Background
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.
Methods
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.
Results
The negative and statistically significant concentration indices (–0.132 in
2000 and –0.165 in 2010,
P
< 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 (
P
= 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%).
Conclusion
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.