Haghighatfard Payam, Rezapour Aziz, Khoramrooz Maryam, Eisavi Mahmoud, Khosravi Ardeshir
Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2023 Aug 21;37:90. doi: 10.47176/mjiri.37.90. eCollection 2023.
More than 15% of the world's population live with some form of disability. Assessing socioeconomic inequalities in disability and monitoring its change over time can help policymakers to design and implement targeted interventions to reduce these inequalities. This study aimed to assess the change in socioeconomic inequality in disability in Iran from 2000 to 2010.
Data for this cross-sectional study were obtained from 2 waves of Iran's demographic and health surveys (2000 and 2010). The Wagstaff normalized concentration index was used to measure the socioeconomic inequality of disability. Contributing factors to the inequality in 2000 and 2010 were investigated by concentration index decomposition. The Blinder-Oaxaca decomposition method was used to determine contributing factors of change in disability inequality. All analyses were conducted in Stata14.
The negative and statistically significant concentration indices (-0.132 in 2000 and -0.165 in 2010, < 0.001) suggested more concentration of disability among poor people. The absolute value of inequality was increased by 0.034 between the 2 points of time ( = 0.025). Level of education (123.5%), household size (12.9%), age (-35.1%), and residency (in terms of Iran's provinces) (-19.3%) were the contributing factors to the measured disability inequality in 2000. In 2010, level of education (105.8%), household size (30.5%), and urban residency (-46.3%) explained the measured inequality. Change in disability inequality was explained by household size (99.4%), province of residence (54.8%), education (36.9%), socioeconomic status (20%), urban residency (-90.3%), and age (-47.7%).
Iran suffers from significant socioeconomic inequality in disability, and it significantly increased over time. Interventions such as increasing health literacy and providing suitable job opportunities for people with low education level, improving the socioeconomic status of extended households, and paying more attention to the balanced development in the provinces and urban and rural areas, and attending to prevention, treatment, and mitigation of disability adversities among poor young and elderly people could be recommended to tackle increased socioeconomic inequality in disability and its unfavorable consequences in Iran.
全球超过15%的人口患有某种形式的残疾。评估残疾方面的社会经济不平等并监测其随时间的变化，有助于政策制定者设计和实施有针对性的干预措施以减少这些不平等。本研究旨在评估2000年至2010年伊朗残疾方面社会经济不平等的变化。
这项横断面研究的数据来自伊朗两轮人口与健康调查（2000年和2010年）。采用瓦格斯塔夫标准化集中指数来衡量残疾的社会经济不平等。通过集中指数分解研究了2000年和2010年不平等的影响因素。使用布林德 - 奥瓦卡分解方法来确定残疾不平等变化的影响因素。所有分析均在Stata14中进行。
负的且具有统计学意义的集中指数（2000年为 -0.132，2010年为 -0.165，<0.001）表明残疾在贫困人口中更为集中。两个时间点之间不平等的绝对值增加了0.034（=0.025）。教育水平（123.5%）、家庭规模（12.9%）、年龄（-35.1%）和居住地区（按伊朗省份划分）（-19.3%）是2000年所测残疾不平等的影响因素。2010年，教育水平（105.8%）、家庭规模（30.5%）和城市居住情况（-46.3%）解释了所测的不平等。残疾不平等的变化由家庭规模（99.4%）、居住省份（54.8%）、教育（36.9%）、社会经济地位（20%）、城市居住情况（-90.3%）和年龄（-47.7%）来解释。
伊朗在残疾方面存在显著的社会经济不平等，且随着时间推移显著加剧。可建议采取一些干预措施，如提高健康素养并为低教育水平者提供合适的就业机会、改善大家庭的社会经济地位、更加关注各省份以及城乡之间的均衡发展，以及关注贫困青年和老年人中残疾问题的预防、治疗和缓解，以应对伊朗残疾方面不断加剧的社会经济不平等及其不利后果。
