313113

    Article  PubMed  Google Scholar 

  9. R Rabin F Charro Particlede (2001) ArticleTitleEQ-5D: A measure of health status from the EuroQol Group Ann Med 33 337–343 Occurrence Handle11491192 Occurrence Handle1:STN:280:DC%2BD3MvksFWqsw%3D%3D

    PubMed  CAS  Google Scholar 

  10. P Kind P Dolan C Gudex et al. (1998) ArticleTitleVariations in population health status: Results from a United Kingdom national questionnaire survey Br Med J 316 736–741 Occurrence Handle1:STN:280:DyaK1c7ptVajtw%3D%3D

    CAS  Google Scholar 

  11. AW Wu KL Jacobson KD Frick et al. (2002) ArticleTitleValidity and responsiveness of the euroqol as a measure of health-related quality of life in people enrolled in an AIDS clinical trial Qual Life Res 11 273–282 Occurrence Handle10.1023/A:1015240103565 Occurrence Handle12074264 Occurrence Handle1:STN:280:DC%2BD38zjtFGjsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  12. WS Weintraub J Foster SD Culler et al. (2004) ArticleTitleMethods for the economic and quality of life supplement to the cilostazol for RESTenosis (CREST) trial J Invasive Cardiol 16 257–259 Occurrence Handle15152132

    PubMed  Google Scholar 

  13. A Siderowf B Ravina HA Glick (2002) ArticleTitlePreference-based quality-of-life in patients with Parkinson’s disease Neurology 59 103–108 Occurrence Handle12105315

    PubMed  Google Scholar 

  14. JW Shaw JA Johnson SJ Coons (2005) ArticleTitleUS valuation of the EQ-5D health states: development and testing of the D1 valuation model Med Care 43 203–220 Occurrence Handle10.1097/00005650-200503000-00003 Occurrence Handle15725977

    Article  PubMed  Google Scholar 

  15. K Burstrom M Johannesson F Diderichsen (2001) ArticleTitleSwedish population health-related quality of life results using the EQ-5D Qual Life Res 10 621–635 Occurrence Handle11822795 Occurrence Handle1:STN:280:DC%2BD38%2Fptlyhuw%3D%3D

    PubMed  CAS  Google Scholar 

  16. J Brazier N Jones P Kind (1993) ArticleTitleTesting the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire Qual Life Res 2 169–180 Occurrence Handle10.1007/BF00435221 Occurrence Handle8401453 Occurrence Handle1:STN:280:DyaK2c%2FgsVyjtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  17. Bélanger A, Berthelot JM, Guimond E, Houle C. A head-to-head comparison of two generic health status measures in the household population: McMaster Health Utilities Index (Mark 3) and the EQ-5D. Statistics Canada. April 2000.

  18. JA Johnson AS Pickard (2000) ArticleTitleComparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada Med Care 38 115–121 Occurrence Handle10.1097/00005650-200001000-00013 Occurrence Handle10630726 Occurrence Handle1:STN:280:DC%2BD3c%2FpsVChsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  19. J Jelsma G Ferguson (2004) ArticleTitleThe determinants of self-reported health-related quality of life in a culturally and socially diverse South African community Bull World Health Organ 82 206–212 Occurrence Handle15112009

    PubMed  Google Scholar 

  20. N Devlin P Hansen P Herbison (2000) ArticleTitleVariations in self-reported health status: Results from a New Zealand survey NZ Med J 113 517–520 Occurrence Handle1:STN:280:DC%2BD3M7gslOhtQ%3D%3D

    CAS  Google Scholar 

  21. EA Lacey SJ Walters (2003) ArticleTitleContinuing inequality: Gender and social class influences on self perceived health after a heart attack J Epidemiol Commun Health 57 622–627 Occurrence Handle1:STN:280:DC%2BD3szltFWntg%3D%3D

    CAS  Google Scholar 

  22. DG Fryback EJ Dasbach R Klein et al. (1993) ArticleTitleThe Beaver Dam Health Outcomes Study: Initial catalog of health-state quality factors Med Decis Making 13 89–102 Occurrence Handle8483408 Occurrence Handle1:STN:280:DyaK3s3kslCktw%3D%3D

    PubMed  CAS  Google Scholar 

  23. P Franks MR Gold K Fiscella (2003) ArticleTitleSociodemographics, self-rated health, and mortality in the US Soc Sci Med 56 2505–2514 Occurrence Handle10.1016/S0277-9536(02)00281-2 Occurrence Handle12742613

    Article  PubMed  Google Scholar 

  24. Franks P, Gold MR. Fiscella K. The sociodemographic determinants of health status in the US. Statistics Canada. in press.

