Social Determinants of Health-Related Quality of Life: A Recreation Setting Analysis

Health Promot Pract. 2020 Nov;21(6):952-961. doi: 10.1177/1524839919827572. Epub 2019 Feb 20.


Objective. To determine if significant differences between park users and non-park users are associated with scores on a composite health-related quality of life (HRQoL) index. Methods. Data for this study were collected based on random intercept of a cross section of eligible Monroe County, Indiana, residents at four selected public recreational parks, as well as nonpark locations from July to December 2017. Based on data collected using validated survey items, we created a composite HRQoL index. Statistical analysis included independent-samples t test, chi-square cross-tabulation, bivariate regression, and multivariate regression. Results. Frequent park users were significantly different from nonfrequent park users in various respects. The most leisure-time physical activity (LTPA) experiences of frequent park users occurred at a park location. Body mass index and park-based LTPA were significantly positively associated with HRQoL scores in a linear regression model. Conclusion. Frequent park use was shown to be positively associated with increased park-based LTPA and HRQoL. It is therefore possible that increasing park visitation will result in more members of a community who report experiencing their LTPA at a park location. Study outcomes lend support to the validity of a composite HRQoL index for population health assessments.

Keywords: behavior change; chronic disease; community assessment; community intervention; exercise; health promotion; obesity; physical activity; program planning and evaluation; social determinants of health; surveys.

MeSH terms

  • Environment Design
  • Exercise
  • Humans
  • Indiana
  • Parks, Recreational
  • Public Facilities
  • Quality of Life*
  • Recreation
  • Residence Characteristics
  • Social Determinants of Health*