Current status of health index in Tehran: A multidimensional approach

Abstract

Background: Health is an essential component of human rights and the rights are interdependent, indivisible, and correlated. The present study aimed at codifying a multidimensional health index according to multistage index development and describing the status of this index in 22 municipal districts of Tehran. Methods: This study was conducted using the data collected in the second round of Urban HEART Project of Tehran (2012-2013). The sample size was 34 700. To develop a multidimensional health index (MDHI), the nine steps of the Organization for Economic Cooperation and Development (OECD) were followed, from codifying theoretical framework to introducing the index. Results: According to the constructed MDHI, the districts no. 13, 10, 17, 1, 3, 4, and 22 had the best status and the district no. 8 the worst status. With respect to physical health, the districts no. 13, 17, 1, 3, 10, and 18 had the best status and the district no. 8 the worst. Concerning mental health, the districts no. 3, 6, 1, and 10 had the best status and the districts no. 8 and 12 the worst status. With respect to social health, the districts no. 10, 22, and 21 had the best status and the districts no. 6, 7, 12, and 14 the worst status. The analysis of sensitivity indicated that the MDHI was more sensitive towards physical health. Based on the mean, minimum, and maximum scores on each indicator of the questionnaires, the physical, mental, social, and MDHI status of Tehran residents (2012-2013) was high-medium, medium, low-medium, and high-medium, respectively. Conclusion: The right to health should be widely investigated, as it is a primary principle needed for sustainable development, which can be accomplished when the attitudes of different organizations towards the health construct are multidimensional rather than unidimensional.

Outpatient health service utilization and associated factors: A cross-sectional population-based study in Tehran in 2019

“…In this study, the presence of a person with a disability in the family as a need factors, increased the use of outpatient health service utilization. In line with the results of the present study, the results of various studies, including Fistom Girma et al, ( 1 ) Rezapour et al, ( 54 ), and Kim and Lee ( 23 ), showed that having a disability or a movement restrictions increased the likelihood of HSU ( 1 , 44 , 55 , 56 , 57 ). This issue may be due to these individuals’ need to receive prolonged care and their various health needs.…”

“…Health is an important factor for the development of societies, and investment in this section can have an indisputable effect on the welfare of the people and the economic growth of the country ( 1 , 2 ). One of the indispensable indicators in evaluating the efficacy of the health care system, especially in low- and middle-income countries, is the prevalence of health service utilization (HSU) ( 3 , 4 ).…”

“…As a human right, HSU is one of the most important mechanisms of the health system and a significant determinant of health ( 5 ). However, the level of HSU in many countries is not satisfactory ( 1 ), and even in countries with a National Health Service system, which provide public coverage, there are differences in the provision of health services for different groups of society ( 3 , 4 ). HSU is defined as the consequence of the interaction between health professionals and people in need ( 6 ).…”

“…To explain this process, most studies apply Anderson’s behavioral model of health service utilization (BM) ( 11 - 19 ), as this BM model provides a convenient theoretical framework for identifying HSU-related factors and explaining why people use health services ( 11 , 20 ). This model divides HSU explanatory factors into three categories: predisposing factors (demographic characteristics providing conditions or readiness to increase the likelihood of using health services), enabling factors (factors impeding or facilitating HSU), and need factors (need for health services, as an understanding of changes in a person's health status that include two subcategories of perceived, needs to receive health services (mentally assessed health status by individual himself/herself, that is, how people view and experience their general health, functional status, symptoms of illness) and evaluated needs assessed by a health care providers (i.e., specialized and professional assessments, and tangible measurements of health status)) ( 1 , 7 , 9 - 15 , 21 - 25 ). The relative impact and significance of each of these factors on HSU are influenced by the cultural background, health policies, and health system in each society ( 5 ).…”

The Relationship Between Spiritual Well-Being and Care Burden in Unofficial Caregivers of Elderly Patients With Dementia

“…Spiritual Well-Being (SWB) is one of the psychological factors that can play an important role in reducing the care burden of caregivers. According the World Health Organization, health is a concept with physical, social, psychological and spiritual dimensions [10]. Among these dimensions, SWB is a concept that is less understood and is more challenging.…”