Health-related quality of life in adult population before and after the onset of financial crisis: the case of Athens, Greece

Purpose Trends of person-oriented indices with respect to the general population have not been adequately investigated. In Athens, two Health Surveys in 2003 and 2016 provide the opportunity to analyze HRQL in the general adult population. The objectives of this study were to investigate changes in HRQL of adults in the broader area of Athens between 2003 and 2016 and their association with certain socio-demographic determinants. Methods We compared participants from pre- and during-crisis cross-sectional surveys. We used data from 982 and 1060 adult residents of Athens from 2003 and 2016 surveys, respectively. Income-related missing data were treated using three alternative methods. Subscale and summary component SF-36 scores were compared with Mann-Whitney tests and linear regression analyses were used to estimate the effect of demographic and socio-economic variables on HRQL before and after the onset of crisis. Results The analysis was based on the results of the procedure of handling missing income data as a separate income group and showed that physical component summary score (PCS) has improved and Mental Component Summary score has deteriorated. The most important predictors of HRQL were being widowed and during the crisis not being employed. Additionally, socio-demographic characteristics explained a higher proportion of variance of HRQL after the onset of crisis, especially for PCS. Conclusion Decline in mental and improvement in physical HRQL were observed between 2003 and 2016. HRQL has been certainly affected by the recession, but it is difficult to estimate the exact impact of the financial crisis on HRQL.