Skip to main content

The relationship of neighbourhood-level material and social deprivation with health-related quality of life

Quality of Life Research volume 27, pages 3265–3274 (2018)Cite this article

Abstract

Purpose

To examine the relationship of neighbourhood-level material and social deprivation with health-related quality of life, measured by the EQ-5D-5L, in the general adult population.

Methods

A sample of 11,835 adults living in Alberta, Canada was drawn from three combined annual Health Quality Council of Alberta Satisfaction and Experiences with Health Care Services surveys from 2012 to 2016. Neighbourhood-level material and social deprivation indices were derived using the Pampalon index and the 2006 Canadian census. The EQ-5D-5L dimensions, index and VAS scores were compared across the deprivation indices quintiles in the overall sample and by participants’ sub-groups. Differences were tested using ANOVA or Chi-square test as appropriate. Multivariate linear regression models were conducted to examine the independent association of material and social deprivation with the EQ-5D-5L index and VAS scores, and multinomial logistic regression models with each of the EQ-5D-5L dimensions.

Results

Respondents in higher material or social deprivation categories had lower EQ-5D-5L index and VAS scores than those in the least deprived categories. Additionally, respondents with higher material deprivation were more likely to report problems on mobility, usual activities, and pain/discomfort; those with higher social deprivation were more likely to report problems on mobility, self-care, usual activities, and anxiety/depression.

Conclusion

Higher neighbourhood-level material and social deprivation is significantly associated with lower health-related quality of life in the general adult population. Examining the factors leading to this inequity in health between individuals living in the least and most deprived neighbourhoods is imperative to mitigating these inequities.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Townsend, P. (1987). Deprivation. Journal of Social Policy, 16(02), 125–146.

    Article  Google Scholar 

  2. Pförtner, T., & Elgar, F.J. (2016). Widening inequalities in self-rated health by material deprivation? A trend analysis between 2001 and 2011 in Germany. Journal Epidemiol Community Health, 70, 82–89.

    Article  Google Scholar 

  3. Havard, S., Deguen, S., Bodin, J., Louis, K., & Laurent, O. (2008). A small-area index of socioeconomic deprivation to capture health inequalities in France. Social Science and Medicine, 67(12), 2007–2016.

    Article  Google Scholar 

  4. Marmot, M. G., & Wilkinson, R. G. (2006). Social determinants of health. Oxford: Oxford University Press.

    Google Scholar 

  5. Charlton, J., Rudisill, C., Bhattarai, N., & Gulliford, M. (2013). Impact of deprivation on occurrence, outcomes and health care costs of people with multiple morbidity. Journal of Health Services Research and Policy, 18(4), 215–223.

    Article  Google Scholar 

  6. Testi, A., & Ivaldi, E. (2009). Material versus social deprivation and health: A case study of an urban area. European Journal of Health Economics, 10, 323–328.

    Article  Google Scholar 

  7. Pampalon, R., Hamel, D., & Gamache, P. (2009). A comparison of individual and area-based socio-economic data for monitoring social inequalities in health. Health Reports, 20(4), 85–94.

    PubMed  Google Scholar 

  8. Drukker, M., & van Os, J. (2003). Mediators of neighbourhood socioeconomic deprivation and quality of life. Social Psychiatry and Psychiatric Epidemiology, 38(12), 698–706.

    Article  Google Scholar 

  9. Diez-Roux, A. V. (2001). Investigating neighborhood and area effects on health. American Journal of Public Health, 91(11), 1783–1789.

    Article  Google Scholar 

  10. Reijneveld, S. A., Verheij, R. A., & de Bakker, D. H. (2000). The impact of area deprivation on differences in health: Does the choice of the geographical classification matter? Journal of Epidemiology and Community Health, 54, 306–313.

    CAS  Article  Google Scholar 

  11. Miltenburg, E. M. (2015). The conditionality of neighbourhood effects upon social neighbourhood embeddedness: A critical examination of the resources and socialization mechanisms. Housing Studies, 30(2), 272–294.

