ObjectivesThe aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population.MethodsThis study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality.ResultsThe concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents’ education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52).ConclusionsAn alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.
Background: Despite the goal of horizontal equity in Iran, little is known about it. This study aimed i) to assess socioeconomic inequality and horizontal inequity in the healthcare utilization; and ii) to explore the contribution of need and non-need variables to the observed inequalities. Methods: This study used national cross sectional dataset from Utilization of Health Services survey in 2015. Concentration Index (C), Concentration Curve (CC) and Horizontal Inequity index (HI) were calculated to measure inequality in inpatient and outpatient health care utilization. Decomposition analysis was used to determine the contribution of need and non-need factors to the observed inequalities. Result: Results showed the pro-poor inpatient services in both rural (C = − 0.079) and non-rural areas (C = − 0.096) and the pro-rich outpatient services in both rural (C = 0.038) and non-rural (C = 0.007). After controlling for need factors, HI was positive and significant for outpatient services in rural (HI = 0.039) and non-rural (HI = 0.008), indicating that for given need, the better off especially in rural make greater use of outpatient services. The HI was pro-poor for inpatient services in both rural (HI = − 0.068) and non-rural (HI =-0.090), was significant only in nonrural area. Non-need factors were the most important contributors to explain inequalities in the decomposition analysis. Conclusion: Disentangle the different contribution of determinants, as well as greater HI in rural areas for outpatient and in non-rural areas for inpatient services, provide helpful information for decision makers to redesign policy and redistribute resource allocation in order to reduce the socioeconomic gradient in health care utilization.
Background This study aims to determine the prevalence of physical inactivity in Iranian adolescents aged 10–12 years and the impact of socioeconomic inequality on it. Methods In this descriptive study, the study population consisted of 10–12 years old adolescents from an Iranian population from Kurdistan, Fars and Markazi provinces in 2018. The sample size was 1590 individuals. The sampling method was cluster sampling. Data was collected using demographic questionnaire, modifiable activity questionnaire (MAQ) and socioeconomic questionnaire. Cut points on the MAQ for light activity, moderate activity and heavy activity were MET< 3, MET = 3–6 and MET> 6, respectively. Linear and logistic regression were used to estimate the final model and the Oaxaca analysis method was applied. All analyses were performed in Stata/SE 14.0. Results Of the 1590 participants, 52.82% were male. The results showed that 25.79% of the subjects were physically inactive and 7.30% engaged in moderate physical activity during the week. The average physical activity during 1 week was more in boys than in girls (P-value< 0.05). Adolescents of mothers with secondary and high school education were more likely to have physical inactivity than mothers with a high school diploma or higher (AOR: 1.35, 95% CI: 1.02–1.77). The concentration index was −.11, indicating a greater concentration of physical inactivity in adolescents with low socioeconomic levels. Conclusion One-fourth of the study population had physical inactivity in this age group. Socioeconomic levels, parental literacy, and sex of adolescents were associated with the level of physical activity.
This qualitative study in the Islamic Republic of Iran aimed to explore facilitators and barriers to the use of reproductive health services by unmarried women. A purposive sample of unmarried women aged 25-60 years in Isfahan city were interviewed about their experiences of reproductive health services in public health centres. Content analysis of responses revealed that the favourable characteristics of reproductive health services in public centres were services that: were delivered by personnel of the same sex in a woman-friendly environment and available at a suitable price, and did not label clients. In contrast, the following characteristics made public health centres undesirable for unmarried women: not addressing single women for reproductive health services; lack of privacy; failure to maintain confidentiality; doubts about skills and scientific ability of personnel; and lack of integration of services. غــر النســاء نظــر وجهــة
Background: Low physical activity (PA) is increasing public health problem. The present study aimed to determine socioeconomic inequality in PA among children aged 10–12 years old in Kurdistan, west of Iran in 2015. Methods: The present cross-sectional study was conducted on 2506 children aged 10–12 in Sanandaj, Iran, in 2015. Data on the children's level of PA were collected using the Modifiable Activity Questionnaire. The concentration index was used to measure inequality and the Oaxaca decomposition to examine the different determinants of the inequality. The data were analyzed in Stata 13 and SPSS 20. Results: Of the 2506 participants, 40.90% (38.97–42.82) had insufficient PA. Girls had a lower level of PA than boys (odds ratio [OR] = 0.34; 95% confidence intervals [CI]: 0.28–0.41) and it is directly related to maternal education (OR = 1.71; 95% CI: 1.18–2.47), the family's Socioeconomic status (SES) (OR = 2.18; 95% CI: 1.56–3.05), and the place of residence (OR = 1.68; 95% CI: 1.16–2.44). The concentration index for insufficient PA was −0.25 (95 CI: −0.30 to −0.21), revealing an insufficient PA in the group with a low SES. The prevalence of insufficient PA is 51.38% (95% CI: 48.45–54.31) in poor group and 28.40% (95% CI: 22.80–33.99) in the wealthier group. The Oaxaca decomposition showed maternal education and the place of residence was the most important determinants of inequality. Conclusions: According to the findings, most of the children especially in the poor groups didn’t have sufficient PA and socioeconomic factors could have the important role.
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