Applied Research in Quality of Life

, Volume 13, Issue 1, pp 179–195 | Cite as

Health-Related Quality of Life in a Low-Socioeconomic Status Public Rental-Flat Population in Singapore

  • Liang En Wee
  • Peter Daniel
  • Aline Sim
  • Rui Lee
  • Sook Muay Tay
  • Nan Luo
  • Gerald Choon-Huat Koh


Health-related quality of life (HRQoL) is a well-established measure of health and general well-being. Socioeconomic status (SES) can affect HRQoL. We sought to determine whether there were differences in HRQoL between low versus higher area-SES flat communities in Singapore. Residents in two integrated public housing precincts comprising of rental-flat blocks (low area-SES neighborhood) and neighboring owner-occupied blocks (higher area-SES neighborhood) were asked to rate their self-perceived HRQoL using the EuroQol Group five dimensions (EQ-5D) instrument. The EQ-5D assesses HRQoL in five domains (mobility, self-care, usual activities, anxiety/mood and pain) and with a global visual analogue scale (EQ-VAS). We evaluated differences in HRQoL between the rental and owner-occupied neighborhoods, and factors associated with anxiety/depression in the rental-flat neighborhood using multivariate logistic regression. The participation rate was 89.1% (634/711). In the owner-occupied neighborhood, 56.7% (216/381) were in full health, compared with 54.2% (137/253) in the rental-flat population (OR = 0.90, 95%CI = 0.66–1.24, p = 0.568). Across the five domains, staying in a rental-flat neighborhood was independently associated with anxiety/depression (adjusted odds ratio [aOR] = 1.79, 95%CI = 1.10–2.92, p = 0.019). In the rental-flat population, having anxiety/depression was independently associated with minority ethnicity, problems with self –care, pain/discomfort, difficulty with healthcare costs, and not being on subsidized primary care (p < 0.05). There was no significant difference on the EQ-VAS between the two neighborhoods (p = 0.627). Staying in a low area-SES neighborhood was associated with more mental health problems. In the rental-flat population, self-reported anxiety/depression was associated with minority ethnicity, physical health problems, and financial disadvantage in healthcare.


Health-related quality of life Low income Socioeconomic status Anxiety 



We thank the Neighborhood Health Screening Organising Committee; Saw Swee Hock School of Public Health; Yong Loo Lin School of Medicine, National University of Singapore for providing the non-financial resources to organize this program and supporting this study.

Compliance with Ethical Standards

Conflict of Interest

The authors report no conflict of interest.


Saw Swee Hock School of Public Health provided funding support for the purchasing of medical consumables. WLE was supported by a Pitch-For-Funds grant from the Division of Medicine, Singapore General Hospital, Singapore.


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Copyright information

© Springer Science+Business Media Dordrecht and The International Society for Quality-of-Life Studies (ISQOLS) 2017

Authors and Affiliations

  • Liang En Wee
    • 1
  • Peter Daniel
    • 2
  • Aline Sim
    • 2
  • Rui Lee
    • 2
  • Sook Muay Tay
    • 3
  • Nan Luo
    • 4
  • Gerald Choon-Huat Koh
    • 4
  1. 1.Singhealth Internal Medicine ResidencySingapore General HospitalSingaporeSingapore
  2. 2.Yong Loo Lin School of Medicine, National University Health SystemNational University of SingaporeSingaporeSingapore
  3. 3.Department of AnesthesiaSingapore General HospitalSingaporeSingapore
  4. 4.Saw Swee Hock School of Public Health, National University Health SystemNational University of SingaporeSingaporeSingapore

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