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International Journal of Public Health

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01-10-2010 | Original Article

The impact of ethnicity, place of residence and socioeconomic status on health-related quality of life: results from a Greek health survey

Authors: Eleni Lahana, Evelina Pappa, Dimitris Niakas

Published in: International Journal of Public Health | Issue 5/2010

Abstract

Objectives

The impact of socioeconomic status (SES) on health previously studied demonstrates that low SES relates to lower health. In Greece, related studies are limited and focused on native population. The aim of this study was to assess the influence of residence, ethnicity and SES on health-related quality of life (HRQoL).

Methods

The study was carried out in Thessaly using a sample of 1,372 individuals (18+ years old, response rate 91.4%) via face-to-face interview. Multiple stepwise linear regression analyses were performed investigating the impact of the above factors on HRQoL, measured by SF-36. Interaction effects between socioeconomic and demographic variables were performed.

Results

Disadvantage of SES, i.e. primary education and low income, was associated with impaired HRQoL in physical and mental health. Albanians reported better HRQoL compared to Greeks but after controlling for SES factors health disparities became insignificant. Rural residents were related to better general and mental health.

Conclusions

SES is an independent predictor of HRQoL, but ethnicity and place of residence had weak impact. Investigating the underline mechanisms that impair HRQoL, so as to take policies that will elucidate the risk of poor health in disadvantage groups, is important.

Adler NE, Ostrove JM (1999) Socioeconomic status and health: what we know and what we don’t. Ann N Y Acad Sci 896:3–15CrossRefPubMed

Alexopoulos EC, Geitona M (2009) Self-rated health: inequalities and potential determinants. Int J Environ Res Public Health 6:2456–2469

Anagnostopoulos F, Niakas D, Pappa E (2005) Construct validation of the Greek SF-36 health survey. Qual Life Res 5:1959–1965CrossRef

Anderson N, Cheryl Armstead C (1995) Toward understanding the association of socioeconomic status and health: a new challenge for the bio-psychosocial approach. Psychosom Med 57:213–225PubMed

Araya R, Lewis G, Rolas G, Fritch R (2003) Education and income: what is more important for mental health. J Epidemiol Community Health 57:501–505CrossRefPubMed

Bacon SL, Bouchard A, Loucks EB, Lavoie KL (2009) Individual-level socioeconomic status is associated with worse asthma morbidity in patients with asthma. Respir Res 10:125CrossRefPubMed

Bhopal R (2007) Ethnicity, race and health in multicultural societies. J Epidemiol Community Health 62:87

Bilanakis N, Madianos MG, Liakos A (1995) Psychiatric morbidity among repatriated Greek immigrants in a rural area. Eur Arch Psychiatry Clin Neurosci 245:36–44CrossRefPubMed

Bollini P (1995) Migration and international health policies. Ann Ig 7:217–224PubMed

Cesari M, Onder G, Zamboni V, Manini T, Shorr RI, Russo A, Bernabei R, Pahor M, Landi F (2008) Physical function and self-rated health status as predictors of mortality: results from longitudinal analysis in the ilSIRENTE study. BMC Geriatr 8:34–43CrossRefPubMed

Cleary KK, Howell DM (2006) Using the SF-36 to determine perceived health-related quality of life in rural Idaho seniors. J Allied Health 35:156–161PubMed

Dahl E, Fritzell J, Lahelma E, Martikainen P, Kunst A, Mackenbach J (2006) Welfare state regimes and health inequalities. In: Siegrist J, Marmot M (eds) Health inequalities in Europe. Oxford University Press, Oxford, England, pp 193–222

Deaton A (2002) Policy implications of the gradient of health and wealth. Health Affairs 21(2):13–30

Doiron D, Jones G, Savage E (2008) Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance. Health Econ 17:317–334CrossRefPubMed

Eng K, Feeny D (2007) Comparing the health of low income and less educated groups in the United States and Canada. Popul Health Metr 16:5–10

Hemingway H, Nicholson A, Stafford M, Roberts R, Marmot M (1997) The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: The Whitehall II Study. Am J Public Health 87:1484–1490CrossRefPubMed

Huguet N, Mark S, Kaplan MS, Feeny D (2008) Socioeconomic status and health-related quality of life among elderly people: results from the Joint Canada/United States Survey of Health. Social Sci Med 66:803–810CrossRef

Jenkinson C, Wright L, Coulter A (1994) Criterion validity and reliability of the SF-36 in a population sample. Qual Life Res Int J Qual Life Aspects Treat Care Rehabil 3:7–12

