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Full-Text Articles in Population Health

Socioeconomic Inequalities In Health-Related Quality Of Life During The Covid-19 Pandemic: A Six-Country Comparison Using The Eq-5d-5 L, Joëlle Eijkens, Joshua M. Bonsel, You-Shan Feng, M. F. Bas Janssen, Erica I. Lubetkin, Juanita A. Haagsma Jun 2026

Socioeconomic Inequalities In Health-Related Quality Of Life During The Covid-19 Pandemic: A Six-Country Comparison Using The Eq-5d-5 L, Joëlle Eijkens, Joshua M. Bonsel, You-Shan Feng, M. F. Bas Janssen, Erica I. Lubetkin, Juanita A. Haagsma

Publications and Research

Purpose

Despite the growing attention to health inequalities, there is no global consensus on how to measure socio-economic status. This study examined inequalities in health-related quality of life (HRQoL) during the early phase of the COVID-19 pandemic across six countries—China, Italy, the Netherlands, Sweden, the United Kingdom (UK), and the United States (US)—using three SES indicators: education level, income, and work status.

Methods

Between April and June 2020, individuals aged 18–75 years old completed a web-based survey. HRQoL was measured using the EQ-5D-5L Level Sum Score (LSS), where higher scores indicate poorer health. Country-specific differences in LSS across SES groups …


Net Effects Of Correlated Determinants Of Health Among U.S. Older Adults, Haomiao Jia, E I. Lubetkin Dec 2025

Net Effects Of Correlated Determinants Of Health Among U.S. Older Adults, Haomiao Jia, E I. Lubetkin

Publications and Research

Background

The health effect produced by a contributing factor alone may be different from the effect when other interacting factors are present. The effects of a set of contributors, estimated by regression coefficients, may be invalid or inappropriate if some of the predictors are correlated or the model has interaction and nonlinear terms. The net effect (NE) of a given contributing factor is the effect produced by the factor alone, not by other factors due to their correlations with the factor of interest. This study estimated NE of selected determinants of health for U.S. older adults.

Methods

Participants, aged ≥ …


Design And Implementation Of Data Quality Controls In The Eq-Daphnie Study: Insights From The Pilot Phase And 15-Country Analysis, Fatima Al Sayah, Hilary Short, Juan M. Ramos-Goñi, Rosalie Viney, Erica I. Lubetkin, Mathieu F. Janssen, Jeffrey A. Johnson Nov 2025

Design And Implementation Of Data Quality Controls In The Eq-Daphnie Study: Insights From The Pilot Phase And 15-Country Analysis, Fatima Al Sayah, Hilary Short, Juan M. Ramos-Goñi, Rosalie Viney, Erica I. Lubetkin, Mathieu F. Janssen, Jeffrey A. Johnson

Publications and Research

Objective

The EQ-DAPHNIE (EuroQol Data for Assessment of Population Health Needs and Instrument Evaluation) project is a large, multi-country survey initiative designed to generate population norms and enable comparative research using self-reported health measures. This paper describes the quality control processes and summarizes data quality metrics from the United Kingdom (UK) pilot and full implementation across 15 countries.

Methods

Representative samples were recruited via Dynata, an online survey panel provider, using quota sampling by age, sex, income, community setting, and language (where applicable). The UK pilot (n = 3012) informed survey refinements ahead of full rollout (n = 68,411). Quality …


Health-Related Quality Of Life In Covid-19 Patients: A Systematic Review And Meta-Analysis Of Eq-5d Studies, Kidu Gidey, Yirga Legesse Niriayo, Solomon Weldegebreal Asgedom, Erica I. Lubetkin Oct 2025

Health-Related Quality Of Life In Covid-19 Patients: A Systematic Review And Meta-Analysis Of Eq-5d Studies, Kidu Gidey, Yirga Legesse Niriayo, Solomon Weldegebreal Asgedom, Erica I. Lubetkin

Publications and Research

Background

COVID-19 has affected millions globally, with a significant proportion experiencing long-COVID and impaired health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to synthesize the existing literature on HRQoL in COVID-19 patients.

