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Preventing Chronic Disease | Geographical Variation in Health-Related Quality of Life Among Older US Adults, 1997–2010 - CDC

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Preventing Chronic Disease | Geographical Variation in Health-Related Quality of Life Among Older US Adults, 1997–2010 - CDC

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Geographical Variation in Health-Related Quality of Life Among Older US Adults, 1997–2010

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Diana Kachan, BS; Stacey L. Tannenbaum, PhD; Henry A. Olano, BA; William G. LeBlanc, PhD; Laura A. McClure, MSPH; David J. Lee, PhD

Suggested citation for this article: Kachan D, Tannenbaum SL, Olano HA, LeBlanc WG, McClure LA, Lee DJ. Geographical Variation in Health-Related Quality of Life Among Older US Adults, 1997–2010. Prev Chronic Dis 2014;11:140023. DOI:http://dx.doi.org/10.5888/pcd11.140023External Web Site Icon.
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Abstract

Introduction
Health-related quality of life (HRQOL) is an important predictor of morbidity and mortality; however, its geographical variation in older adults in the United States has not been characterized. We compared HRQOL among older adults in the 50 US states and the District of Columbia using the Health and Activities Limitation Index (HALex). We also compared the HRQOL of 4 regions: South, West, Midwest, and Northeast.
Methods
We analyzed pooled data from 1997 through 2010 from the National Health Interview Survey for participants aged 65 or older. HALex scores (which range from 0 to 1.00, with higher values indicating better health) were calculated by combining data on participants’ perceived health and activity limitations. We ranked states by mean HALex score and performed multivariable logistic regression analyses to compare low scores (defined as scores in the lowest quintile) among US regions after adjustment for sociodemographics, health behaviors, and survey design.
Results
Older residents of Alaska, Alabama, Arkansas, Mississippi, and West Virginia had the lowest mean HALex scores (range, 0.62–0.68); residents of Arizona, Delaware, Nevada, New Hampshire, and Vermont had the highest mean scores (range, 0.78–0.79). Residents in the Northeast (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.57–0.76) and the Midwest (OR, 64; 95% CI, 0.56–0.73) were less likely than residents in the South to have scores in the lowest quintile after adjustment for sociodemographics, health behaviors, and survey design.
Conclusion
Significant regional differences exist in HRQOL of older Americans. Future research could provide policy makers with information on improving HRQOL of older Americans.
Map of the USA
Figure. States were grouped into West, Midwest, Northeast, and South, according to US Census regions and divisions (15). [A text description of this figure is also available.]

Acknowledgments

This work was supported by Bankhead Coley Cancer Research Program (grant no. 1BG06-341963), the National Institute for Occupational Safety and Health (grant no. R01OH03915), and the National Institute on Aging (grant no. F30AG040886).
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Author Information

Corresponding Author: Diana Kachan, BS, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Room 1073, Miami, FL 33136. Telephone: 305-243-7565. E-mail: dkachan@med.miami.edu.
Author Affiliations: Stacey L. Tannenbaum, Henry A. Olano, William G. LeBlanc, Laura A. McClure, David J. Lee, University of Miami Miller School of Medicine, Miami, Florida.
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