Predictors of health-related quality of life among rural adult residents of western Maharashtra, India

TL;DR

This study identifies key factors affecting health-related quality of life in rural adults in western Maharashtra, India.

Contribution

The study provides new insights into predictors of HRQoL in rural Indian populations using the EQ-5D-5L index.

Findings

36.8% of rural adults reported some to severe impairments in at least one HRQoL dimension.

Key predictors include age over 60, illiteracy, non-earning status, and chronic morbidities.

Pain/discomfort and anxiety/depression were the most affected HRQoL dimensions.

Abstract

Health-related quality of life (HRQoL) is a multidimensional measure encompassing physical, psychological, and social functioning. Information on its predictors will help to identify the strategies for improving the quality of life of the affected population. The objective of the study was to determine the health-related quality of life (HRQoL) of rural adults using the EQ-5D-5L index and to identify its key predictors.

This cross-sectional census enumeration study included all eligible residents from all 35 villages under Male Primary Health Centre (PHC) in Mulshi block, Pune district, Western Maharashtra, India. All permanent residents aged 30 years or older who consented to participate were included in the study. The trained Accredited Social Health Activist (ASHA) workers administered a pretested, validated questionnaire during house-to-house visits. They collected sociodemographic, housing information, tobacco use, and morbidity patterns among these residents. Multivariate regression analysis was utilized to determine the predictors of HRQoL.

Of 11,348 participants enrolled (with a response rate of 93.4%), the mean EQ-5D-5L index score was 0.94 ± 0.17 (SD); 36.8% reported some to severe impairments in at least one dimension. The most affected dimensions were pain/discomfort (28.3%) and anxiety/depression (21.9%). Participants over 60 years old, illiterate, non-earning, those with chronic morbidities, and those who use unclean fuel were found to be significantly associated with impairement in EQ-5D-5L. These factors affected nearly all dimensions of the EQ-5D-5L.

The study demonstrates that approximately one-third (36.8%) of the rural adult population experiences impairment in at least one dimension of health-related quality of life. The key factors were age above 60 years, illiteracy, non-earning status, and those with at least one chronic morbidity. These findings have significant implications for targeted public health interventions that can address modifiable risk factors and enhance chronic disease management in rural areas.

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