    Article  Google Scholar 

  12. Flowerdew, R., Manley, D. J., & Sabel, C. E. (2008). Neighbourhood effects on health: Does it matter where you draw the boundaries? Social Science and Medicine, 66(6), 1241–1255.

    Article  Google Scholar 

  13. Health Quality Council of Alberta. Satisfaction and Experience with Healthcare Services: A Survey of Albertans 2014. Technical Report [Internet]. Calgary, Alberta Canada: Health Quality Council of Alberta; 2014 Dec [cited 2017 Apr 26]. https://d10k7k7mywg42z.cloudfront.net/assets/54e3b14cc0d6714a57020b51/HQCA_2014_Satisfaction_Report___FINAL.pdf.

  14. Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20, 1727–1736.

    CAS  Article  Google Scholar 

  15. The EuroQol Group. (2014). About EQ-5D-5L [Internet]. Rotterdam: The EuroQol Group [cited 2017 Apr 26]. http://www.euroqol.org.

  16. Devlin, N.J., & Krabbe, P.F.M. (2013). The development of new research methods for the valuation of EQ-5D-5L. European Journal of Health Economics, 14, 1–3.

    Article  Google Scholar 

  17. Dolan, P. (1997). Modeling valuations for EuroQol health states. Medical Care, 35(11), 1095–1108.

    CAS  Article  Google Scholar 

  18. Xie, F., Pullenayegum, E., Gaebel, K., Bansback, N., Bryan, S., Ohinmaa, A., Poissant, L., & Johnson, J. A. (2016). Canadian EQ-5D-5L valuation study group. A time trade-offderived value set of the EQ-5D-5L for Canada. Medical Care, 54(1), 98–105.

    Article  Google Scholar 

  19. Pampalon, R., Hamel, D., Gamache, P., Philibert, M.D., Raymond, G., & Simpson, A. (2012). An area-based material and social deprivation index for public health in Quebec and Canada. Canadian Journal of Public Health, 103(8), S17–S22.

    PubMed  Google Scholar 

  20. Pampalon, R., & Raymond, G. (2000). A deprivation index for health and welfare planning in Quebec. Chronic Disease Canada, 21(3), 104–113.

    CAS  Google Scholar 

  21. Verhaeghe, P.P., & Tampubolon, G. (2012). Individual social capital, neighbhourhood deprivation, and self-rated health in England. Social Science and Medicine, 75(2), 349–357.

    Article  Google Scholar 

  22. Idler, E.L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of 27 community studies. Journal of Health and Social Behavior, 38(1), 21–37.

    Article  Google Scholar 

  23. Simon, J. G., De Boer, J. B., Joung, I. M. A., Bosma, H., & Mackenbach, J. P. (2005). How is your health in general? A qualitative study on self-assessed health. European Journal of Public Health., 15(2), 200e208.

    Article  Google Scholar 

  24. Huffman, S., Al Sayah, F., Ohinmaa, A., Johnson, J.A. What does the “usual activities” dimension of the EQ-5D measure? 24th Annual Conference of the International Society for Quality of Life Research, October 18–21, 2017, Philadelphia, United States. Quality of Life Research. 2017; 26: Suppl. 1:(A2035):90. (Poster presentation).

  25. Andersson, H. I., Ejlertsson, G., Leden, I., & Rosenberg, C. (1993). Chronic pain in a geographically defined general population: Studies of differences in age, gender, social class and pain localization. Clinical Journal of Pain, 9, 174–182.

    CAS  Article  Google Scholar 

  26. Papageorgiou, A.C., Macfarlane, G.J., Thomas, E., Croft, P.R., Jayson, M.I.V., & Silman, A.J. (1997). Psychosocial factors in the workplace—Do they predict new episodes of low back pain? Spine, 10, 1137–1142.

    Article  Google Scholar 

  27. Vargas, C. M., Macek, M. D., & Marcus, S. E. (2000). Sociodemographic correlates of tooth pain among adults: United States, 1989. Pain, 85, 87–92.