Methods

We conducted a systematic search of PubMed, Embase, Web of Science, Scopus, and the Cochrane Library for studies published between December 2019 and March 2025. Eligible studies were peer-reviewed and assessed HRQoL in COVID-19 patients using the EQ-5D instrument. Study quality and risk of bias were evaluated using the Newcastle-Ottawa Scale. Pooled health utility values were estimated using a random-effects model, and heterogeneity was …


Euroqol Data For Assessment Of Population Health Needs And Instrument Evaluation (Eq-Daphnie): A Study For Enhancing Population Health Assessment, Jeffrey A. Johnson, Mathieu F. Janssen, Fatima Al Sayah, Henry Bailey, Mihir Gandhi, Dominik Golicki, Nils Gutacker, Erica I. Lubetkin, Brendan Mulhern, Fredrick Dermawan Purba, Juan M. Ramos‑Goñi, Desiree Scott, Hilary Short, Trudy Sullivan, Rosalie Viney, Zhihao Yang, Victor Zárate May 2025

Euroqol Data For Assessment Of Population Health Needs And Instrument Evaluation (Eq-Daphnie): A Study For Enhancing Population Health Assessment, Jeffrey A. Johnson, Mathieu F. Janssen, Fatima Al Sayah, Henry Bailey, Mihir Gandhi, Dominik Golicki, Nils Gutacker, Erica I. Lubetkin, Brendan Mulhern, Fredrick Dermawan Purba, Juan M. Ramos‑Goñi, Desiree Scott, Hilary Short, Trudy Sullivan, Rosalie Viney, Zhihao Yang, Victor Zárate

Publications and Research

Background

Methods for collecting self-reported health status measures in population health surveys vary significantly across countries, presenting challenges to comparability. The EuroQol Data for Assessment of Population Health Needs and Instrument Evaluation (EQ-DAPHNIE) project aims to address this issue by developing infrastructure to generate representative datasets across multiple countries. This initiative aims to standardize data collection methodologies and to evaluate the performance of various health status measures, providing a foundation for reliable population health assessments. This paper describes the rationale, design and data collection methods for the EQ-DAPHNIE project.

Methods/design

EQ-DAPHNIE employs a cross-sectional online survey design targeting the general …


The Performance Relationship Between The Eq-5d-5l Composite "Anxiety/Depression" Dimension And Anxiety And Depression Symptoms In A Large, General Population Sample, Emily Stella Scott, Erica I. Lubetkin, Mathieu F. Janssen, John N. Yfantopolous, Gouke J. Bonsel, Juanita A. Haagsma Sep 2024

The Performance Relationship Between The Eq-5d-5l Composite "Anxiety/Depression" Dimension And Anxiety And Depression Symptoms In A Large, General Population Sample, Emily Stella Scott, Erica I. Lubetkin, Mathieu F. Janssen, John N. Yfantopolous, Gouke J. Bonsel, Juanita A. Haagsma

Publications and Research

Purpose

This cross-sectional study aims to understand the relationship between responses on the Anxiety/Depression (A/D) dimension of the EQ-5D-5L and symptoms of anxiety and depression on the GAD-7 and PHQ-9 instruments. In doing so, we investigate the comparative performance of the dimension between diagnostic groups (i.e. anxiety (GAD-7); depression (PHQ-9); anxiety & depression versus none). We additionally investigate the discriminatory performance between sub-populations based on gender, age, education and self-reported chronic conditions.

