Center for Health Policy Studies, Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou 310058, China.
Medical College, Hangzhou Normal University, Hangzhou 310058, China.
Int J Environ Res Public Health. 2019 Apr 12;16(8):1314. doi: 10.3390/ijerph16081314.
Social determinants are closely related to health and play a significant role in shaping the quality of life of a population. This study aimed to explore the differences in HRQoL (health-related quality of life) scores of residents in the eastern province of Zhejiang and the western province of Qinghai and probe factors affecting the HRQoL among the two populations. A sample of 4210 residents from a cross-sectional survey was included in the analysis. The EQ-5D-3L instrument was used to measure the HRQoL of residents. A Chi-square test and a t-test were used to examine the differences between different variables and analysis of variance (ANOVA) with interaction effects was used to analyze factors associated with the HRQoL between the two provinces. Residents' EQ-5D index score (EQ VAS score) was 0.963 (82.71) and 0.962 (81.51), respectively, in Zhejiang and Qinghai. Generally, residents in Qinghai displayed significantly worse HRQoL scores than those in Zhejiang. The differences between the two regions lay on mobility, pain/discomfort, and anxiety/depressions. In both regions, an increased education level and being employed were most strongly associated with a positive HRQoL; increased age and presence of chronic diseases were most strongly associated with a negative HRQoL. When formulating health policies, the significant health disparities between western and eastern provinces must be given greater consideration. The health of vulnerable groups should be particularly focused on to improve the observed health disparities.
社会决定因素与健康密切相关,对人口生活质量的塑造起着重要作用。本研究旨在探讨浙江省东部和青海省西部居民健康相关生活质量(HRQoL)评分的差异,并探讨影响这两个群体 HRQoL 的因素。分析中纳入了一项横断面调查的 4210 名居民样本。使用 EQ-5D-3L 工具来衡量居民的 HRQoL。采用卡方检验和 t 检验来检验不同变量之间的差异,采用方差分析(ANOVA)和交互效应来分析两个省份之间与 HRQoL 相关的因素。居民的 EQ-5D 指数评分(EQ VAS 评分)分别为 0.963(82.71)和 0.962(81.51),在浙江和青海。总体而言,青海的居民 HRQoL 评分明显低于浙江。两个地区之间的差异在于移动性、疼痛/不适和焦虑/抑郁。在两个地区,较高的教育水平和就业状况与积极的 HRQoL 相关性最强;年龄增加和患有慢性病与负面的 HRQoL 相关性最强。在制定卫生政策时,必须更加重视东西部省份之间存在的显著卫生差异。应特别关注弱势群体的健康,以改善观察到的卫生差异。