The social determinants of health-related quality of life among people with chronic disease: a systematic literature review.

Abstract

Purpose: This systematic review investigates the relationship between Social Determinants of Health (SDoH) and Health-Related Quality of Life (HRQoL) among individuals with chronic diseases. SDoH refer to the conditions in which people live, work, and interact, which are associated with health outcomes and inequalities. Understanding these determinants in the context of chronic diseases is essential for developing targeted interventions to improve their HRQoL.

Methods: We conducted a systematic review following PRISMA guidelines, searching PubMed, Web of Science, and Embase for original research articles published in English during the last 10 years. Studies included quantitative assessments of the relationship between SDoH and HRQoL in chronic disease populations. 38 studies met the eligibility criteria and were included in the analysis.

Results: Significant bivariate associations between SDoH and HRQoL were observed. Younger age, male gender, higher social support, being married, higher education level, employment, higher income, and urban living were generally linked to better HRQoL. Multivariate analyses identified higher education and income as consistent predictors of better HRQoL when considered alongside other SDoH. Urbanization, age, and gender showed some mixed associations with HRQoL, highlighting the need for context-specific interventions.

Conclusion: The findings underscore the critical role of SDoH in HRQoL among chronic disease populations. Policies aimed at improving HRQoL should consider multiple SDoH, particularly focusing on patients with low educational attainment living in low-income areas. However, variability in sample sizes and HRQoL measures complicate comparison. The predominance of cross-sectional studies limits the understanding of time-related effects, thus, future research should prioritize longitudinal studies.