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Original Articles
- Decomposition of Socioeconomic Inequality in Cardiovascular Disease Prevalence in the Adult Population: A Cohort-based Cross-sectional Study in Northwest Iran
- Farhad Pourfarzi, Telma Zahirian Moghadam, Hamed Zandian
- J Prev Med Public Health. 2022;55(3):297-306. Published online May 3, 2022
- DOI: https://doi.org/10.3961/jpmph.22.051
- 2,982 View
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Abstract
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Supplementary Material - Objectives
The incidence of cardiovascular disease (CVD) mortality is increasing in developing countries. This study aimed to decompose the socioeconomic inequality of CVD in Iran.
Methods
This cross-sectional population-based study was conducted on 20 519 adults who enrolled in the Ardabil Non-Communicable Disease cohort study. Principal component analysis and multivariable logistic regression were used, respectively, to estimate socioeconomic status and to describe the relationships between CVD prevalence and the explanatory variables. The relative concentration index, concentration curve, and Blinder-Oaxaca decomposition model were used to measure and decompose the socioeconomic inequality.
Results
The overall age-adjusted prevalence of CVD was 8.4% in northwest Iran. Multivariable logistic regression showed that older adults, overweight or obese adults, and people with hypertension and diabetes were more likely to have CVD. Moreover, people with low economic status were 38% more likely to have CVD than people with high economic status. The prevalence of CVD was mainly concentrated among the poor (concentration index, -0.077: 95% confidence interval, -0.103 to -0.060), and 78.66% of the gap between the poorest and richest groups was attributed to differences in the distribution of the explanatory variables included in the model.
Conclusions
The most important factors affecting inequality in CVD were old age, chronic illness (hypertension and diabetes), marital status, and socioeconomic status. This study documented stark inequality in the prevalence of CVD, wherein the poor were more affected than the rich. Therefore, it is necessary to implement policies to monitor, screen, and control CVD in poor people living in northwest Iran. -
Summary
- Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis
- Hamed Zandian, Amirhossein Takian, Arash Rashidian, Mohsen Bayati, Telma Zahirian Moghadam, Satar Rezaei, Alireza Olyaeemanesh
- J Prev Med Public Health. 2018;51(2):83-91. Published online February 6, 2018
- DOI: https://doi.org/10.3961/jpmph.17.050
- 10,626 View
- 199 Download
- 11 Crossref
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Abstract
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- Objectives
One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households’ income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing. -
Summary
Citations
Citations to this article as recorded by
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Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
Journal of Preventive Medicine and Public Health.2024; 57(1): 65. CrossRef - Decomposition of Socioeconomic Inequality in Cardiovascular Disease Prevalence in the Adult Population: A Cohort-based Cross-sectional Study in Northwest Iran
Farhad Pourfarzi, Telma Zahirian Moghadam, Hamed Zandian
Journal of Preventive Medicine and Public Health.2022; 55(3): 297. CrossRef - Inequality in Private Health Care Expenditures: A 36-Year Trend Study of Iranian Households
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International Journal of Human Rights in Healthcare.2019; 12(3): 208. CrossRef - Explaining the challenges of academic professional ethics training from the perspective of faculty members at Ardabil University of Medical Sciences: a qualitative study
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International Journal of Human Rights in Healthcare.2019; 12(2): 138. CrossRef - Equity in healthcare financing: a case of Iran
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International Journal for Equity in Health.2019;[Epub] CrossRef
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