Health-Related Quality of Life Scores by Gender and Race/Ethnicity: Implications for Evaluating Interventions

Sedentary lifestyles have been linked to higher rates of stroke, hypertension, depression, certain types of cancers, and cardiovascular disease, among other health conditions (World Health Organization, 2015; Centers for Disease Control and Prevention, 2014) and increased mortality. The attendant costs associated with physical inactivity and obesity/overweight are considerable; it has been estimated that those who are physically active spend, on average, about $1000 less in annual medical care services in comparison to their inactive peers (Chenoweth et al., 2006). Given that the majority of the U.S. population is either completely inactive or does not meet the recommended levels of physical activity (Anderson et al., 2005), there is heightened need for effective policies and interventions that meet the standards of rigorous evaluation.

While the rate of physical inactivity varies significantly by gender, race, and ethnicity, with disproportionately higher rates among females and minority group populations, it is important to evaluate the burden of physical inactivity on quality of life for women and racial/ethnic groups separately. Women have lower health-related quality of life scores associated with overweight and obesity than do men (Muennig et al., 2006; Jia and Lubetkin, 2010), reinforcing that such stratification may be a critical dimension to evaluation of physical inactivity.

Utilizing data from the National Health Interview Survey (NHIS), we calculated health-related quality of life scores and quality-adjusted life years (QALYs) for respondents by level of physical inactivity: physically inactive, insufficiently active, and physically active. We investigated the degree to which there are gains associated with physical activity, even when health limitations were present. Among those who have no physical limitations, we assessed the associated impact of physical activity and inactivity on health-related quality of life.

We find that quality of life scores on physical activity by race/ethnicity and gender are significantly different than for males. This finding extends the literature regarding health-related quality of life and for evaluation of interventions and policy directed at changing physical activity, providing greater sensitivity to the value among targeted populations. It is critical to assess the minority, ethnic, and gender dimensions of health-related quality of life as minority group members are disproportionally affected by health disparities. With obesity and physical inactivity presenting nearly intractable burdens on downstream medical costs, directed policies and precise economic evaluation is ever more critical. This study aids in that endeavor by providing new measures of health-related quality of life scores associated with physical (in)activity by critical dimensions of demographic status.