Health-Related Quality of Life across a Variety of Community Contexts
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Health-Related Quality of Life across a Variety of Community Contexts Daniel Shepherd 1
& David
Welch 2 & David McBride 3 & Kim N. Dirks 2
Received: 16 April 2020 / Accepted: 14 August 2020/ # Springer Nature Switzerland AG 2020
Abstract There is increasing interest in the socioeconomic determinants of health and well-being. Efforts to date have focused on the associations between measures of social position and objective measures of health. However, health can also be gauged using subjective measures such as health-related quality of life (HRQOL), while other social determinants, such as neighbourhood factors, appear largely neglected. The aim of this study was to estimate the relationship between HRQOL (as measured by the WHOQoL questionnaire) and both social position (as measured by the New Zealand Deprivation (NZDep) index) and participants’ perceptions about their home neighbourhood. A total of 746 participants living in areas with six different NZDep scores completed a survey probing HRQOL, problems in the neighbourhood, and perceptions of amenity. Results showed that people living in wealthier areas reported better HRQOL, and that amenity ratings mediated the relationship. The study’s findings have implications for researchers interested in the social determinants of health and the operationalisation of these social indicators and health in that health outcomes depended on perceived amenity rather than absolute wealth. Keywords Neighbourhood . Health . Health-related quality of life . Social position .
Deprivation
* Daniel Shepherd [email protected] David Welch [email protected] David McBride [email protected] Kim N. Dirks [email protected] Extended author information available on the last page of the article
Health-related quality of life across a variety of community contexts
Introduction Investigations into the social determinants of health are required to address the health inequalities commonly found across cultures and community settings (Ajwani et al., 2003), and understanding how neighbourhood settings influence their residents’ health is an important goal (Ivory et al. 2012). An individual’s social position (or socioeconomic position) typically determines the conditions they experience, the resources they own and control, and, to a degree, their opportunities regarding employment and access to quality healthcare. As such, differences exist between individuals in terms of housing adequacy, the ability to afford the necessities of life, such as food and heating, access to transportation, and the safety of their local neighbourhood, both in terms of safety from others and from environmental hazards (e.g., air pollution or noise). These differences, in turn, have been linked to differences in health and well-being (Goodyear-Smith and Ashton 2019). While the concept of ‘social class’ goes back several centuries (Serravallo 2008), in modern times, the term socioeconomic status or, as used here, social position (Salmond and Crampton 2012), is more often encountered. Perti
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