The Influence of Neighbourhood Deprivation on Health Related Quality of Life In Advanced Arthritis

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Date
2016
Authors
Cristall, Nora Deane
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Abstract
Arthritis is a growing aging and public health concern in Canada and elsewhere. As with many other chronic health conditions, arthritis occurs more often and has a higher impact on functioning for people who have lower incomes or live in an impoverished environment. There is a large body of research that supports a gradient between socioeconomic status and health and between area level poverty and decreased quality of life. Although this relationship is widely acknowledged, less is known about the influence of broader social conditions at the neighbourhood level on health outcomes. By examining quality of life from the theoretical framework of poverty as a fundamental cause of differences in health (Link & Phelan, 1995) and Bourdieu’s (1984) theory of habitus, I provide an analysis of the direct impact of material and social deprivation on health related quality of life (HRQoL), as well as the impact considering the influence of age, body weight, physical functioning, gender, and coexisting health conditions. I also examine interaction effects between neighbourhood deprivation and individual characteristics. An explanatory three-level multilevel model supported a relationship between individual factors as well as deprivation at the neighbourhood level on quality of life. The impact of neighbourhood deprivation was more pronounced for mental health related life quality, with a history of another health condition making the largest contribution to the model. Physical HRQoL was impacted by gender in interaction with material deprivation and body mass index in interaction with social deprivation. I discuss implications for practice, service delivery, and policy and make suggestions for further research.
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Arthritis, health related quality of life, neighbourhood deprivation
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