    CAS  Article  Google Scholar 

  28. Aggarwal, V.R., Macfarlane, T.V., & Macfarlane, G. J. (2003). Why is pain more common amongst people living in areas of low socio-economic status? A population-based cross-sectional study. British Dental Journal, 194, 383–387.

    CAS  Article  Google Scholar 

  29. Pampalon, R., Hamel, D., Gamache, P., & Raymond, G. (2009). A deprivation index for health planning in Canada. Chronic Diseases in Canada, 29(4), 178–191.

    CAS  PubMed  Google Scholar 

  30. Word Health Organization. Social Determinants of Mental Health [Internet]. Geneva, Switzerland: World Health Organization; 2014 [cited 31 July 2017]. http://apps.who.int/iris/bitstream/10665/112828/1/9789241506809_eng.pdf.

  31. Collins, B. (2013). Using a survey to estimate health expectancy and quality-adjusted life expectancy to assess inequalities in health and quality of life. Value in Health, 16(4), 599–603.

    Article  Google Scholar 

  32. Sayce, L., & Curran, C. (2006). Tackling social exclusion across Europe. In M. Knapp, D. McDaid & E. Mossialos (Eds.), Mental health policy and practice across Europe. New York: McGraw-Hill Companies, Incorporated.

    Google Scholar 

  33. Collins, B. (2017). Results from a well-being survey in the north west of England: Inequalities in EQ-5D-derived quality-adjusted life expectancy are mainly driven by pain and mental health. Value in Health, 20(1), 174–177.

    Article  Google Scholar 

  34. Morgan, C., Burns, T., Fitzpatrick, R., Pinfold, V., & Priebe, S. (2009). Social exclusion and mental health: conceptual and methodological review. British Journal of Psychiatry, 191, 477–483.

    Article  Google Scholar 

  35. Knott, R. J., Black, N., Hollingsworth, B., & Lorgelly, P. K. (2017). Response-scale heterogeneity in the EQ-5D. Health Economics, 26(3), 387–394.

    Article  Google Scholar 

  36. Carstairs, V. (2001). Socio-economic factors at area level and their relationship with health. In: Spatial epidemiology: methods and applications. Oxford University Press. http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780198515326.001.0001/acprof-9780198515326-chapter-4. Accessed 12 July 12 2017.

  37. Gusi, N., Olivares, P. R., & Rajendram, R. (2010). The EQ-5D Health-related quality of life questionnaire. New York: Springer.

    Book  Google Scholar 

Download references

Acknowledgements

This research was produced by funds from the Alberta PROMs and EQ-5D Research and Support Unit (APERSU). APERSU is funded by the EuroQol Research Foundation, Alberta Health Services, and the Health Quality Council of Alberta.

Author information

Affiliations

  1. 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, AB T6G 2E1, Canada

    Hilary Short, Fatima Al Sayah & Jeffrey A. Johnson

  2. 3-267 Edmonton Clinic Health Academy, School of Public Health, University of Alberta, Edmonton, AB TBG 1C9, Canada

    Arto Ohinmaa

  3. Health Quality Council of Alberta, 210, 811 14 Street NW, Calgary, AB T2N 2A4, Canada

    Markus Lahtinen

Authors
  1. Hilary Short
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fatima Al Sayah
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arto Ohinmaa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Markus Lahtinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jeffrey A. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeffrey A. Johnson.

Ethics declarations

Conflict of interest

Fatima Al Sayah, Arto Ohinmaa, and Jeffrey Johnson are members of the EuroQol Group; Jeffrey Johnson is on the Board of Directors for the EuroQol Research Foundation. Markus Lahtinen is a staff member of the Health Quality Council of Alberta. All authors have no other conflicts of interest to declare.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Short, H., Al Sayah, F., Ohinmaa, A. et al. The relationship of neighbourhood-level material and social deprivation with health-related quality of life. Qual Life Res 27, 3265–3274 (2018). https://doi.org/10.1007/s11136-018-1962-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-018-1962-9

Keywords

  • Health-related quality of life
  • EQ-5D
  • Neighbourhood deprivation
  • Material deprivation
  • Social deprivation
  • Alberta