Sociodemographic and neighbourhood determinants of health-related quality of life among grade-five students in Canada

Objectives To describe the health-related quality of life (HRQOL) of grade-five students in Alberta, Canada, and to assess how this correlates with sociodemographic and neighbourhood characteristics. Methods In 2008, we conducted a comprehensive population-based survey among 3,421 grade-five students aged primarily 10-11 years from 148 schools and their parents that included questions on sociodemographic and neighbourhood factors. The HRQOL of the students was assessed using the EQ-5D Canadian English child version (EQ-5DY). We applied multilevel multivariable linear regression to examine the independent importance of sociodemographic and neighbourhood factors for the EQ-5D-Y index and EQ-5D-Y Visual Analogue Scale (VAS) score. Results In five EQ-5D-Y dimensions, problems with ' walking', ' looking after myself, ' usualactivities', ' pain or discomfort' and ' worried, sad or unhappy' were reported by 8.1% (n = 288), 6.5% (n = 215), 11.8% (n = 431), 46.0% n = 1600), and 37.7% (n = 1292) of students, respectively. Their mean EQ-5D-Y index was 0.86 and mean EQ-5D-Y VAS was 80.4. Children from families reporting higher educational attainment reported higher HRQOL both in terms of a higher EQ-5D-Y index and in terms of a higher EQ-5D-Y VAS. Also, children residing in neighbourhood characterized as providing good satisfaction and facilities reported higher HRQOL. Conclusions Public health initiatives to improve HRQOL among children are suggested to take into account the influence of different sociodemographic and neighbourhood characteristics such that priority is given to those residing in towns, rural areas and dissatisfying neighbourhoods with poor access to recreational facilities and stores for fresh products.