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Type: Journal article
Title: Lower educational level and unemployment increase the impact of cardiometabolic conditions on the quality of life: results of a population-based study in South Australia
Author: González-Chica, D.
Adams, R.
Dal Grande, E.
Avery, J.
Hay, P.
Stocks, N.
Citation: Quality of Life Research, 2017; 26(6):1521-1530
Publisher: Springer International Publishing
Issue Date: 2017
ISSN: 0962-9343
Statement of
David Alejandro González, Chica, Robert Adams, Eleonora Dal Grande, Jodie Avery, Phillipa Hay, Nigel Stocks
Abstract: Purpose: To investigate if sociodemographic characteristics increase the adverse effects of cardiovascular diseases (CVD) and cardiometabolic risk factors (CMRF) on health-related quality of life (HRQoL). Methods: Cross-sectional, face-to-face survey investigating 2379 adults living in South Australia in 2015 (57.1 ± 14 years; 51.7% females). Questions included diagnosis of CMRF (obesity, diabetes, hypertension, dyslipidaemia) and CVD. Physical and mental HRQoL were assessed using the SF-12v1 questionnaire. Multiple linear regression models including confounders (sociodemographic, lifestyle, use of preventive medication) and interaction terms between sociodemographic variables and cardiometabolic conditions were used in adjusted analysis. Results: The prevalence of CMRF (one or more) was 54.6% and CVD was 13.0%. The physical HRQoL reduced from 50.8 (95%CI 50.2-51.4) in healthy individuals to 45.1 (95%CI 44.4-45.9) and 39.1 (95%CI 37.7-40.5) among those with CMRF and CVD, respectively. Adjustment for sociodemographic variables reduced these differences in 33%, remaining stable after controlling for lifestyle and use of preventive medications (p < 0.001). Differences in physical HRQoL according to cardiometabolic conditions were twice as high among those with lower educational level, or if they were not working. Among unemployed, having a CMRF or a CVD had the same impact on the physical HRQoL (9.7 lower score than healthy individuals). The inverse association between cardiometabolic conditions and mental HRQoL was subtle (p = 0.030), with no evidence of disparities due to sociodemographic variables. Conclusions: A lower educational level and unemployment increase the adverse effects of cardiometabolic conditions on the physical HRQoL. Targeted interventions for reducing CMRF and/or CVD in these groups are necessary to improve HRQoL.
Keywords: Quality of life
Cardiovascular disease
Metabolic disease
Socioeconomic factors
Health status disparities
Description: Published online: 11 February 2017
Rights: © Springer International Publishing Switzerland 2017
DOI: 10.1007/s11136-017-1503-y
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