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Declining Health-Related Quality of Life in the U.S.

Titulo Declining Health-Related Quality of Life in the U.S.
Autoría Olfson M, Wall M, Liu SM, Schoenbaum M, Blanco C
Fuente Am J Prev Med. 2018 Jan 12. pii: S0749-3797(17)30700-6. doi: 10.1016/j.amepre.2017.11.012. [Epub ahead of print]
Resumen INTRODUCTION: Despite recent declining mortality of the U.S. population from most leading causes, uncertainty exists over trends in health-related quality of life. METHODS: The 2001-2002 and 2012-2013 National Epidemiologic Surveys on Alcohol and Related Conditions U.S. representative household surveys were analyzed for trends in health-related quality of life (n=79,402). Health-related quality of life was measured with the Short Form-6 Dimension scale derived from the Short Form-12. Changes in mean Short Form-6 Dimension ratings were attributed to changes in economic, social, substance abuse, mental, and medical risk factors. RESULTS: Mean Short Form-6 Dimension ratings decreased from 0.820 (2001-2002) to 0.790 (2012-2013; p<0.0001). In regressions adjusted for age, sex, race/ethnicity, and education, variable proportions of this decline were attributable to medical (21.9%; obesity, cardiac disease, hypertension, arthritis, medical injury), economic (15.6%; financial crisis, job loss), substance use (15.3%; substance use disorder or marijuana use), mental health (13.1%; depression and anxiety disorders), and social (11.2%; partner, neighbor, or coworker problems) risks. In corresponding adjusted models, a larger percentage of the decline in Short Form-6 Dimension ratings of older adults (aged ≥55 years) was attributable to medical (35.3%) than substance use (7.4%) risk factors, whereas the reverse occurred for younger adults (aged 18-24 years; 5.7% and 19.7%) and adults aged 25-44 years (12.7% and 16.3%). CONCLUSIONS: Between 2001-2002 and 2012-2013, there was a significant decline in average quality of life ratings of U.S. adults. The decline was partially attributed to increases in several modifiable risk factors, with medical disorders having a larger role than substance use disorders for older adults but the reverse for younger and middle-aged adults.
URL www.ncbi.nlm.nih.gov/pubmed/29338955