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

  • Original Article
  • Published:
International Journal of Public Health

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.

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References

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

    Article  CAS  PubMed  Google Scholar 

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

    Google Scholar 

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

    Article  Google Scholar 

  • 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 57:213–225

    CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  • 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 10:125

    Article  PubMed  Google Scholar 

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

    Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  • 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 8:34–43

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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 17:317–334

    Article  PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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 87:1484–1490

    Article  CAS  PubMed  Google Scholar 

  • 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 66:803–810

    Article  Google Scholar 

  • 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

    CAS  Google Scholar 

  • 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 17:191–198

    Article  PubMed  Google Scholar 

  • 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 279:1703–1708

    Article  CAS  PubMed  Google Scholar 

  • 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 358:2468–2481

    Article  CAS  PubMed  Google Scholar 

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

    Google Scholar 

  • 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 18:1147–1157

    Article  PubMed  Google Scholar 

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

    Google Scholar 

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

    Article  Google Scholar 

  • 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 54:241–249

    Article  PubMed  Google Scholar 

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

    Google Scholar 

  • 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 53:75–82

    Article  CAS  PubMed  Google Scholar 

  • 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 4:476–482

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • 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 60:875–881

    Article  PubMed  Google Scholar 

  • 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 2:56

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Google Scholar 

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

    Book  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • 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 119:561–567

    Article  CAS  PubMed  Google Scholar 

  • 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

    Google Scholar 

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Authors and Affiliations

  1. Faculty of Social Sciences, Hellenic Open University, Riga Fereou 169 & Tsamadou, 26222, Patras, Greece

    Eleni Lahana, Evelina Pappa & Dimitris Niakas

  2. Faculty of Nursing, Technological Educational Institute of Larissa, Larissa, Greece

    Eleni Lahana

Authors
  1. Eleni Lahana
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  2. Evelina Pappa
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  3. Dimitris Niakas
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Correspondence to Eleni Lahana.

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Lahana, E., Pappa, E. & Niakas, D. The impact of ethnicity, place of residence and socioeconomic status on health-related quality of life: results from a Greek health survey. Int J Public Health 55, 391–400 (2010). https://doi.org/10.1007/s00038-010-0171-2

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  • DOI: https://doi.org/10.1007/s00038-010-0171-2

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