ABSTRACT
Socioeconomic status is a known determinant of health. In secondary data analyses, we assessed whether socioeconomic status affected health-related quality of life in a group of overweight (body mass index 25–30 kg/m2) middle-aged (45.9 ± 5.4 years) men, recruited in Auckland (New Zealand). Health-related quality of life was assessed with SF-36v2 three times: at baseline, and 12 and 30 weeks later. Socioeconomic status was determined by geo-coded deprivation scores derived from the current address using the New Zealand Index of Deprivation 2006 (NZDep2006), as well as the capital value of the residence. Univariable and multivariable analyses showed no associations between measures of socioeconomic status and any mental or physical health domains. Our findings may reflect the fact that these men are not currently experiencing comorbidities associated with overweight.
Subjects: Public Health, Metabolic Sciences
Keywords: Male, Wealth, Socioeconomic status, Deprivation, Neighbourhood, Adult, Well-being, Health, Health-related quality of life, Residence
INTRODUCTION
Socioeconomic status (SES) is a major determinant of health. Across the socioeconomic spectrum there are stepwise improvements in mortality and morbidity with increasing wealth (Adler & Ostrove, 1999; Braveman & Gottlieb, 2014). SES is likely to affect health through complex direct and indirect pathways (Adler & Newman, 2002; Braveman & Gottlieb, 2014). For example, people with lower incomes report greater financial obstacles to effective treatment, often leading to delayed diagnosis and suboptimal management of health conditions (Osborn et al., 2016).
Health-related quality of life (HRQL) refers to the effects of health, illness and treatment on perceived quality of life (Ferrans et al., 2005). SES has previously been described to affect HRQL in a nationally representative cohort of Canadian adults (Ross et al., 2012), in adults with a chronic disease in Germany (Mielck, Vogelmann & Leidl, 2014), and among males (but not females) in Japan (Yamazaki, Fukuhara & Suzukamo, 2005). Among patients with rheumatoid arthritis and other chronic conditions, there was evidence that lower-income How to cite this article Derraik et al. (2018), Socioeconomic status is not associated with health-related quality of life in a group of overweight middle-aged men. PeerJ 6:e5193; DOI 10.7717/peerj.5193 was associated with poorer HRQL (Alishiri et al., 2008; Ovayolu, Ovayolu & Karadag, 2011), but females made up the vast majority of both study populations. Of note, in the USA, disparities in self-rated health when stratified by income group were widest in adults aged 45 to 54 years (Robert et al., 2009). Previous studies have also indicated that poorer SES is associated with adverse metabolic outcomes, but two of these studies observed this association only among women (Chichlowska et al., 2008; Lim et al., 2012), with a third investigation showing only a week association among male participants (Loucks et al., 2007).
We are not aware of any previous study in New Zealand into the association between SES and HRQL in middle-aged males. Importantly, the prevalence of obesity among adult males in New Zealand increased from 26% in 2006/07 to 30.5% in 2015/16, and it was highest in the most deprived areas at 40.7% (Ministry of Health, 2016). Thus, in light of previous evidence and given the increasing prevalence of obesity in New Zealand men (and its particularly high prevalence in areas of low socioeconomic status), we aimed to investigate whether lower SES would also be associated with HRQL in a phenotypically homogenous group of overweight middle-aged men.
CONCLUSION
Our findings show that SES per se was not associated with HRQL in middle-aged men who are overweight but otherwise healthy, an important and increasing group. While the equality of HRQL across the socioeconomic spectrum in this group would generally be considered favorable, overweight men of lower SES are known to have increased cardiometabolic risk. That this risk is not associated with impaired quality of life potentially reduces the likelihood that such men will seek to improve their health. This finding underscores the fact that health promotion interventions aimed at improving the health of at-risk men should also aim to reach asymptomatic people who feel generally well.
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Socioeconomic status is not associated with health-related quality of life in a group of overweight middle-aged menADDITIONAL INFORMATION AND DECLARATIONS
Funding
This study was supported by a TECHNZ grant (University of Auckland—UniS 30475.001) through the New Zealand Ministry of Science and Innovation. Martin de Bock was funded by the Joan Mary Reynolds Trust. The Paykel Trust has provided long-term funding for the Clinical Research Unit at the Liggins Institute (University of Auckland). The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.
Grant Disclosures
The following grant information was disclosed by the authors: New Zealand Ministry of Science and Innovation: UniS 30475.001. Joan Mary Reynolds Trust. The Paykel Trust.
Competing Interests
José G.B. Derraik is an Academic Editor for PeerJ. The authors have no financial or non-financial conflicts of interest to disclose that may be relevant to this work.
Author Contributions
- José G.B. Derraik conceived and designed the experiments, analyzed the data, prepared figures and/or tables, authored or reviewed drafts of the paper, approved the final draft. Derraik et al. (2018), PeerJ, DOI 10.7717/peerj.5193 8/12
- Benjamin B. Albert conceived and designed the experiments, prepared figures and/or tables, authored or reviewed drafts of the paper, approved the final draft. • Martin de Bock conceived and designed the experiments, performed the experiments, authored or reviewed drafts of the paper, approved the final draft.
- Éadaoin M. Butler authored or reviewed drafts of the paper, approved the final draft, literature review.
- Paul L. Hofman conceived and designed the experiments, authored or reviewed drafts of the paper, approved the final draft.
- Wayne S. Cutfield conceived and designed the experiments, authored or reviewed drafts of the paper, approved the final draft.
Human Ethics
The following information was supplied relating to ethical approvals (i.e., approving body and any reference numbers): Ethical approval for this study was provided by the Northern Y Regional Ethics Committee from the New Zealand Ministry of Health (NTY/11/02/015).
Data Availability
The following information was supplied regarding data availability: The raw data are provided as a Supplemental File.
Supplemental Information
Supplemental information for this article can be found online at http://dx.doi.org/10.7717/ peerj.5193#supplemental-information.
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Professor Siavosh Kaviani was born in 1961 in Tehran. He had a professorship. He holds a Ph.D. in Software Engineering from the QL University of Software Development Methodology and an honorary Ph.D. from the University of Chelsea.
Maryam kakaei was born in 1984 in Arak. She holds a Master's degree in Software Engineering from Azad University of Arak.
Nasim Gazerani was born in 1983 in Arak. She holds a Master's degree in Software Engineering from UM University of Malaysia.
