A nationwide survey conducted by researchers from Hiroshima University found that the health-related quality of life (HRQoL) among working-age Japanese adults declined steadily between fiscal years 2017 and 2024. The findings, published on June 2 in Scientific Reports, highlight changes before, during, and after the COVID-19 pandemic.
The research team surveyed adults aged 20 to 85 across Japan using the EQ-5D-3L standardized questionnaire developed by the EuroQol Group. The survey measured five dimensions of HRQoL—mobility, self-care, usual activities, pain/discomfort, and anxiety/depression—across three time points: FY2017 (pre-pandemic), FY2020 (during pandemic), and FY2024 (post-pandemic). Responses were tailored for age groups and used a value set specific to Japan.
Participation rates were similar across years with valid responses at 34.0% in FY2017, 44.1% in FY2020, and 29.5% in FY2024. Over seven years, the national mean EQ-5D-3L utility score decreased from 0.9133 to 0.8834. Statistically significant declines were observed among men in their 40s to 60s and women in their 30s to 50s nationwide over all three survey periods.
Researchers also examined regional differences using Bayesian methods rather than conventional statistics due to varying sample sizes across prefectures. This approach allowed more reliable comparisons between regions with different population sizes.
"During the COVID-19 pandemic, many indirect effects on HRQoL have been reported, including reduced use of healthcare services, decreased physical activity, and worsening mental health. While this study does not directly examine causal relationships, the marked decline in HRQoL among the working-age population may reflect the cumulative impact of these behavioral and social changes. In particular, attention should be paid to the fact that this gradual decline has continued over time," said Akita.
The researchers plan ongoing monitoring of HRQoL trends nationwide as well as deeper analyses into causes for decline and international comparisons going forward. "It is necessary to continue monitoring health-related quality of life (HRQoL) nationwide while also conducting deeper analyses of the causes of its decline and comparisons with other countries," said Akita.
