Health-Related Quality of Life and Bereavement in the 2019 Georgia Behavioral Risk Factor Surveillance System

Poor Self-Rated Health (SRHp) is part of a four-item scale for self-assessment. SRH from the 2019 Behavioral Risk Factor Surveillance Survey (BRFSS) is used to test hypotheses linking population-level well-being influenced by bereavement due to the death of a close friend or relative. By linking the prevalence rates of population-level well-being with exposure to bereavement, we extend our knowledge of this exposure beyond single-person studies. SRHp and bereavement were asked about in the 2019 field survey of 7354 adults aged 18 years and older. Multiple imputation was applied to handle missing values. Data modeling included adjusted logistic regression and mediation analyses. In the total sample, the prevalence rate of SRHp was 23.1% and the rate of bereavement was 45.5%. The SRHp subgroup had a significantly greater prevalence of bereavement (24.9% versus 21.6% compared to all other SRH categories combined). Elevated bereavement rates were also observed for the group with poor physical health (18.3% versus 14.9%) and poor mental health (17.5% versus 12.8%). Multiple losses (three or more deaths) increased the risk for SRHp by 42% in adjusted logistic models. Although these are cross-sectional data, the analyses provide evidence that bereavement is more common among people engaged in negative health behaviors. In mediation analyses, bereavement increases the prevalence of SRHp by 56.8% through an indirect effect on smoking. Bereavement also increased the rate of SRHp by 40.7% through an indirect effect on obesity. More research is needed to evaluate the association between bereavement and health behavior.