Health domains and race in generic preference-based health-related quality of life instruments in the United States literature

Abstract

Race differences in health have been extensively analyzed and documented in the literature, especially between African Americans or blacks and whites in the United States. Despite the vast literature in the area, the majority of studies that explore the relationship between race and health use outcomes such as selfrated health, mortality or morbidity, and disability, but very few use Health-Related Quality of Life (HRQoL) measures and their domains or dimensions. This narrative review aims to provide a better understanding of the relationship between race and health domains that are commonly used in preference-based HRQoL measures. We investigated the literature on race, physical health, mental health, pain and discomfort, cognition, neurologic spectrum domains, dexterity, ambulation, vitality and social functioning domains. We conducted a literature search and review using the key words race and the health domain of interest, using medical and social sciences databases, such as MEDLINE/Pubmed, Web of Science, and the Google Scholar portal.The majority of the studies identified in the literature show that African Americans or blacks in the United States tend to have lower scores than whites throughout a variety of health domains found in preference-based HRQoL measures. This review also emphasizes the scarcity of studies that investigate some health domains, such as social functioning, dexterity, vitality and neurologic spectrum domains, and therefore we identify the need for more studies focusing on race and measures that address such domains.