Contrasted trends in health-related quality of life across gender, age categories and work status in France, 1995-2016: repeated population-based cross-sectional surveys using the SF-36

Background Interest in monitoring health-related quality of life (HRQoL) in general populations has increased in the past 20 years, reinforced by population ageing and repeated economic crises. This study aims to identify temporal trends in HRQoL in France between 1995 and 2016 and to assess disparities according to demographic and socioeconomic characteristics. Methods Data from repeated population-based cross-sectional surveys conducted in 1995, 2003 and 2016 were used. HRQoL was measured using the Medical Outcomes Study 36-item Short Form (SF-36) questionnaire. Results A substantial decrease in score was observed between 1995 and 2016 for both genders in almost all subscales of the SF-36, with the largest decrease being in the mental health dimension for men. However, the age group 18-54 years were the most affected with persistent negative or even worsening trends in HRQoL. The largest decreases were among men aged 45-54 years and women aged 35-44 years in most dimensions, and among the age group 18-24 years in vitality. Conversely, an overall improvement was noted among the age group 65-84 years. People in employment were more affected than the unemployed by the decline in several HRQoL dimensions. Conclusion A general decline in HRQoL was found between 1995 and 2016 in the French population, but with wide disparities in trends between age groups. Young and especially middle-aged, employed people exhibited persistent negative and worsening trends. Consistent with evidence from traditional mental health morbidity and mortality indicators, our findings raise questions about the potential influence of macro-socioeconomic factors, especially the 2008 crisis; these observations deserve special attention from health policy-makers.