Construct validity of SF-6D health state utility values in an employed population
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Health utility values permit cost utility analysis in workplace health promotion; however, utility measures of working populations have not been validated.
To investigate construct validity of SF-6D health utility in a public service workforce.
SF-12v2 Health Survey was administered to 3,408 randomly selected public service employees in Australia in 2010. SF-12 scores were converted to SF-6D health utility values. Associations and correlates of SF-6D with health, socio-demographic and work characteristics [comorbidities, body mass index (BMI), Kessler-10 psychological distress (K10), education, salary, effort-reward imbalance (ERI), absenteeism] were explored. Ceiling effects were analysed. Nationally representative employee SF-6D values from the Household, Income and Labour Dynamics in Australia (HILDA) survey (n = 11,234) were compared. All analyses were stratified by sex.
Mean (SE) age was 45.7 (0.35) males; 44.5 (0.22) females. Females represented 72 % of the sample. Mean (SE) health utility 0.792 (0.004); 0.771 (0.003) was higher in males. SF-6D demonstrated both a significant inverse association (p < 0.01) and negative correlations (female; male) with K10 (r = −0.63; r = −0.66), comorbidity count (r = −0.40; r = −0.33), ERI (r = −0.37; r = −0.34) and absenteeism (p < 0.005, r = −0.25; r = −0.21). Mean (SE) SF-6D in HILDA was 0.792 (0.002); 0.775 (0.003) males; females. Correlates and associations in all samples were similar. The general employed demonstrated a significant inverse association with age and positive association with salary. SF-6D was independent of BMI.
Psychological distress, comorbidity, effort-reward imbalance and absenteeism are negatively associated with employee health. SF-6D is a valid measure of perceived health states in working populations.
KeywordsSF-6D Health utility SF-12 SF-36 Employee Workplace health promotion
HILDA staff, Nicole Watson (Senior Research Fellow and HILDA Deputy Director of Survey Methodology, Melbourne Institute) and Professor Robert Bruenig (Australian National University) ‘This paper uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either DSS or the Melbourne Institute.’ NHMRC Grant No. H0010501.
Conflict of interest
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