Perceived stress hits adults living with two or more chronic conditions twice as hard as those without long-term illnesses, according to a University of Eastern Finland study published in Health Promotion International.
Chronic Disease Burden Multiplies Stress Impact
Researchers analyzed survey data from 4,003 Finnish adults aged 19 to 79 collected through the PROM 2024 online survey. Nearly three in four respondents reported at least one long-term health condition, while almost half reported two or more. These conditions included high blood pressure, high cholesterol, migraine, and back problems among 21 listed long-term ailments.
Health-related quality of life was measured using the EQ-5D-5L instrument across five everyday domains: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression.
Higher perceived stress linked to poorer quality of life across all participants, even after adjusting for age, gender, education, employment, and financial strain. For individuals managing two or more conditions, a given increase in stress correlated with an approximately twofold larger decline in quality of life compared to healthy respondents.
“Living with several conditions can mean managing appointments, medication routines and information from different services,” said Jing Zhou, a postdoctoral researcher at the University of Eastern Finland. “Our findings suggest that stress deserves particular attention when considering quality of life among people facing these demands.”
Health Literacy Relates to Lower Stress Levels
The study also examined health literacy, defined as an individual’s ability to find, understand, evaluate, and use health information for daily decisions. Adults who reported easier access to and comprehension of health information tended to report lower stress levels across all three study groups.
Researchers said that much of the statistical association between health literacy and quality of life operated directly through perceived stress. Professor Tomi Mäki-Opas pointed out the practical hurdles facing patients with complex health profiles.
“From a health policy perspective, making health information easier to understand is important, but people managing several conditions may also face substantial practical demands,” Mäki-Opas said.
Next Steps in Chronic Care Research
Because the cross-sectional data collected information at a single point in time, the study could not establish cause and effect. Poorer health status may elevate stress levels, just as heightened stress can diminish a patient’s overall quality of life.
Future longitudinal and intervention studies will test specific approaches combining accessible health information, coordinated care services, and targeted stress support. Mäki-Opas said that researchers need to search for effective solutions to better coordinate care and provide easier access to support systems.
Questions About the PROM 2024 Study Findings
How many chronic conditions were included in the study?
Participants reported on 21 long-term health problems, which included high blood pressure, high cholesterol, migraines, and back issues.
What age group did the survey cover?
The PROM 2024 online survey gathered responses from 4,003 adults living in Finland aged 19 to 79.
Can this study prove that stress directly causes lower quality of life?
No, the researchers emphasized that the study describes a statistical association rather than a causal effect because data was measured at a single point in time.