The impact of community based prevention on quality of life – the necessity to control for general health trends. The Northern Sweden MONICA Study in 2014

Abstract

Background: The Västerbotten intervention program (VIP), is a public health promotion program in northern Sweden with the aim of preventing cardiovascular disease. Positive effects on risk factors and risk of coronary heart disease have been reported although the evidence is not unequivocal. Since only historical controls have been used, effects from other sources than the program have largely been uncontrolled for and health related quality of life (QoL) has not been evaluated. Aim: By using the neighbouring county of Norrbotten (NB) as the reference population, we compare QoL in Västerbotten (VB) and in NB. Method: The Northern Sweden MONICA survey in 2014 examined a random sample from the two counties. QoL was measured with the EQ-5D-3L. In total, 1112 subjects participated aged 40-74 years, 516 in VB and 594 in NB. Results: Average QoL measured by the EQ-5D-index was 0.798 in VB and 0.811 in NB, a difference of 0.013 (p=0.2, CI -0.009 to 0.036). For subjects aged 45-54 years, the QoL was lower in VB than in NB, a difference of 0.048 (p=0.041; CI 0.002 to 0.0094). In NB, QoL decreased with age, a pattern not seen in VB. Men had higher QoL than women, and university educated had higher QoL than those without university education. EQ-VAS showed similar results. Subjects from NB and from VB did not differ regarding age, gender and level of education. Conclusion: We found similar levels of QoL in VB and in NB.