title: Do poor health behaviors affect health-related quality of life and healthcare utilization among veterans? The Veterans Health Study.
abstract: The impact of health behaviors on Health-Related Quality of Life (HRQoL) and HealthCare Utilization (HCU) was examined in a sample of male veterans. We examined the relationship between health behaviors (cigarette smoking, alcohol use, exercise, seat belt use, cholesterol level, and body mass index [BMI]), and HRQoL and HCU, among Veterans Health Study participants providing complete baseline (t0) and 12-month follow-up (t12) data. (Respective sample sizes were 1242 and 1397.) HRQoL measures were derived from the SF-36, expressed as physical component summary (PCS) and mental component summary (MCS) scores. Prospective 12-month outpatient and inpatient utilization data were obtained from a VA administrative database. Exercise and BMI were significant PCS predictors at t0 and t12, adjusting for age, social supports, education, employment status, and comorbidities. Smoker status was negatively associated with PCS only at t0. Nonproblem (no abuse) alcohol users had significantly higher t0 PCS scores than nonusers. Only current problem alcohol use was associated with lower MCS at t0 and t12 in multivariate analyses. Regarding HCU, current smokers had fewer medical visits than never smokers; alcohol nonusers had more medical visits than current alcohol users, current problem users, and former problem users. No behaviors were associated with mental health visits or inpatient stays. HRQoL is negatively affected by poor health behaviors. HRQoL and physical health may be improved by practitioners targeting these behaviors for preventive interventions. This study did not support an association between poor health behaviors and higher HCU. Future research should consider the effect of moderating variables on this relationship.
authors.affiliation: Center for Health Quality, Outcomes and Economic Research (CHQOER), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA. amb@bu.edu
authors.forename: Ann M
authors.initials: AM
authors.lastname: Borzecki
authors.forename: Austin
authors.initials: A
authors.lastname: Lee
authors.forename: David
authors.initials: D
authors.lastname: Kalman
authors.forename: Lewis E
authors.initials: LE
authors.lastname: Kazis
mesh_terms: D000368:Aged; D001900:Boston; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D014728:Veterans