The way in which people value health is likely to vary across countries, due to social and cultural factors. In Muslim-majority countries such as the United Arab Emirates (UAE), for example, people’s religious views may lead to particular ways of thinking about the trade-offs between quality of life, length of life, and death. The UAE is also unique in terms of its health needs and the medical-seeking behaviour of its population.
Just published in BMJ Open is a qualitative study of the effect of religion on the perception of health states amongst a sample of adult Emiratis. The paper reports findings from a follow-up questionnaire administered as part of a broader study examining the feasibility of using stated preference methods to elicit EQ-5D-5L values in the UAE. The feasibility study reported evidence of striking differences in the way that Emiratis valued health states compared with other cultural groups.
Eighty-one percent of survey respondents claimed that their perception of health states was influenced by their spiritual or religious beliefs. Thematic analysis was used to analyse responses to the follow-up questions. The authors identified a recurring theme of fatalism, comprising three subthemes:
- Inevitability and invincibility – individual life conditions depend heavily on God and are thus inevitable.
- Powerlessness, helplessness or submission – respondents emphasised their powerlessness with respect to their health conditions, stating that they can only submit to God and accept his will.
- Unacceptability of certain ideas – for example, the unacceptability of consciously avoiding death, which is in God’s power.
A second main theme identified was the preservation of life. This theme comprised subthemes relating to appreciation, fear, acceptance and patience. Several respondents made comments suggesting that the valuation questions had made them appreciate their health and reminded them to be more religious.
The study has provided insight into the ways that religious and spiritual beliefs influence health state values amongst adult Emiratis. The findings emphasise the need for further work to establish locally relevant value sets for Middle Eastern countries for use in decision making, rather than relying on value sets from other regions.
The research was undertaken by OHE’s Koonal Shah and Nancy Devlin in collaboration with researchers at the United Arab Emirates University and Eli Lilly & Company. The feasibility study was summarised in a previous OHE blog.
The paper is available for free download here(open access).
Elbarazi, I., Devlin, N.J., Katsaiti, M.S., Papadimitropoulos, E.A., Shah, K.K. and Blair, I., 2017. The effect of religion on the perception of health states among adults in the United Arab Emirates: a qualitative study. BMJ Open, 7, e016969.
Related OHE research:
- A paper in Quality of Life Research exploring differences between Japan and two European countries in the self-reporting and valuation of pain and discomfort [available open access].
- A paper in Value in Health Regional Issues reporting the feasibility study upon which this qualitative research was based.