Evaluation of the relation between poverty and health-related quality of life in the people over 60 years-old in the district 4 of Tehran municipality in 2009-2010

Mohammad Ali Heidarnia, Tahmineh Ghaemian, Ali Montazeri, Ali Reza Abadi

205

Abstract

Please cite this article as: Heidarnia MA, Ghaemian T, Montazeri A, Abadi AR. Evaluation of the relation between poverty and health-related quality of life in the people over 60 years-old in the district 4 of Tehran municipality in 2009-2010. Novel Biomed 2013;1:23-28.

As the articles in recent years well indicate, more than all other factors, social determinants of health are involved in people's health status and quality of life (QOL). Among these social factors, the economic one is introduced as the main factor determining health status. This study was designed to evaluate the impact of poverty on QOL. The health-related QOL of poor people under coverage of a public charity institution (group 1) was compared with the QOL of ordinary people (group2) using the SF-36 questionnaire. The QOL scores in the groups 1 and 2 were analyzed by Mann-Whitney, Kruskal -Wallis tests and logistic regression using the SPSS 16.00 software. A total of 400 individuals were studied. The results showed significant differences between the two groups in the QOL measures of SF-36, except for physical and mental health measures (P<0.001). With regard to the adverse consequence of the Physical Component Scale (PCS), employing logistic regression analysis, statistically significant relationships between the two groups in the demographic characteristics, except age and marital status, were found. For the adverse consequence of Mental Component Scale (MCS), logistic regression showed statistically significant differences between the two groups in the demographic characteristics, except for age. The findings indicate that poverty diminishes the QOL in most aspects; however, considering all aspects of QOL is necessary to promote the individuals' health.

Keywords

poverty; quality of life; social determinants of health

Full Text:

PDF

References

Motlagh M, OliayiManesh A, Beheshtian M. The Health and Social Determinants of it. Ministry of Health. March. 2008.

Etemadi A. Social Determinants of health, theme issue on poverty and human development. Arch Iran Med. 2007;10(4): 433-4.

Vahdaninia M, Montazeri A. The Socio–Economic Health Inequalities and That Measurement. Iran Epidemiol J. 2007;3: 53-8.

Draper P. Quality of life as quality of being: an alternative to subject-object dichotomy. J Adv Nurs.1999;17: 956-70.

Centers for Disease Control and Prevention.Measuring healthy days: population assessment of health-related quality of life. Atlanta (GA). 2000.

The Center for Health Promotion. Quality of life model. http://www.utoronto.ca/chp [accessed in April 2009].

Marmot M. The influence of Income on health: views of an epidemiologist: does money really matter? Or is it a maker for something else? Health Aff. 2003;21(2): 31-46.

Fein O. The influence of social class on health status: American and British research on health inequalities. J Gen Intern Med. 1995 Oct;10(10):577-86.

Geyer S, Peter R. Income, occupational position, qualification and health inequalities—competing risks? (Comparing indicators of social status). J Epidemiol Community Health. 2000;54:299-305.

Marmot M. Social determinants of health: from observation to policy. Med J Aust. 2000 Apr 17;172(8):379-82.

Turrell G, Mathers CD. Socioeconomic status and health in Australia. Med J Aust. 2000 May 1;172(9):434-8.

Zack MM, Moriarty DG, Stroup DF, Ford ES, Mokdad AH. Worsening trends in adult health-related quality of life and self-rated health-United States, 1993-2001. Public Health Rep. 2004 Sep-Oct;119(5):493-505.

Hennessy CH, Moriarty DG, Zack MM, Scherr PA, Brackbill R. Measuring health-related quality of life for public health surveillance. Public Health Rep. 1994 Sep-Oct;109(5):665-72.

Muennig P, Franks P, Jia H, Lubetkin E, Gold MR. The income-associated burden of disease in the United States. Soc Sci Med. 2005;61(9): 2018–26.

Montazeri A, McEwen J. Effective communication: perception of two anti-smoking advertisements. Patient Educ Couns. 1997;30(1):29-35.

Bowling A, Bond M, Jenikson C, Lamping DL. Short form 36(SF-36) Health Survey questionnaire which normative data should be used? Comparisons Between the normsprovided by the omnibus survey in Britain, the health survey for England and the oxford healthy life survey. J Public Health Med.1999;21: 255-270.

Thumboo J, Fong KY, Machin D, Chan SP, Soh CH, Leong KH, et al. Quality of life in an urban Asian Population : The Impact of ethnicity and Socioeconomic Status. Soc Sci Med. 2003;56:1761-72.

Montazeri A,Goshtasebi A ,vahdaninia M, Gandek B. The short form healthy survey(SF-36) : Translation and Validation study of Iranian Version. Qual Life Res. 2005;14 :875-82.

Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83.

Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220-33.

Johnson JA, Pickard AS. Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Med Care. 2000 Jan;38(1):115-21.

Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005 Aug;14(6):1523-32.

Bazazian S. Rajaeiy J. The Relationship between Socioeconomic status with mental and physical health. Iran Psychol. 2007;3(11): 237-48.

Lynch JW, Kaplan GA, Shema SJ. Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. N Engl J Med. 1997 Dec 25;337(26):1889-95.

Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82(6): 816–20.

Metzler M. Social determinants of health: what, how, why, and now. Prev Chronic Dis. 2007;4(4):A85. http://www.cdc.gov/pcd/issues/2007/oct/07_0136.htm

Tajvar M, Arab M, Montazeri A. Determinants of health-related quality of life in elderly in Tehran, Iran. BMC Public Health. 2008;8:323.

Ross CE, Mirowsky J, Goldsteen K. The impact of the family on health: The decade in review. J Marriage Fam.1990;52: 1059-78.

United Nations Development Programme. Human Development Report 2006. New York: UNDP, 2006.

Carvalho S, White H. Combining the Quantitative and Qualitative Approaches to Poverty Measurement and Analysis. Washington DC: World Bank; 1997.

Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D. Social capital, income inequality, and mortality. Am J Public Health. 1997 Sep;87(9):1491-8.

Marmot M, Wilkinson RG. Social determinants of health. Oxford (UK): Oxford University Press. 1999.

Lochner K, Pamuk E, Makuc D, Kennedy BP, Kawachi I. State-level income inequality and individual mortality risk: a prospective, multilevel study. Am J Public Health. 2001 Mar;91(3):385-91.

Kobetz E, Daniel M, Earp JA. Neighborhood poverty and self-reported health among low-income, rural women, 50 years and older. Health Place. 2003;9(3): 263–71.

Smith AE, Sim J, Scharf T, Phillipson C. Determinants of quality of life amongst older people in deprived neighbourhoods. Ageing Soc. 2004;24: 793–814.

Wagstaff A, Bull World Health Organization. 2002;Aug;83(8) :569-77.

Zack MM, Moriarty DG, Stroup DF, Ford ES, Mokdad AH. Worsening trends in adult health-related quality of life and self-rated health-United States, 1993-2001. Public Health Rep. 2004 Sep-Oct;119(5):493-505.