Gengliang Bai ^1,2 Jiawen Zhang ² Yijun Chen ¹ Lejing Cao ¹ Yong Yang ^1,2* Chao Jiang ^3*

• ¹ School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
• ² School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Liaoning Province, China
• ³ Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Liaoning Province, China

Background：Due to the rising standard of living and advances in public health and medical care in recent years in China, the health-related quality of life (HRQoL) has been increasingly acknowledged as an important part of health management of adults. This study aimed to analyze the HRQoL of Chinese adults and identify the influencing factors, proposing specific recommendations for improvement. Methods：A cross-sectional study was conducted among 1,291 selected adults from four provinces spanning different regions in China aged ≥ 18 years from July 2021 and January 2022. The EuroQol-5D-5L (EQ-5D-5L) was used to conduct the HRQoL survey, and a general questionnaire was administered to collect demographic characteristics, general information, and health behaviors of participants. The health utility value was measured, and one-way analysis of variance was performed. The Tobit regression model was employed to analyze the factors influencing the HRQoL of Chinese adults. Results：The mean health utility values and visual analogue scale scores for adults were 0.9400 ± 0.1197 and 84.09 ± 14.392, respectively. Notably, 60.3% of respondents reported no difficulties in any of the five dimensions of EQ-5D. However, a substantial proportion faced challenges in anxiety/depression (27%) and pain/discomfort (26.2%). Tobit regression model revealed that age, marital status, educational level, diet, sleep, mental state, mood, and chronic diseases significantly impact the HRQoL of Chinese adults. Conclusions: The HRQoL among Chinese adults is generally satisfactory, but pay particular attention on areas such as pain, psychological anxiety, chronic diseases, and negative emotions is needed. The factors such as stress associated with marriage and the demands of high-skilled occupations might influence the overall health of the population. According to our findings, public health strategies to improve HRQoL should be developed to promote relatively healthy environments and lifestyles for older adults. Moreover, proactive measures are crucial for mitigating the potential health impacts associated with marital stress and high-skilled employment.