  25. RS Kington JP Smith (1997) ArticleTitleSocioeconomic status and racial and ethnic differences in functional status associated with chronic diseases Am J Public Health 87 805–810 Occurrence Handle9184510 Occurrence Handle1:STN:280:DyaK2szisl2msA%3D%3D

    PubMed  CAS  Google Scholar 

  26. SB Cohen (2003) ArticleTitleDesign strategies and innovations in the Medical Expenditure Panel Survey Med Care 41 III5–III12 Occurrence Handle12865722

    PubMed  Google Scholar 

  27. MEPS Fact Sheet. January 2003. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps. ahrq.gov/whatismeps/bulletin.htm; accessed May 25, 2005.

  28. MEPS HC-050 2000 Full Year Consolidated Data File. Center for Financing, Access and Cost Trends. AHRQ. June 2003; available at http://www.meps.ahrq.gov/PufFiles/H50/H50doc.pdf; accessed May 25, 2005.

  29. PW Sullivan WF Lawrence V Ghushchyan (2005) ArticleTitleA national catalogue of preference-based scores for chronic conditions in the U.S Med Care 43 736–749 Occurrence Handle10.1097/01.mlr.0000172050.67085.4f Occurrence Handle15970790

    Article  PubMed  Google Scholar 

  30. SJ Walters JE Brazier (2003) ArticleTitleWhat is the relationship between the minimally important difference and health state utility values? The case of the SF-6D Health Qual Life Outcomes 1 4 Occurrence Handle10.1186/1477-7525-1-4 Occurrence Handle12737635

    Article  PubMed  Google Scholar 

  31. P Grootendorst D Feeny W Furlong (2000) ArticleTitleHealth Utilities Index Mark 3: evidence of construct validity for stroke and arthritis in a population health survey Med Care 38 290–299 Occurrence Handle10.1097/00005650-200003000-00006 Occurrence Handle10718354 Occurrence Handle1:STN:280:DC%2BD3c7otFarsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  32. JN Burdine MR Felix AL Abel et al. (2000) ArticleTitleThe SF-12 as a population health measure: An exploratory examination of potential for application Health Serv Res 35 885–904 Occurrence Handle11055454 Occurrence Handle1:STN:280:DC%2BD3crgsVOksQ%3D%3D

    PubMed  CAS  Google Scholar 

  33. J Ware SuffixJr M Kosinski SD Keller (1996) ArticleTitleA 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity Med Care 34 220–233 Occurrence Handle10.1097/00005650-199603000-00003 Occurrence Handle8628042

    Article  PubMed  Google Scholar 

  34. XS Ren BC Amick (1996) ArticleTitleRacial and ethnic disparities in self-assessed health status: evidence from the National Survey of Families and Households Ethn Health 1 293–303 Occurrence Handle9395574 Occurrence Handle1:STN:280:DyaK1c%2FltFOmtA%3D%3D Occurrence Handle10.1080/13557858.1996.9961798

    Article  PubMed  CAS  Google Scholar 

  35. SAS [computer program]. Version 9. Cary, NC: SAS Institute Inc., 2004.

  36. PD Sorlie E Backlund JB Keller (1995) ArticleTitleU.S. mortality by economic, demographic, and social characteristics: The National Longitudinal Mortality Study Am J Pub Health 85 949–956 Occurrence Handle7604919 Occurrence Handle1:STN:280:DyaK2MzivVKmug%3D%3D

    PubMed  CAS  Google Scholar 

  37. RS Cooper (1993) ArticleTitleHealth and the social status of blacks in the United States Ann Epidemiol 3 137–144 Occurrence Handle8269065 Occurrence Handle1:STN:280:DyaK2c%2FptlOruw%3D%3D

    PubMed  CAS  Google Scholar 

  38. MW Otten SuffixJr SM Teutsch DF Williamson et al. (1990) ArticleTitleThe effect of known risk factors on the excess mortality of black adults in the United States JAMA 263 845–850 Occurrence Handle10.1001/jama.263.6.845 Occurrence Handle2296146

