Differences in rating of health-related quality of life between ethnic groups
What were we trying to do?
We wanted to find out whether there were differences between how ethnic groups rated their health-related quality of life when completing the EQ-5D-5L.
The EQ-5D-5L is a questionnaire where people self-report whether they have any problems in 5 main areas:
• Mobility
• Self-care
• Usual activities
• Pain/discomfort
• Anxiety/depression
Why was this important?
The results from the EQ-5D-5L questionnaire are used in a variety of ways to plan and measure healthcare provision and funding.
But there were concerns that variations in how ethnic groups self-report their health-related quality of life could cause inequalities in the design of health services, as well as the potential for health inequalities to be measured incorrectly.
How did we do it?
We used a model called the Hierarchical Ordered Probit (HOPIT) to analyse the responses of 2,642,805 participants given in the General Practice Patient Survey.
We separated the long-term health conditions of each participant from their self-reported health-related quality of life and then broke the results down into the following ethnic groups:
- White: 2.3 million respondents
- Asian: 160k respondents
- Black: 70k respondents
- Mixed or Multiple background: 20k
- Other: 60k respondents
Findings
- We found that self-rating of health varies across ethnic groups after accounting for long-term conditions.
- Asian and Black ethnic groups were generally more likely to report a better health status.
- White ethnic group respondents were generally more likely to choose middle levels of the 5-point scale.
- Asian and Black ethnic groups with long term health conditions could be more likely to report better status related to anxiety, depression, and the ability to carry out daily activities than white populations.
Interpretation of findings
The project’s lead researcher, Dr Juan Virdis, suggests the following implications from the research findings:
“Our study found that certain black and Asian ethnic groups could be more likely to downplay different aspects of how health affects their lives. This is important because differences between perceived and actual health can affect how you seek healthcare health care and could, for example, delay a clinical consultation. But understanding these differences is crucial for designing equitable health services and improving outcomes across diverse populations.
“Our research provides a scenario for further studies using objectively measured health conditions, such as biological risk factors, or objective measures of physical health such as grip strength. In addition, we were not able to investigate the mechanisms at play, so this could be a focus for future qualitative research”
Resources
More information
Senior Programme Lead
Mike Spence
michael.spence@manchester.ac.uk