You are here

Article Text

Article menu

Download PDFPDF

XML
Epidemiology
Research
Socioeconomic inequality in health domains in Tehran: a population-based cross-sectional study
  1. Vali Baigi1,
  2. Saharnaz Nedjat2,
  3. Ahmad Reza Hosseinpoor3,
  4. Majid Sartipi4,
  5. Yahya Salimi5,
  6. Akbar Fotouhi6
  1. 1 Department of Epidemiology and Biostatistics, School of Public Health, Student’s Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
  2. 2 Department of Epidemiology and Biostatistics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3 Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
  4. 4 Department of Epidemiology and Biostatistics, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
  5. 5 Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
  6. 6 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  1. Correspondence to Dr Saharnaz Nedjat; nejatsan{at}tums.ac.ir

Abstract

Objective Reduction of socioeconomic inequality in health requires appropriate evidence on health and its distribution based on socioeconomic indicators. The objective of this study was to assess socioeconomic inequality in various health domains and self-rated health (SRH).

Methods This study was conducted using data collected in a survey in 2014 on a random sample of individuals aged 18 and above in the city of Tehran. The standardised World Health Survey Individual Questionnaire was used to assess different health domains. The age-adjusted prevalence of poor health was calculated for each health domain and SRH based on levels of education and wealth quintiles. Furthermore, the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were applied to assess socioeconomic inequality in each of the health domains and SRH.

Results The age-adjusted prevalence of poor health was observed in a descending order from the lowest to the highest wealth quintiles, and from the lowest level of education to the highest. RII also showed varying values of inequality among different domains, favouring rich subgroups. The highest wealth-related RII was observed in the ‘Mobility’ domain with a value of 4.16 (95% CI 2.01 to 8.62), and the highest education-related RII was observed in the ‘Interpersonal Activities’ domain with a value of 6.40 (95% CI 1.91 to 21.36).

Conclusions Substantial socioeconomic inequalities were observed in different health domains in favour of groups of better socioeconomic status. Based on these results, policymaking aimed at tackling inequalities should pay attention to different health domains as well as to overall health.

  • inequality
  • inequity
  • social status
  • Iran
  • relative index of inequality

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-018298

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors VB and SN made substantial contributions to the study conception and design, the acquisition, analysis and interpretation of data, drafting the manuscript, and revising the manuscript critically for important intellectual content. AF and MS contributed to the study design, acquisition and interpretation of data, and revised the manuscript critically. ARH and YS participated in statistical analysis, interpretation of data and revising the manuscript critically for important intellectual content. All authors agreed on the final manuscript prior to submission. All authors agreed to be accountable for all aspects of this work.

    • Funding This project was financially supported by the Vice Chancellor of Research at Tehran University of Medical Sciences (project no 25621-27-03-93).

    • Disclaimer The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval This study has been ethically approved by the Ethics Committee of Tehran University of Medical Sciences with code number IR.TUMS.REC.1394.532.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Additional unpublished data are available by request to the corresponding author.