IPOKE Research Institute, MBA National and Kapodistrian University of Athens, Athens, Greece.
MBA National and Kapodistrian University of Athens, Athens, Greece.
Front Public Health. 2023 Jun 5;11:1138982. doi: 10.3389/fpubh.2023.1138982. eCollection 2023.
The aim of this study was twofold: (i) to assess the health gap among young socio-economic groups generated by the economic crisis in Greece and (ii) to investigate HRQoL (Health Related Quality of Life) inequalities using the Theil index.
The EQ-5D-5L instrument was administered to a sample of 4,177 young individuals in Greece, mean age 22.3 (±SD 4.8) and 53.8% males, and 46.2% females. The Greek version of the EQ-5D-5L instrument was used in a web-based questionnaire to collect data. Subjects were asked to assess their subjective health status during the economic crisis of 2016 using the EQ-5D-5L instrument, and to recall their health before the crisis of 2009. The health gap was assessed on a Visual Analogue Scale (EQ-VAS), the EQ-5D-5L Index, and the five dimensions of the EQ-5D-5L instrument. Regression analysis was employed to measure the effects of the economic crisis on age, sex, education, and income on the EQ-VAS and EQ-5D-5L. Theil index was used to assess HRQoL inequalities.
The economic crisis brought a significant deterioration in the HRQoL of young Greeks. The EQ-VAS was reduced during the crisis by -10.05% ( < 0.001) and the EQ-5D-5L index declined by -19.61% ( < 0.001). The prevalence of the health gap in each dimension of the EQ-5D-5L was also significant in terms of deterioration of Mobility [change by 66.8% ( < 0.001)], Self-care [change by 61.0% ( < 0.001)], Usual activities [change by 97.1% ( < 0.001)], Pain/discomfort [change by 65.0% ( < 0.001)], and Anxiety/depression [change by 70.5% ( < 0.001)]. Significant reductions in EQ-5D-5L indices were also associated with greater inequalities in the distribution of health among age, gender, income, and educational groups. The EQ-5D-5L health gap among the poor was much greater (0.198), in comparison to richer (0.128) classes. Similar gaps were also found in terms of educational inequalities. The EQ-5D-5L health gap among those with primary education was 0.211, whereas for those with tertiary education it was 0.16. The Theil index indicated an increase in income-related HRQoL inequalities by 222.3% for the EQ-5D-5L index and by 124.2% for the EQ-VAS. The effects of demographic and socioeconomic variables on the EQ-VAS were found statistically significant: sex ( < 0.05), age ( < 0.001), education ( < 0.001), and income ( < 0.001).
The EQ-5D-5L instrument appears to be a powerful tool in assessing the health gap and the HRQoL inequalities among young people in Greece. The findings indicate the importance of developing effective health policies to combat inequalities and mitigate the impact of austerity measures on the quality of life of the young.
本研究旨在评估希腊经济危机对年轻社会经济群体健康差距的影响，并使用泰尔指数研究健康相关生活质量（HRQoL）的不平等。
在希腊，对 4177 名年龄在 22.3（±4.8）岁、53.8%为男性、46.2%为女性的年轻人进行了 EQ-5D-5L 工具的评估。希腊版 EQ-5D-5L 仪器用于网络问卷调查，收集数据。调查对象被要求使用 EQ-5D-5L 仪器评估他们在 2016 年经济危机期间的主观健康状况，并回忆他们在 2009 年经济危机前的健康状况。使用视觉模拟量表（EQ-VAS）、EQ-5D-5L 指数和 EQ-5D-5L 仪器的五个维度评估健康差距。回归分析用于衡量经济危机对年龄、性别、教育和收入对 EQ-VAS 和 EQ-5D-5L 的影响。泰尔指数用于评估 HRQoL 的不平等。
经济危机给希腊年轻人的 HRQoL 带来了显著恶化。在危机期间，EQ-VAS 下降了 10.05%（<0.001），EQ-5D-5L 指数下降了 19.61%（<0.001）。EQ-5D-5L 仪器的每个维度的健康差距在移动性（变化 66.8%（<0.001））、自我护理（变化 61.0%（<0.001））、日常活动（变化 97.1%（<0.001））、疼痛/不适（变化 65.0%（<0.001））和焦虑/抑郁（变化 70.5%（<0.001））方面也显著恶化。EQ-5D-5L 指数的显著下降也与年龄、性别、收入和教育群体之间健康分布的更大不平等有关。贫困人群的 EQ-5D-5L 健康差距（0.198）明显大于富裕人群（0.128）。在教育不平等方面也发现了类似的差距。接受过小学教育的人的 EQ-5D-5L 健康差距为 0.211，而接受过高等教育的人的健康差距为 0.16。泰尔指数表明，EQ-5D-5L 指数的收入相关 HRQoL 不平等增加了 222.3%，EQ-VAS 增加了 124.2%。人口统计学和社会经济变量对 EQ-VAS 的影响具有统计学意义：性别（<0.05）、年龄（<0.001）、教育（<0.001）和收入（<0.001）。
EQ-5D-5L 仪器似乎是评估希腊年轻人健康差距和 HRQoL 不平等的有力工具。研究结果表明，制定有效的健康政策以应对不平等问题和减轻紧缩措施对年轻人生活质量的影响非常重要。
