OBJECTIVES:

Health-related quality of life (HRQoL) is an important consideration in assessing the impact of chronic diseases. West Virginians (a part of Appalachian population) disproportionately differ with higher morbidity and mortality compared with the nation as a whole. The primary objective of this study was thus to categorize the factors associated with HRQoL among groups with different chronic conditions (e.g., cardiovascular diseases, kidney disease, cancer, respiratory disease, and diabetes) in West Virginia (WV). The secondary objective was to examine the association between HRQoL categories and covariates related to demographics and health risks behaviours.

METHODS:

HRQOL was examined using the national Behavioural Risk Factor Surveillance System (BRFSS) for three time points – 2015, 2018 and 2022. A total of 3701 respondents were included in the analysis. A latent class analysis (LCA) was conducted to determine the classes using 4 BRFSS HRQoL indicators of general health, physical health, mental health and functional status. A multivariable logistic regression model was utilized to understand the association between the revealed latent classes and covariates.

RESULTS:

The LCA method revealed four latent classes of HRQoL- Healthy (73.8%); Physically unhealthy (10.3%); Mentally unhealthy (9.4%); and both physically and mentally unhealthy (6.6%). The unhealthy classes were associated with older age, being female, unable to work, disabled, unemployed, and no participation in leisure time physical activity (P<0.01). Individuals suffering from asthma or diabetes were more almost 6 times more likely to be physically and mentally unhealthy (Asthma:OR-6.43; p<0.01 Diabetes:OR-6.03;p<0.01). These odds were found to be increased from 2015 to 2021 (P<0.01).

CONCLUSIONS:

This study enables us to identify the subgroups within the WV population with elevated risks of poor HRQoL. These findings can aid to create creative policy and intervention initiatives and can also be used to develop prevention strategies that can have a positive effect on West Virginian's HRQoL.