title: The association between socioeconomic status and health-related quality of life among Polish postmenopausal women from urban and rural communities.
abstract: In recent years, more scholarly attention has been paid to a growing range of geographic characteristics as antecedents of inequalities in women's health and well-being. The purpose of this study was to evaluate differences in health-related quality of life between rural and urban Polish postmenopausal women. Using a data set from a reproductive health preventive screening of 660 postmenopausal women aged 48-60 years, inhabitants of Wielkopolska and Lublin provinces, the association of place of residence, socioeconomic status and lifestyle factors with health-related quality of life (the SF-36 instrument) was evaluated using ANCOVA models and multiple logistic regression analysis with backward elimination steps. A consistent rural-to-urban gradient was found in all indices of physical health functioning and well-being but not in vitality, social functioning, emotional role and mental health scales with women in large cities being likely to enjoy the highest and those in villages the lowest quality of life. The rural-urban disparities in health-related quality of life were mediated by women's socioeconomic status. The likelihood of worse physical and mental functioning and well-being was 2-3 times greater for the low socioeconomic status rural women than their counterparts from more affluent urban areas. The educational attainment and employment status were the most powerful independent risk factors for health-related quality of life in both rural and urban women. Better understanding of the role of socioeconomic status that acts as a mediator in the association between area of residence and health-related quality of life may be useful in developing public health policies on health inequalities among women at midlife.
authors.affiliation: Department of Human Biological Development, Institute of Anthropology, Faculty of Biology, Adam Mickiewicz University in Poznań, Poland. Electronic address: makac@amu.edu.pl.
authors.forename: M
authors.initials: M
authors.lastname: Kaczmarek
authors.affiliation: Department of Animal Physiology, Institute of Experimental Biology, Faculty of Biology, Adam Mickiewicz University in Poznań, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Pacholska-Bogalska
authors.affiliation: I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Poland.
authors.forename: W
authors.initials: W
authors.lastname: Kwaśniewski
authors.affiliation: I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Kotarski
authors.affiliation: Department of Obstetrics, Endocrinology and Gynaecology, Medical University of Poznań, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Halerz-Nowakowska
authors.affiliation: Department of Molecular Virology, Institute of Experimental Biology, Faculty of Biology, Adam Mickiewicz University in Poznań, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Goździcka-Józefiak
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011044:Poland; D017698:Postmenopause / Q000502:physiology* / Q000523:psychology*; D011788:Quality of Life; D012307:Risk Factors; D012423:Rural Health; D012424:Rural Population; D012923:Social Class; D011795:Surveys and Questionnaires; D014504:Urban Health; D014505:Urban Population
keywords: Lifestyle behaviour; Place of residence; Postmenopausal health; SF-36; Socioeconomic status