Health-Related Quality of Life among Food Bank Users in Spain: A Cross-Sectional Study

Background: Food bank users experience food insecurity, which is a social determinant of health associated with poorer physical and mental outcomes. However, there is little evidence in Spain regarding the health-related quality of life (HRQoL) of food bank users. Objectives: To assess the HRQoL of users of the Navarra Food Bank (BAN) by identifying the associated factors and comparing it with the general population. Methods: Cross-sectional study of heads of families using the BAN. Simple random sample of 350 from a population of 2,749 families (p and q 0.5). We evaluated HRQoL using the EQ-5D-5L scale via telephone survey. We analyzed scores on the utility index (EQ-5D-5L Index) and the visual analog scale (VAS), as well as the distribution of problems related to mobility, personal care, daily activities, pain/discomfort, and anxiety/depression. To enhance interpretability and avoid the influence of arbitrary thresholds or extreme values, the VAS and EQ-5D-5L Index variables were dichotomized into higher and lower health-related quality of life (HRQoL) groups using a data-driven K-means cluster analysis. Subsequently, binary logistic regression was applied to identify factors associated with the higher HRQoL group, with age, sex, socioeconomic variables, and EQ-5D-5L dimensions included as independent variables. Odds ratios with 95% CI were calculated. Results: The VAS was 73.56 (71.62-75.50) compared to 88.1 in Navarra. The prevalence of problems with mobility, self-care, daily activities, pain/discomfort, and anxiety/depression was higher in all cases than in Navarra: 25.5% vs. 13.0%; 8.7% vs. 5.3%; 19.7% vs. 8.0%; 55.7% vs. 35.7%; and 62.9% vs. 17.3% (all p < 0.001). Sociodemographic variables (age, sex, education, and employment) showed no significant association with HRQoL clusters (p > 0.05). Conversely, controlling for age and sex, belonging to the group with the highest VAS was associated with a lower prevalence of problems: Mobility OR= 3.91 (95% CI: 1.84-8.30); Daily Activities OR= 2.98 (95% CI: 1.16-7.65); Pain/Discomfort OR=3.36 (95% CI: 1.64-6.89); and Anxiety/Depression OR= 2.84 (95% CI: 1.41-5.73). Belonging to the group with the highest EQ-5D-5L Index was not significantly associated with Anxiety/Depression (OR = 1.62; 95% CI: 0.73–3.56), whereas the remaining dimensions showed similar significant associations. Conclusions: Users of the Navarra Food Bank have a significantly worse HRQoL than the general population, primarily associated with a high prevalence of mental health challenges and pain. These findings highlight that food banks are critical touchpoints for the early detection of health vulnerabilities, necessitating a shift from purely nutritional aid toward integrated social and health support models.