Socioeconomic-related inequalities in self-rated health status in Kermanshah city, Islamic Republic of Iran: a decomposition analysis
Eastern Mediterranean Health Journal
Socioeconomic-related inequalities in health are a major public health challenge in both developed and developing countries. Little evidence is available on socioeconomic-related inequalities in health in different regions of the Islamic Republic of Iran. This study aimed to determine socioeconomic-related inequality in poor self-rated health in adults in Kermanshah city, western Islamic Republic of Iran. This cross-sectional study with stratified sampling obtained data on socioeconomic status,
... demographic characteristics, behavioural risk factors and self-rated health of 2040 adults (≥ 18 years) in Kermanshah city. A self-administrated questionnaire was used to collect data from the participants. The concentration (C) index and C curve were used to determine the socioeconomic-related inequality in poor self-rated health. A decomposition analysis of the C index was done to identify the factors explaining socioeconomic-related inequality in poor self-rated health. The crude and age-adjusted prevalence of poor self-rated health was 13.8% and 18.1%, respectively. The estimated C for the whole sample was -0.295, indicating that poor SRH was concentrated in the poor. The decomposition results suggested that socioeconomic status (45.5%), having a chronic health condition (11.9%) and smoking (7.3%) were the main factors contributing to the concentration of poor self-rated health among those of lower socioeconomic status. The concentration of poor self-rated health among the poor in Kermanshah city warrants policy attention. Policies aimed at reducing inequality in wealth distribution and risky health behaviour and preventing chronic health conditions among the poor may mitigate socioeconomic-related inequalities in poor self-rated health in Kermanshah.