Social determinants of health and quality of life among Korean Americans with chronic hepatitis B

Hepatitis B virus (HBV) infection disproportionately affects Korean Americans, who often experience persistent social and structural challenges that may influence quality of life. Recent community studies showed most Korean Americans with chronic hepatitis B (CHB) were disengaged from clinical care, emphasizing the need to better understand factors affecting their well-being. This study examined associations between social determinants of health (SDOH) and physical and mental health related quality of life (HRQoL) among Korean Americans with CHB. A total of 365 CHB patients completed the enrollment survey. SF-12 was used to measure quality of life, calculating physical and mental components summary scores (PCS-12 and MCS-12). SDOH were measured across five domains, including education (highest education level, survey language), economic stability (employment, income, financial sufficiency), social/community context (marital status, social support), neighborhood (perceived social cohesion, physical disorder), and health care access (primary care provider, health insurance). Descriptive statistics and multivariable linear regression were used. Participants had a mean age of 60.1 years, and 44% were female. In multiple linear regression analyses, being employed (PCS β = 1.77, 95% CI: 0.16–3.38; MCS β = 1.99, 95% CI: 0.38–3.61) and financial sufficiency (PCS β = 2.38, 95% CI: 0.44–4.32; MCS β = 3.93, 95% CI: 1.98–5.87) was positively associated with PCS-12 and MCS-12 scores. Social support (β = 0.17, 95% CI: 0.09–0.25) and perceived neighborhood social cohesion (β = 0.24, 95% CI: 0.01–0.47) were associated with better mental health, while being married (β = 2.62, 95% CI: 0.76–4.47) was associated with better physical health. In addition, females (β = -2.52, 95% CI: -3.93 to -1.10) had lower levels of physical health than males. Older adults reported worse physical (β = -0.13, 95% CI: -0.21 to -0.05) but better mental health (β = 0.18, 95% CI: 0.10–0.25). Economic stability, social support, and neighborhood cohesion are the key determinants of quality of life among Korean Americans with CHB. These findings emphasize the need for interventions that address both structural and psychosocial factors to improve quality of life in this underserved population.