Health-related quality of life and marine-related health risks in coastal communities of Palawan, Philippines

Coastal fishing communities depend on marine resources yet face significant occupational and environmental health risks. This study asssessed health-related quality of life (HRQoL) and self-reported accidents and health outcomes among adults in three coastal municipalities of Palawan, Philippines. A cross-sectional survey recruited 431 adults across 10 barangays, with 401 complete responses analyzed. The HRQoL was assessed using the Philippine Short Form-12 (SF-12), producing Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12) scores. Fifteen self-reported health items were examined using exploratory factor analysis, identifying three domains: marine accidents, musculoskeletal complaints, and infections and skin diseases. Women had higher odds of reporting marine-related accidents compared thaan men (OR = 2.07; 95% CI: 1.87–2.54). More than half of respondents (56.9%, n = 228) had PCS-12 ≤50 (mean 48.3 ± 5.7), indicating poor physical health, while 26.4% (n = 106) scored MCS-12 ≤42 (mean 47.3 ± 8.3), suggesting possible mental health concerns. Musculoskeletal complaints were the most prevalent health outcome, affecting up to 71.1% of respondents, while those in the poorest marine-based income bracket had nearly twice the odds of reporting infections and skin diseases (OR = 1.87; 95% CI: 1.22–3.86). The HRQoL varied by study site, gender, age, and education, whereas ethnicity, religion, and coastal proximity were not significantly associated. These findings showed that women and low-income fishers face greater occupational and environmental health risks. Interventions should prioritize gender-responsive safety, ergonomic support, accessible healthcare, and stronger social protection. Further qualitative research is needed to clarify the pathways that drive these disparities.