title: Quality of life in an urban Asian population: the impact of ethnicity and socio-economic status.
abstract: The relationships between ethnicity, socio-economic status (SES) and health-related quality of life (HRQoL) have not been well characterised in most Asian populations. We therefore studied the influence of ethnicity and SES on HRQoL in a multi-ethnic urban Asian population, adjusting for the influence of other known determinants of HRQoL. In a disproportionately stratified, cross-sectional, population-based survey, Chinese, Malay and Indian subjects in Singapore completed the Short Form 36 Health Survey (SF-36) HRQoL measure and were assessed to determine demographic, socio-economic, psychosocial and other characteristics. Multiple linear regression models were used to study the influence of ethnicity and SES on SF-36 scores while adjusting for the influence of other determinants of HRQoL. The survey participation rate was 92.8%. Ethnic differences in HRQoL were present for all 8 SF-36 scales (p<0.001 for all scales except General Health) among the 4122 Chinese, Malays and Indians surveyed. These ethnic groups also differed in several known determinants of HRQoL (e.g., Chinese had more years of education and Indians had more chronic medical conditions). After adjusting for the influence of these factors, ethnicity and SES independently influenced HRQoL, with mean differences in SF-36 scores due to ethnicity ranging from 1.4 to 13.1 points. Educational level and housing type (markers of SES) were also associated with SF-36 scores (0.5-0.6 point increase per year of education and 3.5-4.0 point increase with better housing type, respectively). Better HRQoL was also associated with better family support, and poorer HRQoL with acute and chronic medical conditions and sick days. The study concludes that ethnicity and SES are associated with clinically important differences in HRQoL in a multi-ethnic, urban Asian population.
authors.affiliation: Department of Rheumatology and Immunology, Tan Tock Seng Hospital, Singapore. mdctj@nus.edu.sg
authors.forename: Julian
authors.initials: J
authors.lastname: Thumboo
authors.forename: Kok Yong
authors.initials: KY
authors.lastname: Fong
authors.forename: David
authors.initials: D
authors.lastname: Machin
authors.forename: Siew Pang
authors.initials: SP
authors.lastname: Chan
authors.forename: Chang Heok
authors.initials: CH
authors.lastname: Soh
authors.forename: Keng Hong
authors.initials: KH
authors.lastname: Leong
authors.forename: Pao Hsii
authors.initials: PH
authors.lastname: Feng
authors.forename: Szu tien
authors.initials: St
authors.lastname: Thio
authors.forename: Mee Leng
authors.initials: ML
authors.lastname: Boey
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000328:Adult; D002681:China / Q000208:ethnology; D002908:Chronic Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003710:Demography; D004522:Educational Status; D005192:Family Health / Q000208:ethnology; D005260:Female; D006305:Health Status Indicators; D006798:Housing; D006801:Humans; D007194:India / Q000208:ethnology; D007214:Indonesia / Q000208:ethnology; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D018434:Sickness Impact Profile; D012846:Singapore / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*