Race and gender associations between obesity and nine health-related quality-of-life measures.

PURPOSE: To assess how health-related quality of life (HRQoL) varies by body mass index (BMI) category among gender and racial subgroups using nine HRQoL measures. METHODS: Among 3,710 US adults, we evaluated self-reported height, weight, and HRQoL that was measured by six indexes (EQ-5D; HUI2; HUI3; SF-6D; QWB-SA; HALex) and three summary measures (theta; PCS; MCS). Mean HRQoL was estimated by weighted regression for normal, overweight, and obese subgroups (BMI: 18.5-24.9 kg/m(2); 25-29.9; and 30-50). RESULTS: HRQoL was significantly lower (P < 0.0001) with increasing BMI category except for MCS. Obese individuals were 5.3 units lower on PCS (1-100 scale) and 0.05-0.11 lower on the HRQoL indexes (0-1 scale) than those with normal weight. MCS scores were significantly lower for obese than normal-weight among women (P = 0.04) but not men (P = 0.11). Overweight blacks had higher HRQoL than blacks in other BMI categories (P = 0.033). CONCLUSIONS: Six commonly used HRQoL indexes and two of three health status summary measures indicated lower HRQoL with obesity and overweight than with normal BMI, but the degree of decrement varied by index. The association appeared driven primarily by physical health, although mental health also played a role among women. Counter to hypotheses, blacks may have highest HRQoL when overweight.

Socioeconomic status and age variations in health-related quality of life: results from the national health measurement study.

OBJECTIVES: We examine whether multiple health-related quality of life (HRQoL) measures are stratified by socioeconomic status (SES) and age in the United States. METHODS: Data are from the 2005/2006 National Health Measurement Study, a telephone survey of a nationally representative sample of U.S. adults. We plot mean HRQoL scores by SES within age groups. Regression analyses test whether education, income, and assets each have independent associations with three "preference-based" HRQoL measures and self-rated health (SRH). We test whether these associations vary by age. RESULTS: There are SES disparities in HRQoL and SRH among adults in the United States at all age groups. Income differentials in HRQoL are strong across current adult age cohorts, except the 75-89 age cohort. Education and assets have statistically significant but weaker associations with HRQoL. All three SES measures are associated with SRH (net of each other) at every age group. Those in the lowest income and education groups in the 35-44 age cohort have worse HRQoL and SRH than those in higher SES groups in the 65+ age cohort. DISCUSSION: Significant improvements in HRQoL at the population level will only be possible if we improve the HRQoL of people at the lowest end of the socioeconomic distribution.

US norms for six generic health-related quality-of-life indexes from the National Health Measurement study.

BACKGROUND: A number of indexes measuring self-reported generic health-related quality-of-life (HRQoL) using preference-weighted scoring are used widely in population surveys and clinical studies in the United States. OBJECTIVE: To obtain age-by-gender norms for older adults on 6 generic HRQoL indexes in a cross-sectional US population survey and compare age-related trends in HRQoL. METHODS: The EuroQol EQ-5D, Health Utilities Index Mark 2, Health Utilities Index Mark 3, SF-36v2 (used to compute SF-6D), Quality of Well-being Scale self-administered form, and Health and Activities Limitations index were administered via telephone interview to each respondent in a national survey sample of 3844 noninstitutionalized adults age 35-89. Persons age 65-89 and telephone exchanges with high percentages of African Americans were oversampled. Age-by-gender means were computed using sampling and poststratification weights to adjust results to the US adult population. RESULTS: The 6 indexes exhibit similar patterns of age-related HRQoL by gender; however, means differ significantly across indexes. Females report slightly lower HRQoL than do males across all age groups. HRQoL seems somewhat higher for persons age 65-74 compared with people in the next younger age decade, as measured by all indexes. CONCLUSIONS: Six HRQoL measures show similar but not identical trends in population norms for older US adults. Results reported here provide reference values for 6 self-reported HRQoL indexes.