Nouraei Motlagh Soraya, Asadi Piri Zahra, Asadi Heshmatollah, Bajoulvand Razyeh, Rezaei Satar
Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
Ph.D Student in Health Care Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Cost Eff Resour Alloc. 2022 Jun 29;20(1):30. doi: 10.1186/s12962-022-00364-1.
There are large gaps in health and well-being among different groups of the society. Socioeconomic factors play a significant role in determining the health status of the society. The present study was conducted to examine socioeconomic inequality in health status among the adult population of Khorramabad city, the capital of Lorestan province, wester part of Iran.
A cross-sectional study was conducted on 1348 participants selected through multistage sampling. A valid and reliable questionnaire was used for data collection. The wealth index as an indicator of the socioeconomic status (SES) was used to categorize the subjects in terms of the SES. The concentration index and concentration curve was used to measure socioeconomic inequity in poor self-rated health (SRH) of population. Finally, after determine the status of inequity in poor SRH, a decomposition analysis approach was used to identify the most important determinants of this inequity.
The prevalence of poor SRH was 18.91% in all subjects, 38.52% in the lowest SES group, and 11.15% in the highest SES group. The value of the concentration index for poor SRH was - 0.3243 (95% CI - 0.3996 to - 0.2490), indicating that poor SRH was more concentrated among the poor. The results of decomposition analysis showed that SES (41.2%), higher body mass index (28.6%) and lack of physical activity (26.9%) were the most important factors associated with the concentration of poor SRH in the poor groups.
Identification of socioeconomic factors affecting on health status is the first step for proper policymaking. Policymakers and health system managers at the national and subnational levels can use the results of this study as well as other similar domestic studies to design and implement proper interventions to promote equity and improve the health status of population.
社会中不同群体在健康和福祉方面存在巨大差距。社会经济因素在决定社会健康状况方面发挥着重要作用。本研究旨在调查伊朗西部洛雷斯坦省首府霍拉马巴德市成年人口健康状况中的社会经济不平等情况。
通过多阶段抽样选取1348名参与者进行横断面研究。使用一份有效且可靠的问卷收集数据。将财富指数作为社会经济地位（SES）的指标，根据SES对受试者进行分类。使用集中指数和集中曲线来衡量人群自评健康状况不佳（SRH）中的社会经济不平等。最后，在确定了SRH不佳的不平等状况后，采用分解分析方法来确定这种不平等的最重要决定因素。
所有受试者中SRH不佳的患病率为18.91%，最低SES组为38.52%，最高SES组为11.15%。SRH不佳的集中指数值为-0.3243（95%CI -0.3996至-0.2490），表明SRH不佳在贫困人口中更为集中。分解分析结果显示，SES（41.2%）、较高的体重指数（28.6%）和缺乏体育活动（26.9%）是与贫困人口中SRH不佳集中相关的最重要因素。
识别影响健康状况的社会经济因素是制定合理政策的第一步。国家和地方各级的政策制定者和卫生系统管理者可以利用本研究的结果以及其他类似的国内研究，来设计和实施适当的干预措施，以促进公平并改善人群的健康状况。
