OBJECTIVES: Health is influenced by many factors, of which social determinants of health (SDH) are one type of non-medical factor. In Japan, introduction of a questionnaire concerning SDH in diabetes and other lifestyle-related diseases is being considered for specified medical checkups. This study examines the association between health-related quality of life (HRQoL) and SDH for diabetes patients compared with that of the general population in Japan using cross-sectional patient survey data.

METHODS: Data from the 2022 Patient Mindscape® survey was used. Patient Mindscape® is a Japanese nationwide patient-reported outcomes survey conducted annually among 500,000+ patients for 80+ conditions. Two populations were included: 1) Patients aged 40 or older that reported suffering from diabetes only within the past one year and 2) General persons aged 40 or older having no drug-treated disease within the past one year. SDH were defined as gender, employment status, household income, marital status, number of children living with the family, and presence of diabetes among cohabiting family members. EQ-VAS scores were used as a measure of HRQoL. Linear regression models were used to examine the association between HRQoL and SDH for each population. A p value of less than 0.05 was considered statistically significant.

RESULTS: 2,390 diabetes patients and 75,916 general persons were analyzed. For general persons, while household income and marital status had a statistically significant positive association with HRQoL, employment status had a statistically significant negative association. A similar trend was observed for diabetes patients, with a strong association for household income more than 3 million yen, marital status and employment status.

CONCLUSIONS: There are differences in the strength of the association between HRQoL and SDH factors for diabetes patients compared to the general population in Japan. As such, it is important to consider policy initiatives taking into consideration the strength of the association between HRQoL and SDH.