A comparison of health-related quality of life and personal, social, and environmental factors of older adults according to a residential area: a propensity score matching analysis.

Purpose: This study identified individual, social, and environmental factors affecting the health-related quality of life (HRQoL) of older individuals living in urban and non-urban areas of the Republic of Korea and investigated their effects on HRQoL.

Methods: A secondary data analysis study was conducted using raw data from Korea's 2017 Community Health Survey. Propensity score matching (PSM) was performed to compare the individual, social, and environmental characteristics of older individuals living in urban and non-urban areas (16,695 and 29,106 individuals, respectively). Statistical analyses were performed using R program 4.0.5. The differences between variables were analyzed using chi-squared and t-tests, whereas factors influencing HRQoL were analyzed using multiple regression analysis.

Results: Among the individual factors, the living arrangement (p = 0.001, confidence interval [CI] = 0.00-0.02) was an influencing factor in urban areas, whereas it showed no statistical significance in non-urban areas. Moreover, Helping their neighbors (p = 0.001, CI = 0.00-0.01) among the social factors and satisfaction with the living environment (p = 0.011, CI = 0.00-0.02) and with healthcare services (p = 0.047, CI = 0.00-0.01) among the environmental factors were influencing factors in urban areas, whereas they showed no statistical significance in non-urban areas.

Conclusion: Satisfaction with the living environment and with healthcare services was positively associated with HRQoL among older individuals living in urban areas. Therefore, factors associated with regional health inequality should be identified, and health equality sought through the development of local government policies that consider diversity in population composition and health indicators by region.