A Population-Based Comparison of Health-Related Quality of Life (HRQoL) Scores Among Stroke Survivors by Gender and Race/Ethnicity

Abstract

Objectives: To compare health-related quality of life (HRQoL) among stroke survivors by gender and race/ethnicity to identify gender and racial/ethnic disparities. Methods: This study adopted a retrospective cross-sectional research design utilizing data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS), a state-based telephone survey administered to noninstitutionalized United States citizens. Inclusion criteria for this project were adults aged 50 or older who: participated in the 2013 BRFSS survey; indicated they had ever been told by a provider that they had experienced a stroke (of any type); and reported data on seven questions aimed to assess HRQoL (general, physical, and mental health; life satisfaction; emotional support; activity limitations; and sleep quality). Chi square tests and logistic regression models were used to compare HRQoL responses by gender and race/ethnicity. Results: In the 2013 BRFSS database 20,391 of 491,773 respondents reported experiencing stroke. Of those, 16,561 met the inclusion criteria. The majority were female (61.1%) and identified their race/ethnicity as white (78.6%). Logistic regression analysis revealed females were more likely than males to report worse outcomes across the following three HRQoL domains: activity limitations (AOR=0.752, 95% CI 0.617-0.918); mental health (AOR=1.398, 95% CI: 1.110-1.761); and general health (AOR=0.764, 95% CI: 0.588-0.993). Minority populations (African American, Hispanic, and Other) were more likely to report activity limitations (AOR=0.766, 95%CI: 0.614-0.955) and fair/poor general health (AOR=1.837, 95%CI: 1.324-2.549). Conclusions: Analysis identified gender and racial/ethnic disparities in HRQoL indicators among stroke survivors. Females and minority populations were more likely to report poorer outcomes.