Methods

19,902 general population participants completed a health survey in May/June 2020, from five European countries and the United States. Performance of A/D was calculated using the Area …


The Frequency And Predictive Factors Of Change In Alcohol Consumption During The Covid-19 Pandemic: Results From A Multi-Country Longitudinal Study, Carolien Verhei, Nadja Alexandrov, Erica I. Lubetkin, Gouke J. Bonsel, John N. Yfantopoulos, Mathieu F. Janssen, Stephanie C.E. Schuit, Suzanne Polinder, Pleunie P.M. Rood, Juanita A. Haagsma Aug 2024

The Frequency And Predictive Factors Of Change In Alcohol Consumption During The Covid-19 Pandemic: Results From A Multi-Country Longitudinal Study, Carolien Verhei, Nadja Alexandrov, Erica I. Lubetkin, Gouke J. Bonsel, John N. Yfantopoulos, Mathieu F. Janssen, Stephanie C.E. Schuit, Suzanne Polinder, Pleunie P.M. Rood, Juanita A. Haagsma

Publications and Research

Background: The COVID-19 pandemic has had multiple health and behavioral effects in the general population worldwide, including effects on nutritional and lifestyle behavior such as alcohol consumption. This study aimed to determine the frequency of and predictors for change in alcohol consumption two years after onset of the COVID-19 pandemic among participants from the general population of six countries. Methods: Longitudinal study design with 4999 participants (47% male; aged 18–75 years) from a general population cohort from six countries: Greece, Italy, the Netherlands, Sweden, the United Kingdom (UK) and the United States of America (US). Measurements: Three web-based surveys at …


Exploring The Comparability Between Eq-5d And The Eq Health And Wellbeing In The General Australian Population, Peter Lee, Lidia Engel, Erica I. Lubetkin, Lan Gao Apr 2024

Exploring The Comparability Between Eq-5d And The Eq Health And Wellbeing In The General Australian Population, Peter Lee, Lidia Engel, Erica I. Lubetkin, Lan Gao

Publications and Research

Objectives

The EQ Health and Wellbeing (EQ-HWB) is a novel measure that conceptually overlaps with the 5-level EQ-5D (EQ-5D-5L) while capturing broader dimensions of health and well-being. This study aimed to explore the extent to which the EQ-HWB and EQ-5D-5L capture overlapping or complementary constructs and to explore the discriminative ability of the EQ-HWB Short version (EQ-HWB-S) as a multiattribute utility instrument in the Australian setting.

Methods

A secondary analysis of data from a nationally representative cross-sectional survey of 2002 Australian adults was performed. The survey included socioeconomic questions and health characteristics and the EQ-HWB and EQ-5D-5L instruments. Convergent and …


An Intersectional Approach To Quantifying The Impact Of Geographic Remoteness And Health Disparities On Quality-Adjusted Life Expectancy: Application To Australia, Peter Lee, Steven J. Bowe, Lidia Engel, Erica I. Lubetkin, Nancy Devlin, Lan Gao Dec 2023

An Intersectional Approach To Quantifying The Impact Of Geographic Remoteness And Health Disparities On Quality-Adjusted Life Expectancy: Application To Australia, Peter Lee, Steven J. Bowe, Lidia Engel, Erica I. Lubetkin, Nancy Devlin, Lan Gao

Publications and Research

Objectives

An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) is a novel method for exploring the interaction between sociodemographic characteristics that affect health outcomes. This study explores the interaction between geographic remoteness and socioeconomic status on health outcomes in Australia from an intersectional perspective.

Methods

Data from a cross-sectional survey were matched with data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare. To explore the effect of health-related quality of life on life expectancy, quality-adjusted life expectancy (QALE) was estimated through applying utility values derived from the EQ-5D-5L to life table …


Cross-Sectional And Longitudinal Comparison Of Health-Related Quality Of Life And Mental Well-Being Between Persons With And Without Post Covid-19 Condition, Emily Stella Scott, Erica I. Lubetkin, Mathieu F. Janssen, John Yfantopolous, Gouke J. Bonsel, Juanita A. Haagsma May 2023

