Race and preference-based health-related quality of life measures in the United States

Health-related quality of life instruments (HRQoL) are widely used to produce measures that summarize population health and to inform decision-making and health policy. Although the literature about the relationship between health and race in the United States is quite extensive, there is a lack of studies that comprehensively examine the relationship between race and preference-based HRQoL. Given the widespread use of these measures, it becomes important to understand the extent of the race differences in HRQoL scores and factors associated with any such differences. We examined the differences in HRQoL, between blacks and whites and associated factors, using the summary scores of the SF-6D, EQ-5D, QWB-SA, HUI2, HUI3, administered by telephone to a nationally representative sample of 3,578 black and white US adults between the ages of 35 and 89 in the National Health Measurement Study (NHMS). Black women had substantially lower HRQoL than white women. The difference was largely explained by sociodemographic and socioeconomic variables. Black men did not differ significantly from white men, except for the EQ-5D. HRQoL among black men was higher at higher income levels, while the HRQoL of black women was especially low compared to other groups at high income levels.