Mafakheri Sediqheh, Mansouri-Shad Fatemeh, Cheraghi Parvin, Nouri Qhadir, Cheraghi Zahra
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
BMC Public Health. 2025 May 15;25(1):1798. doi: 10.1186/s12889-025-22982-z.
The increasing demographic shift toward an aging population in Iran highlights the urgent need to understand how socioeconomic inequalities affect the ability of older individuals to access essential resources and services. This study examined socioeconomic inequalities in meeting the needs of older people in Hamadan, Iran.
This cross-sectional study was conducted on the 501 elderly people living in western Iran. Data collection was carried out from December 1, 2022 to March 31, 2023, among elderly individuals who were registered in the SIB (Unified Health System). system. Elderly were selected by stratified random sampling among 17 comprehensive urban health centers (CURHCs) in Hamadan province. The data collection process consisted of four sections, including: A demographic information questionnaire, the Abbreviated Mental Test (AMT) questionnaire to determine the absence of dementia, cognitive impairment and the Barthel Index questionnaire to measure functional independence status and 4) Camberwell Assessment of Need for the Elderly. Socio-economic inequalities were assessed using the concentration index and a decomposition approach, determining the contribution of each factor to the socio-economic inequality at 95% CI.
The concentration index for met needs was 0.15 (95% CI: 0.12, 0.19), indicating a concentration of met needs among the elderly with higher economic status. Subgroup analysis (with statistically significant results) revealed that the lowest levels of met needs were observed among illiterate people (53.09% vs. 92.11% (p < 0.001)) and those with dyslipidemia (55.86% vs. 65.98, p = 0.050). Education (60.38%) and economic status (25.32%) were the primary contributors to inequality in elderly individuals' met needs.
The findings reveal significant disparities in meeting the needs of the elderly, particularly among the wealthy, the illiterate, and those with dyslipidemia. To address these issues, public health initiatives should focus on expanding education and providing economic support to disadvantaged older adults. In addition, personalized health care for those with chronic conditions is essential. Proposed solutions include training health care workers in geriatric care, developing community-based programs with home care, and creating economic support packages for low-income seniors.
伊朗人口日益老龄化，这凸显了迫切需要了解社会经济不平等如何影响老年人获取基本资源和服务的能力。本研究调查了伊朗哈马丹市老年人需求满足方面的社会经济不平等情况。
本横断面研究针对居住在伊朗西部的501名老年人开展。数据收集于2022年12月1日至2023年3月31日期间，在统一卫生系统（SIB）登记的老年人中进行。通过在哈马丹省17个综合城市健康中心（CURHCs）进行分层随机抽样选取老年人。数据收集过程包括四个部分，即：一份人口信息问卷、用于确定是否存在痴呆、认知障碍的简易精神状态检查表（AMT）问卷、用于测量功能独立状态的巴氏指数问卷以及4）老年人坎伯韦尔需求评估。使用集中指数和分解方法评估社会经济不平等情况，确定各因素在95%置信区间对社会经济不平等的贡献。
需求满足的集中指数为0.15（95%置信区间：0.12，0.19），表明需求满足情况集中在经济状况较好的老年人中。亚组分析（结果具有统计学意义）显示，文盲人群（53.09%对92.11%（p < 0.001））和血脂异常人群（55.86%对65.98，p = 0.050）的需求满足水平最低。教育程度（60.38%）和经济状况（25.32%）是老年人需求满足不平等的主要影响因素。
研究结果揭示了在满足老年人需求方面存在显著差异，特别是在富裕人群、文盲人群和血脂异常人群中。为解决这些问题，公共卫生举措应侧重于扩大教育并为弱势老年人提供经济支持。此外，为慢性病患者提供个性化医疗保健至关重要。建议的解决方案包括培训老年护理医护人员、开展基于社区的居家护理项目以及为低收入老年人制定经济支持方案。
