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Original article Socioeconomic inequality in health-related quality of life among Korean adults with chronic disease: an analysis of the Korean Community Health Survey
Thi Huyen Trang Nguyen1orcid , Thi Tra Bui1orcid , Jinhee Lee1orcid , Kui Son Choi1orcid , Hyunsoon Cho2orcid , Jin-Kyoung Oh1orcid
Epidemiol Health 2024;e2024018
DOI: https://doi.org/10.4178/epih.e2024018 [Accepted]
Published online: January 8, 2024
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1Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
2Department of Cancer AI & Digital Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
Corresponding author:  Hyunsoon Cho,
Email: jkoh@ncc.re.kr
Jin-Kyoung Oh,
Email: jkoh@ncc.re.kr
Received: 4 September 2023   • Revised: 5 December 2023   • Accepted: 8 December 2023

OBJECTIVES
Health-related quality of life is crucial for people dealing with chronic illness. This study investigated the quality of life in individuals with 5 common chronic conditions in Korea. We also analyzed socioeconomic factors such as education, income, occupation, and urbanization to identify determinants of inequality.
METHODS
Using 2016 Community Health Survey data, we examined individuals aged 30 or older with chronic diseases (diabetes, hypertension, cardiovascular disease, hyperlipidemia, arthritis) using the EQ-5D-3L tool. We analyzed the associations between socioeconomic factors (education, income, occupation, urbanization) and quality of life using descriptive statistics and regression analysis. Inequality indices (RII, SII) were used to measure inequality in quality of life.
RESULTS
Individuals with higher income levels showed a 1.95-fold higher likelihood of a better quality of life than those with the lowest income. The lowest income group had higher odds of mobility (adjusted odds ratio [aOR]=2.2), self-care (aOR=2.1), activity limitations (aOR=2.4), pain/discomfort (aOR=1.8), and anxiety/depression (aOR=2.3). Educational disparities included a 3-fold increase in mobility and daily activity problems for those with elementary or lower education. Well-educated participants had a 1.94 times higher quality of life, with smaller differences in anxiety/depression and self-management. The income gap accounted for 14.1% of variance in quality-of-life disparities.
CONCLUSIONS
Addressing socioeconomic disparities in the quality of life for individuals with chronic diseases necessitates tailored interventions and targeted health policies. This research informs policymakers in developing focused initiatives to alleviate health inequities. It emphasizes the importance of mental health support and ensuring affordable, accessible healthcare services.


Epidemiol Health : Epidemiology and Health