Why Gender Matters for the Quality of Life of University Students: The Role of Socioeconomic Status, Health Behaviors, and Clinical Conditions

Purpose To assess QoL and its associated factors among Brazilian university students, with analyses stratified by gender to identify gender-specific predictors. Design Cross-sectional epidemiological study. Setting Undergraduate students enrolled in higher education institutions located in Brazil. Subjects 1.616 undergraduate students of both genders, aged 18 years or older. Measures Participants completed a sociodemographic and health questionnaire and the EUROHIS-QOL-8 index. Analysis Descriptive analyses, bivariate comparisons, multiple linear regression models, and moderation analyses, overall and stratified by gender, were applied to identify independent predictors of QoL. Results Male students reported higher overall QoL scores than females (3.7 ± 0.6 vs 3.5 ± 0.5; P < 0.001). In the total sample, lower QoL was associated with female gender, Black race/skin color, diabetes, and tobacco use. In contrast, higher income and regular physical activity were predictors of high QoL. Stratified models revealed that physical activity and family income positively predicted QoL in both genders, but smoking was a stronger negative predictor among men, while diabetes was associated with low QoL in women. The protective effect of physical activity was more pronounced in female students. Moderation analyses confirmed that sex significantly moderated the associations between family income and physical activity and QoL. Conclusion Gender differences in QoL among university students reflect distinct behavioral and socioeconomic vulnerabilities. The moderating role of sex suggests that health promotion strategies may need to be tailored by gender.