    Article  PubMed  Google Scholar 

  39. G Howard RT Anderson G Russell et al. (2000) ArticleTitleRace, socioeconomic status, and cause-specific mortality Ann Epidemiol 10 214–223 Occurrence Handle10.1016/S1047-2797(00)00038-7 Occurrence Handle10854956 Occurrence Handle1:STN:280:DC%2BD3czhsVemsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  40. JP Smith R Kington (1997) ArticleTitleDemographic and economic correlates of health in old age Demography 34 159–170 Occurrence Handle9074837 Occurrence Handle1:STN:280:DyaK2s3ivVyisw%3D%3D

    PubMed  CAS  Google Scholar 

  41. S Sharma AM Malarcher WH Giles et al. (2004) ArticleTitleRacial, ethnic and socioeconomic disparities in the clustering of cardiovascular disease risk factors Ethn Dis 14 43–48 Occurrence Handle15002922

    PubMed  Google Scholar 

  42. DH Osmond K Vranizan D Schillinger et al. (1996) ArticleTitleMeasuring the need for medical care in an ethnically diverse population Health Serv Res 31 551–571 Occurrence Handle8943990 Occurrence Handle1:STN:280:DyaK2s%2FpvFCisQ%3D%3D

    PubMed  CAS  Google Scholar 

  43. SM Shetterly J Baxter LD Mason et al. (1996) ArticleTitleSelf-rated health among Hispanic vs non-Hispanic white adults: The San Luis Valley Health and Aging Study Am J Public Health 86 1798–1801 Occurrence Handle9003141 Occurrence Handle1:STN:280:DyaK2s7ls1Omsw%3D%3D Occurrence Handle10.2105/AJPH.86.12.1798

    Article  PubMed  CAS  Google Scholar 

  44. RM Weinick EA Jacobs LC Stone et al. (2004) ArticleTitleHispanic healthcare disparities: challenging the myth of a monolithic Hispanic population Med Care 42 313–320 Occurrence Handle15076807

    PubMed  Google Scholar 

  45. C Hui HC Triandis (1989) ArticleTitleEffects of culture and response format in extreme response style J Cross-Cult Psychol 20 296–309

    Google Scholar 

  46. JL Fuh SJ Wang SR Lu et al. (2000) ArticleTitlePsychometric evaluation of a Chinese (Taiwanese) version of the SF-36 health survey amongst middle-aged women from a rural community Qual Life Res 9 675–683 Occurrence Handle10.1023/A:1008993821633 Occurrence Handle11236857 Occurrence Handle1:STN:280:DC%2BD3M3jtl2rtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  47. CL Lam B Gandek XS Ren et al. (1998) ArticleTitleTests of scaling assumptions and construct validity of the Chinese (HK) version of the SF-36 Health Survey J Clin Epidemiol 51 1139–1147 Occurrence Handle10.1016/S0895-4356(98)00105-X Occurrence Handle9817131 Occurrence Handle1:STN:280:DyaK1M%2Fjt1Shsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  48. SC Wu CY Li DS Ke (2000) ArticleTitleThe agreement between self-reporting and clinical diagnosis for selected medical conditions among the elderly in Taiwan Public Health 114 137–142 Occurrence Handle10.1016/S0033-3506(00)00323-1 Occurrence Handle10800154 Occurrence Handle1:STN:280:DC%2BD3c3mtFyluw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  49. K Fiscella P Franks MR Gold CM Clancy (2000) ArticleTitleInequality in quality: Addressing socioeconomic, racial, and ethnic disparities in health care JAMA 283 2579–2584 Occurrence Handle10815125 Occurrence Handle1:STN:280:DC%2BD3c3ns1ShtA%3D%3D

    PubMed  CAS  Google Scholar 

  50. AS Bierman N Lurie KS Collins JM Eisenberg (2002) ArticleTitleAddressing racial and ethnic barriers to effective health care: The need for better data Health Aff (Millwood) 21 91–102 Occurrence Handle10.1377/hlthaff.21.3.91

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Erica I. Lubetkin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lubetkin, E.I., Jia, H., Franks, P. et al. Relationship Among Sociodemographic Factors, Clinical Conditions, and Health-related Quality of Life: Examining the EQ-5D in the U.S. General Population. Qual Life Res 14, 2187–2196 (2005). https://doi.org/10.1007/s11136-005-8028-5

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-005-8028-5

Keywords

Navigation