Kandula NR, Launderdale DS, Baker DW (2007) Differences in self reported health among Asians, Latinos and non-Hispanic whites: the role of language and nativity. Ann Epidemiol 17:191–198CrossRefPubMed

Kunst AE, Roskam AJ (2007) Comparison of educational inequalities in general health in 12 European countries: application of an integral measure of self-assessed health. Department of Public Health, Rotterdam, The Netherlands. Accessed May 12, 2008, at http://www.eurothine.org

Lantz PM, House JS, Lepkowski JM et al (1998) Socioeconomic factors, health behaviors and mortality: results from a nationally representative prospective study of US adults. JAMA 279:1703–1708CrossRefPubMed

Mackenbach JP, Stirbu I, Roskam AR, Schaap MM, Menvielle G, Leinsalu M, Kunst AE (2008) Socioeconomic inequalities in health in 22 European countries. N Engl J Med 358:2468–2481CrossRefPubMed

Marmot M (2002) The influence of income on health: views of an epidemiologist. Health Affairs 21(2):31–46

Michel G, Bisegger C, Fuhr DC, Abel T (2009) Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Qual Life Res 18:1147–1157CrossRefPubMed

Muller A (2002) Education income inequality and mortality: a multiple regression analysis. Biomed J 324:23–25

Pappa E, Kontodimopoulos N, Niakas D (2005) Validating and norming of the Greek SF-36 health survey. Qual Life Res 5:1433–1438CrossRef

Pappa E, Kontodimopoulos N, Papadopoulos AA, Niakas D (2009) Assessing the socio-economic and demographic impact on health-related quality of life: evidence from Greece. Int J Public Health 54:241–249CrossRefPubMed

Philip D, Havens B, Van Ineveld CHM, Finlayson M (2002) Rural–urban differences in health status of elderly Manitobans. CJRM 7:89–93

Regidor E, Barrio G, de la Fuente L, Domingo A, Rodriguez C, Alonso J (1999) Association between educational level and health related quality of life in Spanish adults. J Epidemiol Community Health 53:75–82CrossRefPubMed

Reklaitiene R, Baceviciene M, Andrijauskas K (2009) Quality of life in Lithuanian population: the impact of country residence and socio-economic status. Cent Eur J Med 4:476–482CrossRef

Riise T, Moen BE, Nortvedt MW (2003) Occupation, lifestyle factors and health-related quality of life: the Hordaland Health Study. J Occup Environ Med 45:324–332CrossRefPubMed

Shkolnikov VM, Andreev EM, Jasilionis D, Leinsalu M, Antonova OI, McKee M (2006) The changing relation between education and life expectancy in central and eastern Europe in the 1990s. J Epidemiol Community Health 60:875–881CrossRefPubMed

Slifkin R, Goldsmith L, Ricketts T (2000) Race and place: urban–rural differences in health for racial and ethnic minorities. NC RHRP Working Paper Series, No. 66

Veenstra M, Pettersen K, Rollag A, Stavern K (2004) Association of changes in health-related quality of life in coronary heart disease with coronary procedures and socio-demographic characteristics. Health Qual Life Outcomes 2:56CrossRefPubMed

Walters SJ, Munro JF, Brazier JE (2001) Using SF-36 with older adults: a cross-sectional community-based survey. Age Ageing 30:337–343CrossRefPubMed

Ware JE, Kosinski M, Keller SD (1994) SF-36 physical and mental health summary scales: a user’s manual. The Health Institute, Boston, MA

Wilkinson RG (1996) Unhealthy societies: the afflictions of inequality. Routledge, London, EnglandCrossRef

Wilkinson RG, Pickett KE (2006) Income inequality and population health: a review and explanation of the evidence. Soc Sci Med 62:1768–1784CrossRefPubMed

Yamazaki S, Fukuhara S, Suzukamo Y (2005) Household income is strongly associated with health-related quality of life among Japanese men but not women. Public Health 119:561–567CrossRefPubMed

Zahran HS, Kobau R, Moriarty DG, Zack MM, Holt J, Donehoo R (2005) Health related quality of life surveillance: United States 1993–2002. MMWR 54(SS04):1–35

Title: The impact of ethnicity, place of residence and socioeconomic status on health-related quality of life: results from a Greek health survey
Authors: Eleni Lahana
Evelina Pappa
Dimitris Niakas
Publication date: 01-10-2010
Publisher: SP Birkhäuser Verlag Basel
Published in: International Journal of Public Health / Issue 5/2010
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-010-0171-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact of ethnicity, place of residence and socioeconomic status on health-related quality of life: results from a Greek health survey

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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