Effect of the Physical Environment on the Health-related Quality of Life of the Low-income Korean Elderly Population

  • Seonhye LEE Dept. of Nursing, Gyeongnam National University of Science and Technology, 33, Dongjin-ro, Jinju-si, Gyeongsangnam-do, 52725, Republic of Korea
  • Chang Heon CHEONG Mail Dept. of Architectural Engineering, Gyeongnam National University of Science and Technology, 33, Dongjin-ro, Jinju-si, Gyeong-sangnam-do, 52725, Republic of Korea
Elderly, Health, Korean community health survey, Low income, Quality of life


Background: The increasing number of elderly citizens due to changes in the social structure is of national interest. This study aimed to provide basic data for devising policies to promote the quality of life of elderly National Basic Livelihood Security System (NBLSS) beneficiaries in South Korea by identifying the effects of their general characteristics and physical environment on their health-related quality of life (HRQoL).

Methods: Using the 2013 Korean Community Health Survey (KCHS) raw data, we analyzed 3537 NBLSS beneficiaries aged 65 yr and older. HRQoL was measured using the Euro QoL five-dimension questionnaire (EQ-5D). Hierarchical multiple regression analyses were used to predict the EQ-5D scores.

Results: The explanatory power for HRQoL increased to 21.4% when the general characteristics and physical environment were included. HRQoL showed statistically significant differences in the environmental variable, level of safety (P=0.001), natural environment (P=0.001), living environment (P=0.001), traffic condition (P<0.001), and access to health services (P<0.001). Physical environment positively correlated with HRQoL(r=.119, P<0.001), thus confirming its influence (ß=.092, P<0.001).

Conclusion: We should strive to manage the physical environment to improve the quality of life of elderly NBLSS beneficiaries.