Cross-Sectional And Longitudinal Comparison Of Health-Related Quality Of Life And Mental Well-Being Between Persons With And Without Post Covid-19 Condition, Emily Stella Scott, Erica I. Lubetkin, Mathieu F. Janssen, John Yfantopolous, Gouke J. Bonsel, Juanita A. Haagsma

Publications and Research

Background:

Still little is known about the impact of post COVID-19 condition (PC) on health-related quality of life (HRQOL) and mental well-being. We compared participants with PC with three groups: an acute COVID-19 infection (AC) only, at least one chronic condition (CC) but no COVID-19, or no condition at all, healthy (PH). Between these disease groups, we also estimated and compared HRQOL and mental well-being change over time.

Methods:

Participants from six countries (Greece, Italy, Netherlands, Sweden, United Kingdom and United States) completed two web-based questionnaires (T1 = April–May 2020 and T2 = April–June 2022). Primary outcomes were HRQOL, measured …


Association Between Self-Reported Body Mass Index And Active Life Expectancy In A Large Community-Dwelling Sample Of Older U.S. Adults, Haomiao Jia, Erica I. Lubetkin Apr 2022

Association Between Self-Reported Body Mass Index And Active Life Expectancy In A Large Community-Dwelling Sample Of Older U.S. Adults, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Background: Obesity may have a protective effect (greater survival) in older adults, a finding known as the "obesity paradox." This study examined the association between self-reported body mass index (BMI) and active life expectancy (ALE) among older U.S. adults.

Methods: Using the Medicare Health Outcomes Survey Cohort 15 (2012 baseline, 2014 follow-up), we estimated life expectancy and ALE by participants' baseline BMI and age using multi-state models. A participant was classified as in an active state if this person reported having no difficulty for any of these six activities of daily living (ADLs).

Results: Small differences in life expectancy were …


Health Inequality Analysis In Europe: Exploring The Potential Of The Eq-5d As Outcome, Inge Spronk, Juanita A. Haagsma, Erica I. Lubetkin, Suzanne Polinder, M F. Janssen, G J. Bonsel Nov 2021

Health Inequality Analysis In Europe: Exploring The Potential Of The Eq-5d As Outcome, Inge Spronk, Juanita A. Haagsma, Erica I. Lubetkin, Suzanne Polinder, M F. Janssen, G J. Bonsel

Publications and Research

Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS).

Methods: A sample comprising the general population from Italy, the Netherlands, and United Kingdom (UK) completed the EQ-5D-5L and the EQ VAS. The level of education was selected as a proxy for socio-economic status (SES). EQ-5D-5L level sum scores (LSS) were compared against EQ VAS scores. Stratified and multivariable analyses were used to study the associations between SES and the LSS/EQ VAS relative to the presence of chronic …


Health-Related Quality Of Life And Mental Well-Being Of Healthy And Diseased Persons In 8 Countries: Does Stringency Of Government Response Against Early Covid-19 Matter?, Di Long, Juanita A. Haagsma, Mathieu F. Janssen, John N. Yfantopoulos, Erica I. Lubetkin, Gouke J. Bonsel Sep 2021

Health-Related Quality Of Life And Mental Well-Being Of Healthy And Diseased Persons In 8 Countries: Does Stringency Of Government Response Against Early Covid-19 Matter?, Di Long, Juanita A. Haagsma, Mathieu F. Janssen, John N. Yfantopoulos, Erica I. Lubetkin, Gouke J. Bonsel

Publications and Research

Objectives

Our study aimed to (1) assess health-related quality of life (HRQoL) and mental well-being of healthy and diseased persons in the general population during the early stage of the COVID-19 pandemic and (2) examine the relationship between HRQoL and mental well-being and individual characteristics and government response against COVID-19, as measured by the stringency index.

Methods

A web-based survey was administered to a cohort of persons from the general population of eight countries: Greece, Italy, the Netherlands, Russia, South Africa, Sweden, the United Kingdom (UK) and the United States of America (US) from April 22 to May 5 and …