Mental health and health-related quality of life in Croatian island population

Aim To explore differences in self-perceived health as an indicator of health status and mortality, in six isolated populations from Croatian islands and to compare the results with control from general Croatian population obtained through the National Health Survey. Method Health-related quality of life was measured using the Short Form Health Status Questionnaire (SF-36). The questionnaire was administered to 600 participants, inhabitants of 6 villages: Rab, Barbat, Lopar, and Supetarska Draga on island Rab, and Komiza and Vis, on island Vis, and to control group of 600 participants from the general Croatian population matched by age and gender to islanders. Results The islanders scored higher than controls on 3 out of 8 health dimensions, physical functioning (80.1 +/- 22.4 vs 73.2 +/- 24.8, P < 0.001), vitality (61.0 +/- 20.3 vs 55.7 +/- 19.9, P < 0.001), and pain (70.1 +/- 28.0 vs 65.9 +/- 26.5, P = 0.008). Social functioning of islanders was significantly lower than in control group (73.4 +/- 18.6 vs 77.6 +/- 23.4, P = 0.001). There was also a significant variation in health status among the islanders according to the isolation level, with the largest differences in general health perception and mental health. High isolation group reported the lowest score of all groups on mental health (P = 0.018), physical functioning (P = 0.045), general health (P = 0.001), and vitality dimension (P = 0.027). Conclusion Inhabitants of Croatian islands in general showed better health-related functioning on the most of the health dimensions than general population. Islanders scored lower than controls only on social functioning which can be explained by their geographical isolation and small population. Low mental health score of islanders in the highly isolated group should be taken in account in planning health services for islands.