Background: The definition of health is changing to emphasize the quality of life, rather than solely mean the prolonging of life, and health-related quality of life has become a key outcome measure of health as a comprehensive measure of physical, me...
Background: The definition of health is changing to emphasize the quality of life, rather than solely mean the prolonging of life, and health-related quality of life has become a key outcome measure of health as a comprehensive measure of physical, mental, and social quality of life. While a number of previous studies have shown differences in health-related quality of life by household type, there is still a lack of research that has segmented household types and studied the characteristics associated with health-related quality of life. Therefore, this study aimed to study the characteristics associated with health-related quality of life by categorizing the different household types among Korean adults in order to provide a basis for establishing national policies to improve health-related quality of life.
Methods: Raw data from the 2019 and 2020 Korea National Health and Nutrition Examination Surveys (KNHANES) was used. The final sample size included 7,087 adults aged 19 and older, of which 884 people were living alone, 1,952 were in childless couple households, and 4,251 were living with unmarried children. Differences in health-related quality of life according to the characteristics of each household type were identified with univariate analysis through independent sample t-test and one-way ANOVA, which also reflect the characteristics of the complex sample design. A multivariate analysis via multiple linear regression was performed to analyze the characteristics associated with health-related quality of life by household type. Analyses were performed using SAS ver.9.4 (SAS Institute Inc., Cary, NC, USA), with a significance level of 5%.
Results: In terms of health-related quality of life by household type, those living with children (97.02±0.12), married couples without children (94.49±0.25), and those living alone (93.46±0.46) had the best health-related quality of life. Multivariate analyses controlling for sociodemographics, health behavior, and health and functional status characteristics by household type showed that younger age, higher level of education, higher household income, being economically active, not perceiving stress daily, and not having unmet essential health care needs were associated with higher levels of health-related quality of life across all household types. Interestingly, there were differences in characteristics associated with health-related quality of life by household when multi-person households were subdivided. In single-person households, private health insurance subscription (p=0.034), home ownership (p=0.007), frequency of eating out (p=0.008), and regular health check-ups (p=0.046) were shown to be related to health-related quality of life. In married households without children, gender (p=0.015), private health insurance subscription (p=0.043), body mass index (p=0.048), and aerobic physical activity (p=0.001) were prominent influencing factors. In households with unmarried children, gender (p=0.047) and frequency of eating breakfast (p=0.013) were confirmed to be related to health-related quality of life.
Conclusion: This study is different from previous studies in that it presents the different levels of health-related quality of life and different characteristics associated with health-related quality of life by household type. In addition, because the health-related quality of life of childless couples in multi-person households was found to be low, it is necessary to focus on childless couples as well as single-person households in order to effectively improve the health-related quality of life in South Korea. In addition, when establishing national-level health and welfare policies or implementing community-level health promotion programs, the effectiveness of policies is expected to be higher if differences in the characteristics associated with health-related quality of life by household type are considered.