Article Text

Contrasted trends in health-related quality of life across gender, age categories and work status in France, 1995–2016: repeated population-based cross-sectional surveys using the SF-36
  1. Anne-Caroline Clause-Verdreau1,
  2. Étienne Audureau2,3,
  3. Alain Leplège4,5,
  4. Joël Coste1,4
  1. 1 Biostatistics and Epidemiology Unit, Hôtel Dieu Hospital, Paris, France
  2. 2 Department of Public Health, APHP, CHU Henri Mondor, Creteil, France
  3. 3 CEpiA EA7376, UPEC, Créteil, France
  4. 4 APEMAC EA 4360, Paris, France
  5. 5 Laboratoire SPHERE, UMR 7219, CNRS-Université Paris Diderot - Sorbonne Paris Cité, Paris, France
  1. Correspondence to Dr Joël Coste, Biostatistics and Epidemiology Unit, Hôtel Dieu Hospital, Paris 75004, France; joel.coste{at}


Background Interest in monitoring health-related quality of life (HRQoL) in general populations has increased in the past 20 years, reinforced by population ageing and repeated economic crises. This study aims to identify temporal trends in HRQoL in France between 1995 and 2016 and to assess disparities according to demographic and socioeconomic characteristics.

Methods Data from repeated population-based cross-sectional surveys conducted in 1995, 2003 and 2016 were used. HRQoL was measured using the Medical Outcomes Study 36-item Short Form (SF-36) questionnaire.

Results A substantial decrease in score was observed between 1995 and 2016 for both genders in almost all subscales of the SF-36, with the largest decrease being in the mental health dimension for men. However, the age group 18–54 years were the most affected with persistent negative or even worsening trends in HRQoL. The largest decreases were among men aged 45–54 years and women aged 35–44 years in most dimensions, and among the age group 18–24 years in vitality. Conversely, an overall improvement was noted among the age group 65–84 years. People in employment were more affected than the unemployed by the decline in several HRQoL dimensions.

Conclusion A general decline in HRQoL was found between 1995 and 2016 in the French population, but with wide disparities in trends between age groups. Young and especially middle-aged, employed people exhibited persistent negative and worsening trends. Consistent with evidence from traditional mental health morbidity and mortality indicators, our findings raise questions about the potential influence of macro-socioeconomic factors, especially the 2008 crisis; these observations deserve special attention from health policy-makers.

  • quality of life
  • employment
  • inequalities
  • psychosocial factors
  • self-rated health

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  • Contributors JC and EA planned the study. A-CC-V did the statistical analyses and drafted the manuscript. A-CC-V, EA, AL and JC contributed to the analysis and reviewed the manuscript. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. JC and A-CC-V are the guarantors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The 1995 study was performed by SOFRES as part of the IQOLA project. All of the participants gave written informed consent before data collection. The 2003 study was performed by the National Institute for Statistics and Economic Studies. All of the participants gave written informed consent before data collection. The data were made available in the public research domain without any identification of personal information. The 2016 study were performed by IPSOS as part of a European study designed to test the psychometric properties of the PROMIS-29 questionnaire. All of the participants gave written informed consent before data collection. The study was conducted in conformity with the Declaration of Helsinki ( and with the French law on privacy.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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