1. Kim HY, Oh KS, Oh KO et al (2008). [Quality of life in low-income Korean Aged]. J Korean Acad Nurs, 38(5): 694-703.
2. Ministry of Health and Welfare (2014). 2014 National Basic Livelihood Security Recipi-ents Status.
3. Bak SS, Kim KS, Choi JH (2010). Quality of life of older women living alone –National Basic Livelihood Act Recipients. J Korean Gerontol Nurs, 12(3): 248-55.
4. Kim HK, Lee HJ, Park SM (2010). Factors influencing quality of life in elderly wom-en living alone. J Korean Gerontol Soc, 30(2): 279-92.
5. Kim JI (2013). Levels of health-related quali-ty of life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas. J Korean Acad Community Health Nurs, 24(1): 99-109.
6. Ferrans CE, Zerwic JJ, Wilbur JE, Larson JL (2005). Conceptual model of health-related quality of life. J Nurs Scholarsh, 37(4):336-42.
7. Kang EJ, Shin HS, Park HJ, Jo MW, Kim NY (2006). A valuation of health status using EQ-5D. Korean J Health Econ Policy, 12(2): 19-43.
8. Thiem U, Klaaβen-Mielke R, Trampish U et al (2014). Falls and EQ-5D rated quality of life in community dwelling seniors with concurrent chronic diseases: a cross-sectional study. Health Qual Life Outcomes, 8;12:2.
9. Sultana M, Sarker AR, Mahumud RA et al (2016). Inequalities in health status from EQ-5D findings; a cross-sectional study in low-income communities of Bangla-desh. Int J Health Policy Manag, 5(5): 301-8.
10. Sun S, Chen J, Johannesson M et al (2011). Population health status in China: EQ-5D results, by age, sex and socio-economic status, from the National Health Services Survey 2008. Qual Life Res, 20(3): 309-20.
11. Garcia-Gordillo MA, Collado-Mateo D, Olivaresd PR, Adsuar JC (2016). Applica-tion of EQ-5D-5L questionnaire in pa-tients suffering from urinary inconti-nence. Actas Urol Esp, 40(7): 457-62.
12. Chin YR, Lee IS, Lee HY (2014). Effects of Hypertension, Diabetes, and/or Cardio-vascular Disease on Health-related Quali-ty of Life in Elderly Korean Individuals: A Population-based Cross-sectional Sur-vey. Asian Nurs Res (Korean Soc Nurs Sci), 8(4): 267-73.
13. Srinivasan S, O’Fallon LR, Dearry A (2003). Creating healthy communities, healthy homes, healthy people: initiating a re-search agenda on the built environment and public health. Am J Public Health, 93(9): 1446-50.
14. Cho NS, Hwang EJ (2014). A Comparative study on conditions of a livable city. Soc Sci Gen Studies, 32(2): 235-67.
15. Joung YJ, Lee SK (2015). The study on the causality among built environment, social relationship, and health of the elderly. J Korean Region Develop Assoc, 27(2): 75-94.
16. Sung HG (2011). A study on the impacts of residential neighborhood built environ-ment on personal health indicators–focused on the planning elements of transit-oriented development. J Korea Plan Assoc, 46(3): 235-51.
17. Lee JA, Park JH, Kim M (2015). Social and physical environments and self-rated health in urban and rural communities in Korea. Int J Environ Res Pub Health, 12(11): 14329-41.
18. Kim KR (2015). Policy considerations for the living conditions of older Koreans. Health Welfare Forum, 223: 68-78.
19. Kim HR (2014). Predicting factors of health related quality of life among older adults at senior centers in Korea. J Korean Geron-tol Nurs,16(2): 95-106.
20. Brooks R, Rabin RM, Charro F (2005). The measurement and valuation of health status using EQ-5D. Dordrecht: The Netherland Kuwer Academic Publisher.
21. Korea Centers for Disease Control (2010). South Korean time trade-off values for EQ-5D health states. Seoul, Korea: Korea Centers for Disease.
22. Lee HK, Cho SH, Kim JH, Choo HI (2014). [Influence of self-efficacy, social support and sense of community on health-related quality of life for middle-aged and elderly-residents living in a rural commu-nity]. J Korean Acad Nurs, 44(6): 608-16.
23. Korean Society for the Study of Obesity (KSSO) (2000). Obesity diagnostic criteria. Guide to obesity treatment. Seoul: Han-wui hak.
24. Hong SW (2009). [Factors influencing health-related quality of life in Korean Medicaid beneficiaries]. J Korean Acad Nurs, 39(4): 480-9.
25. Chung SS, Joung KH (2010). Predictors of Health-related Quality of Life (HRQoL) in the home-dwelling disabled persons by using EQ-5D: results from the 3rd Korea National Health and Nutritional Examination Survey 2005. J Korean Acad Adult Nurs, 22(3): 291-302.
26. Fortin M, Lapointe L, Hudon C et al (2004). Multimorbidity and quality of life in pri-mary care : A systematic review. Health Qual Life Outcomes, 2:51.
27. Aghamolaei T, Tavafian SS, Zare S (2011). Determinants of health related quality of life on people living in Bandar Abbas, Iran. Iran J Public Health, 40(3): 128-35.
28. Yim ES, No KH (2010). The effects of re-lated factors on health-related quality of life for the frail elderly. J Korean Acad Community Health Nurs, 21(1): 12-20.
29. Ko HY, Lee JK, Shin JY, Jo E (2015). Health-related quality of life and cardio-vascular disease risk in Korean adults. Ko-rean J Fam Med, 36(6): 349-56.
30. Chang NT, Chi LY, Ysnh NP, Chou P (2010). The impact of fall and fear of fall-ing on health-related quality of life in Taiwnaese Elderly. J Community Health Nurs, 27(2): 84-95.
31. Ferándex-Portero C, Alrcón D, Padura ÁB (2017). Dwelling conditions and life satis-faction of older people through residen-tial satisfaction. J Environ Psychol, 49: 1-7.
32. Kim WJ, Kim TY (2013). A study on the neighborhood physical and social envi-ronment and health: The mediating role of perceived environments. Journal of Community Welfare, 46: 23-47.
How to Cite
LEE S, CHEONG CH. Effect of the Physical Environment on the Health-related Quality of Life of the Low-income Korean Elderly Population. Iran J Public Health. 47(12):1865-1873.
Original Article(s)