Health-related quality of life of single-person households in the United States: results from the 2014-2023 Behavioral Risk Factor Surveillance System.

Abstract

Purpose: Little is known about the health-related quality of life (HRQOL) of single-person households. We evaluated the physical and mental health impairment associated with household arrangements.

Methods: We conducted a cross-sectional analysis of 2014-2023 Behavioral Risk Factor Surveillance System (BRFSS) data. We included individuals aged ≥ 18 years and categorized household living arrangements into single-person, two or more adults, single-parent with children, parents with children, and others. Study outcomes included physically and mentally unhealthy days for measuring HRQOL using the Healthy Days Measures. Survey logistic regression models were used to estimate HRQOL for each household living arrangement, controlling for sociodemographic and clinical variables.

Results: Among 1,532,179 individuals, 23.2% and 10.5% were single-person households and parents with children households, respectively. Single-person households had a significantly lower physical (adjusted odds ratio [aOR] 1.25, 95% confidence interval [CI] 1.18-1.33) and mental health (aOR 1.33, 95% CI 1.25-1.41) compared to parents with children. For physical health, compared to parents with children, single female households showed higher aOR (aOR 1.36, 95% CI 1.25-1.48) than single male households (aOR 1.10, 95% CI 1.00-1.21); particularly, single female households aged ≤ 44 years showed higher OR for physical health (aOR 1.43, 95% CI 1.21-1.69). Mental health was significantly reduced in both male (aOR 1.32, 95% CI 1.20-1.46) and female (aOR 1.30, 95% CI 1.21-1.40) single households.

Conclusions: Single-person households had poorer physical and mental health, especially the physical health of young single women, highlighting the need for further longitudinal research to explore potential causal relationships.