Differences in health-related quality of life between Roma and non-Roma coronary heart disease patients: The role of hostility

Objectives: The aim of this study was to assess differences in health-related quality of life (HRQoL) between Roma and non-Roma coronary heart disease (CHD) patients, and whether differences in hostility contribute to this association. Methods: We examined 570 CHD patients (mean age 57.8, 28.1 female) scheduled for coronary angiography, 88 (15.4 ) of whom were Roma. Hostility was measured using the 27-item Cook-Medley Scale and HRQoL using the Short-Form Health Survey 36, from which the mental and physical component summary (MCS, PCS) were calculated. The relationship between ethnicity, hostility and HRQoL was examined using regression analyses. Results: Roma ethnicity was associated with poorer MCS (B = -3.44; 95 % CI = -6.76; -0.13 and poorer PCS (B = -4.16; 95 % CI = -7.55; -0.78) when controlled for age, gender and socioeconomic status. Adding hostility to the model weakened the strength of the association between Roma ethnicity and MCS (B = -1.87; 95 % CI = -5.08; 1.35) but not between Roma ethnicity and PCS (B = -4.07; 95 % CI = -7.50; -0.64). Conclusions: Roma ethnicity is associated with poorer MCS and PCS. Hostility may mediate the association between Roma ethnicity and MCS. The poorer HRQoL of Roma CHD patients requires attention in both care and research, with special attention on the role of hostility. © 2013 Swiss School of Public Health.