Researching health-related quality of life at a community level: results from a population survey conducted in Burgas, Bulgaria.

Researching health-related quality of life (HrQoL) at a community health promotion level is an approach to understand the health inequalities. The objective of this study is to measure the health of a representative sample by conducting a population survey in Burgas by using the EuroQoL EQ-5D-3L questionnaire, and further to assess the influence of socio-economic, demographic and behavioural factors on HrQoL. The relationship between HrQoL and social capital is analysed through a network-based approach. The achieved ambition was to build the public health capacity of the key stakeholders in order to support decision making. A cross-sectional study was conducted in 2011 using a representative sample of the citizens of Burgas (n = 1050, >18 years old). Respondents were selected through the method of two-stage random selection. HrQoL was assessed by the standardized EQ-5D-3L questionnaire. People without any problem in all five dimensions represent only 26.5% (n = 278) of the respondents, whereas 52.2% (n = 548) reported a moderate problem in at least one dimension; any extreme problem reported 11.6% (n = 122) of the respondents. The mean state of health recorded on the Visual Analogue Scale was 70 (SD ±23). There were differences in self-reported health based on the respondent's age, occupation, education, income, smoking behaviour and membership in community groups. People who have hobby and practice sports assessed their health status higher. The results were communicated in a following Delphi-study; a consensus has been reached that the combination of routine measures of health with measurement of self-rated health could provide better understandings of the community health needs.