Results from a Well-Being Survey in the North West of England: Inequalities in EQ-5D-Derived Quality-Adjusted Life Expectancy Are Mainly Driven by Pain and Mental Health.

BACKGROUND: There is a growing body of evidence that once quality-of-life decrements are factored in, health inequalities become more prominent than using life expectancy alone.

OBJECTIVES: This study aimed to understand what the drivers were in inequalities in quality-adjusted life expectancy (QALE).

METHODS: This study used EuroQol five-dimensional (EQ-5D) questionnaire data from a large survey from the North West of England (N = 11,500), which were combined with population and mortality data from administrative datasets, to calculate estimated QALE by deprivation quintile.

RESULTS: The gap in QALE between the most and least deprived quintiles was 16.8 years in males and 14.5 years in females. The gap in health-related quality of life between the rich and the poor was most prominent in males and in the age group of 55 to 64 years. People who live in the least deprived areas are less likely to show any level of problems across all five domains of the EQ-5D than those who live in the most deprived areas. People from the least deprived areas are less likely to have severe problems on two domains: pain (odds ratio = 0.45 [95% confidence interval 0.33-0.62]) and anxiety/depression (odds ratio = 0.3 [95% confidence interval 0.19-0.47]).

CONCLUSIONS: This study has shown that, in the North West of England, inequalities in QALE are driven by pain and anxiety/depression.