Association between health-related quality of life and noncommunicable diseases in South Korea

Health-related quality of life (HRQoL) is a key indicator of population health, but its association with noncommunicable diseases (NCDs) has not been fully clarified. This study aimed to clarify the association between NCDs and HRQoL in South Korea, focusing on differences by sex, age, and household income. Under Strengthening the Reporting of Observational Studies in Epidemiology guidelines, this study examined the association between HRQoL and NCDs using data from Korean adults aged ≥19 years in the Korea National Health and Nutrition Examination Survey between 2010 and 2023. HRQoL was assessed using the European Quality of Life 5 Dimensions 3 Level (for mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and the presence of 10 major NCDs, including hypertension, myocardial infarction, stroke, dyslipidemia, kidney disease, diabetes mellitus, osteoarthritis, allergic rhinitis, asthma, and atopic dermatitis, was determined by self-reported physician diagnoses. Weighted multivariate logistic regression models were used to estimate weighted odds ratios with 95% confidence intervals for the association between HRQoL and NCDs. Among 40,985 adults (56.57% females) in the Korea National Health and Nutrition Examination Survey from 2010 to 2023, lower HRQoL was consistently associated with higher odds of NCDs, with the strongest associations observed for stroke (weighted odds ratio, 1.32 [95% confidence interval, 1.27–1.38]) and osteoarthritis (1.37 [1.33–1.42]). No significant sex differences were observed across NCDs except for stroke, for which the association with reduced HRQoL was stronger in males (1.74 [1.63–1.86]) than in females. Stratified results indicated stronger associations among younger adults, particularly those aged 30 to 39 years, with the highest odds observed for hypertension (1.37 [1.09–1.72]), myocardial infarction (2.05 [1.48–2.83]), diabetes mellitus (1.77 [1.35–2.32]), allergic rhinitis (1.31 [1.18–1.46]), and asthma (1.31 [1.18–1.46]). Inverse socioeconomic gradients were observed for osteoarthritis (2.24 [2.04–2.45]) and myocardial infarction (1.59 [1.42–1.77]), with the strongest associations found in the second-highest income quartile. Decreased HRQoL was associated with higher odds of NCDs across ten conditions in Korean adults, with the strongest associations in younger and higher-income groups. These findings underscore HRQoL as a valuable indicator for NCD management and the need for policies addressing emerging health disparities.