Health related quality of life and well-being: The case of Somali refugees living in the community

Healthy People 2020 is monitoring health related quality of life (HRQoL) and well-being to measure the effects of chronic illnesses and disabilities in the everyday lives of people.  Healthy People 2020 is using the Patient Reported Outcomes Measurement Information System (PROMIS), a global health measure assessing global physical, mental, and social HRQoL.  Healthy People 2020 also acknowledges the need for further methodological development of HRQoL measures.  We propose that the World Health Organization’s Quality Of Life instrument (WHOQOL) be more widely used because it is a community based measure, unlike most HRQoL measures (PROMIS), that are hospital based.  We have adapted, translated, and validated the 26-question World Health Organization’s Quality Of Life instrument (WHOQOL-BREF) to the Somali language. The WHOQOL-BREF measures a person’s physical health, psychological health, social relationships, and environment. This HRQoL instrument has already been validated in many languages, including English, Spanish, and Farsi.  It has the ability to compare quality of life from vastly different cultural groups living in the community on the same scale, and across time.  We validated the WHOQOL-BREF with 300 Somali refugees in Ohio who are experiencing different levels of health impairment.  Refugees and immigrants often struggle with numerous daily stressors that induce health disparities during their resettlement in the United States.  WHO anticipates that the WHOQOL-BREF can be used for health policy research, and we will use it to evaluate health and social policies addressing health disparities among refugee and immigrant communities living in similar or different regions of the United States.