Rezaei Satar, Hajizadeh Mohammad, Salimi Yahya, Moradi Ghobad, Nouri Bijan
Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
J Prev Med Public Health. 2018 Sep;51(5):219-226. doi: 10.3961/jpmph.18.012. Epub 2018 Aug 7.
This study aimed to explain the health-related quality of life (HRQoL) gap between the poorest and the wealthiest quintiles in the capitals of Kermanshah and Kurdistan Provinces (Kermanshah and Sanandaj), in western Iran.
This was a cross-sectional study conducted among 1772 adults. Data on socio-demographic characteristics, socioeconomic status (SES), lifestyle factors, body mass index, and HRQoL of participants were collected using a self-administered questionnaire. The slope and relative indices of inequality (SII and RII, respectively) were employed to examine socioeconomic inequality in poor HRQoL. Blinder-Oaxaca (BO) decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of poor HRQoL between the wealthiest and the poorest groups.
The overall crude and age-adjusted prevalence of poor HRQoL among adults was 32.0 and 41.8%, respectively. The SII and RII indicated that poor HRQoL was mainly concentrated among individuals with lower SES. The absolute difference (%) in the prevalence of poor HRQoL between the highest and lowest SES groups was 28.4. The BO results indicated that 49.9% of the difference was explained by different distributions of age, smoking behavior, physical inactivity, chronic health conditions, and obesity between the highest and lowest SES groups, while the remaining half of the gap was explained by the response effect.
We observed a pro-rich distribution of poor HRQoL among adults in the capitals of Kermanshah and Kurdistan Provinces. Policies and strategies aimed at preventing and reducing smoking, physical inactivity, chronic health conditions, and obesity among the poor may reduce the gap in poor HRQoL between the highest and lowest SES groups in Iran.
本研究旨在解释伊朗西部克尔曼沙阿省和库尔德斯坦省首府（克尔曼沙阿和萨南达季）最贫困和最富裕五分位数人群之间的健康相关生活质量（HRQoL）差距。
这是一项针对1772名成年人的横断面研究。使用自填问卷收集参与者的社会人口学特征、社会经济地位（SES）、生活方式因素、体重指数和HRQoL数据。采用不平等斜率和相对指数（分别为SII和RII）来检验HRQoL较差人群中的社会经济不平等情况。使用布林德-奥瓦萨卡（BO）分解法来量化解释变量对最富裕和最贫困群体之间HRQoL较差患病率差距的贡献。
成年人中HRQoL较差的总体粗患病率和年龄调整患病率分别为32.0%和41.8%。SII和RII表明，HRQoL较差主要集中在SES较低的个体中。最高和最低SES组之间HRQoL较差患病率的绝对差异（%）为28.4。BO结果表明，49.9%的差异可由最高和最低SES组之间年龄、吸烟行为、缺乏身体活动、慢性健康状况和肥胖的不同分布来解释，而其余一半的差距则由应答效应来解释。
我们观察到在克尔曼沙阿和库尔德斯坦省首府的成年人中，HRQoL较差呈现有利于富人的分布情况。旨在预防和减少穷人吸烟、缺乏身体活动、慢性健康状况和肥胖的政策和策略，可能会缩小伊朗最高和最低SES组之间HRQoL较差的差距。
