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Impact of war on health related quality of life in Croatia: population study.

AIM
To present health-related quality of life in post-war Croatia, focusing on the population as a whole rather than on the specific group of people.


METHOD
The study was conducted in six Croatian counties in the 1997-1999 period. Three of those counties had been directly affected by the 1991-1995 war. The sample consisted of 1,297 randomly selected respondents aged 18 years and older. The questionnaire was anonymous, consisting of questions on sociodemographic characteristics of respondents and Medical Outcome Study 36-item short-form health survey (SF-36). SF-36 comprised the following nine subscales: physical functioning (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role-emotional (RE), mental health (MH), and health transition (HT).


RESULTS
Mean subscale scores for the areas directly affected by war were PF 64.21; RP 52.70; BP 59.35; GH 49.02; VT 49.52; SF 68.29; RE 63.02; MH 57.95; HT 41.28; and for the areas not affected by war were PF 65.35; RP 62.01; BP 61.79; GH 50.45; VT 49.40; SF 71.41; RE 74.11; MH 60.33; HT 45.14. The two areas differed significantly in RP (p<0.001), SF (p=0.035), RE (p<0.001), MH (p=0.038), and HT (p=0.003). Respondents living in the areas directly affected by war achieved lower total health-related quality of life scores. Younger respondents, respondents with secondary education, and those with lower income were the groups mostly affected by war.


CONCLUSION
War affects self-perceived health, physical ability, and emotional and mental health of the entire population affected by war, especially younger age groups, those with lower education, and lower income.