title: Determinants of Health-Related Quality of Life (HRQoL) in the Multiethnic Singapore Population - A National Cohort Study.
abstract: HRQoL is an important outcome to guide and promote healthcare. Clinical and socioeconomic factors may influence HRQoL according to ethnicity.
  
  
  
  A multiethnic cross-sectional national cohort (N = 7198) of the Singapore general population consisting of Chinese (N = 4873), Malay (N = 1167) and Indian (N = 1158) adults were evaluated using measures of HRQoL (SF-36 version 2), family functioning, health behaviours and clinical/laboratory assessments. Multiple regression analyses were performed to identify determinants of physical and mental HRQoL in the overall population and their potential differential effects by ethnicity. No a priori hypotheses were formulated so all interaction effects were explored.
  
  
  
  HRQoL levels differed between ethnic groups. Chinese respondents had higher physical HRQoL (PCS) than Indian and Malay participants (p<0.001) whereas mental HRQoL (MCS) was higher in Malay relative to Chinese participants (p<0.001). Regressions models explained 17.1% and 14.6% of variance in PCS and MCS respectively with comorbid burden, income and employment being associated with lower HRQoL. Age and family were associated only with MCS. The effects of gender, stroke and musculoskeletal conditions on PCS varied by ethnicity, suggesting non-uniform patterns of association for Chinese, Malay and Indian individuals.
  
  
  
  Differences in HRQoL levels and determinants of HRQoL among ethnic groups underscore the need to better or differentially target population segments to promote well-being. More work is needed to explore HRQoL and wellness in relation to ethnicity.
authors.affiliation: Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Republic of Singapore ; Singapore Institute for Clinical Sciences, ASTAR, Singapore, Republic of Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore ; Office of Clinical Sciences, Duke-NUS Graduate School of Medicine, Singapore, Republic of Singapore.
authors.forename: Melvin Khee-Shing
authors.initials: MK
authors.lastname: Leow
authors.forename: Konstadina
authors.initials: K
authors.lastname: Griva
authors.forename: Robin
authors.initials: R
authors.lastname: Choo
authors.forename: Hwee-Lin
authors.initials: HL
authors.lastname: Wee
authors.forename: Julian
authors.initials: J
authors.lastname: Thumboo
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Stanton
authors.initials: S
authors.lastname: Newman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D012846:Singapore; D012959:Socioeconomic Factors; D055815:Young Adult