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- Measurement and Decomposition of Socioeconomic Inequality in Metabolic Syndrome: A Cross-sectional Analysis of the RaNCD Cohort Study in the West of Iran
- Moslem Soofi, Farid Najafi, Shahin Soltani, Behzad Karamimatin
- J Prev Med Public Health. 2023;56(1):50-58. Published online January 6, 2023
- DOI: https://doi.org/10.3961/jpmph.22.373
- 2,671 View
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Abstract
PDF - Objectives
Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran.
Methods
This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middle-aged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CIn) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants.
Results
The proportion of MetS in the sample was 41.1%. The CIn of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%).
Conclusions
Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population. -
Summary
Citations
Citations to this article as recorded by
- Sleep Quality, Nutrient Intake, and Social Development Index Predict Metabolic Syndrome in the Tlalpan 2020 Cohort: A Machine Learning and Synthetic Data Study
Guadalupe Gutiérrez-Esparza, Mireya Martinez-Garcia, Tania Ramírez-delReal, Lucero Elizabeth Groves-Miralrio, Manlio F. Marquez, Tomás Pulido, Luis M. Amezcua-Guerra, Enrique Hernández-Lemus
Nutrients.2024; 16(5): 612. CrossRef - Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults
Pardis Mohammadzadeh, Farhad Moradpour, Bijan Nouri, Farideh Mostafavi, Farid Najafi, Ghobad Moradi
Epidemiology and Health.2023; 45: e2023083. CrossRef
- Measuring and decomposing socioeconomic inequality in catastrophic healthcare expenditures in Iran
- Satar Rezaei, Mohammad Hajizadeh
- J Prev Med Public Health. 2019;52(4):214-223. Published online June 14, 2019
- DOI: https://doi.org/10.3961/jpmph.19.046
- 6,501 View
- 216 Download
- 15 Crossref
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Abstract
PDF
- Objectives
Equity in financial protection against healthcare expenditures is one the primary functions of health systems worldwide. This study aimed to quantify socioeconomic inequality in facing catastrophic healthcare expenditures (CHE) and to identify the main factors contributing to socioeconomic inequality in CHE in Iran.
Methods
A total of 37 860 households were drawn from the Households Income and Expenditure Survey, conducted by the Statistical Center of Iran in 2017. The prevalence of CHE was measured using a cut-off of spending at least 40% of the capacity to pay on healthcare services. The concentration curve and concentration index (C) were used to illustrate and measure the extent of socioeconomic inequality in CHE among Iranian households. The C was decomposed to identify the main factors explaining the observed socioeconomic inequality in CHE in Iran.
Results
The prevalence of CHE among Iranian households in 2017 was 5.26% (95% confidence interval [CI], 5.04 to 5.49). The value of C was -0.17 (95% CI, -0.19 to -0.13), suggesting that CHE was mainly concentrated among socioeconomically disadvantaged households in Iran. The decomposition analysis highlighted the household wealth index as explaining 71.7% of the concentration of CHE among the poor in Iran.
Conclusions
This study revealed that CHE is disproportionately concentrated among poor households in Iran. Health policies to reduce socioeconomic inequality in facing CHE in Iran should focus on socioeconomically disadvantaged households. -
Summary
Citations
Citations to this article as recorded by- Examining the level and distribution of catastrophic health expenditure from 2013 to 2018: A province-level study in China
Mingsheng Chen, Lizheng Xu, Lei Si, Zhonghua Wang, Stephen Jan
Economic Modelling.2023; 121: 106233. CrossRef - Equity and extent of financial risk protection indicators during COVID-19 pandemic in rural part of Tamil Nadu, India
Yuvaraj Krishnamoorthy, Sathish Rajaa, Isha Sinha, Murali Krishnan, Gerald Samuel, Krishna Kanth
Heliyon.2023; 9(8): e18902. CrossRef - Prevalence and determinants of catastrophic healthcare expenditures in Iran from 2013 to 2019
Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
Journal of Preventive Medicine and Public Health.2023;[Epub] CrossRef - Catastrophic household expenditure associated with out-of-pocket payments for dental healthcare in Spain
Samuel López-López, Raúl del Pozo-Rubio, Marta Ortega-Ortega, Francisco Escribano-Sotos
The European Journal of Health Economics.2022; 23(7): 1187. CrossRef - User fee removal for the poor: a qualitative study to explore policies for social health assistance in Iran
Manal Etemadi, Mohammad Hajizadeh
BMC Health Services Research.2022;[Epub] CrossRef - A 25-Year Trend of Catastrophic Health Expenditure and Its Inequality in China: Evidence from Longitudinal Data
Yongjian Xu, Yiting Zhou, Andi Pramono, Yazhuo Liu, Cong Jia
Risk Management and Healthcare Policy.2022; Volume 15: 969. 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 - Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature
Taslima Rahman, Dominic Gasbarro, Khurshid Alam
Health Research Policy and Systems.2022;[Epub] CrossRef - Incidence of catastrophic healthcare expenditure and its main determinants in Mexican households caring for a person with a mental disorder
Lina Diaz-Castro, Héctor Cabello-Rangel, Carlos Pineda-Antúnez, Alejandra Pérez de León
Global Mental Health.2021;[Epub] CrossRef - Unmet dental care need in West of Iran: determinants and inequality
Amjad Mohamadi-Bolbanabad, Farman Zahir Abdullah, Hossein Safari, Satar Rezaei, Abdorrahim Afkhamzadeh, Shina Amirhosseini, Afshin Shadi, Jamal Mahmoudpour, Bakhtiar Piroozi
International Journal of Human Rights in Healthcare.2021; 14(5): 426. CrossRef - The impact of out-of pocket payments of households for dental healthcare services on catastrophic healthcare expenditure in Iran
Abraha Woldemichael, Satar Rezaei, Ali Kazemi Karyani, Mohammad Ebrahimi, Shahin Soltani, Abbas Aghaei
BMC Public Health.2021;[Epub] CrossRef - Measuring Out-of-pocket Payment, Catastrophic Health Expenditure and the Related Socioeconomic Inequality in Peru: A Comparison Between 2008 and 2017
Akram Hernández-Vásquez, Carlos Rojas-Roque, Rodrigo Vargas-Fernández, Diego Rosselli
Journal of Preventive Medicine and Public Health.2020; 53(4): 266. CrossRef Incidence and Intensity of Catastrophic Health-care Expenditure for Type 2 Diabetes Mellitus Care in Iran: Determinants and Inequality
Bakhtiar Piroozi, Amjad Mohamadi-Bolbanabad, Ghobad Moradi, Hossein Safari, Shahnaz Ghafoori, Yadolah Zarezade, Farzam Bidarpour, Satar Rezaei
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 2865. CrossRef- Trend and status of out-of-pocket payments for healthcare in Iran: equity and catastrophic effect
Satar Rezaei, Abraha Woldemichael, Mohammad Ebrahimi, Sina Ahmadi
Journal of the Egyptian Public Health Association.2020;[Epub] CrossRef - Catastrophic Out-of-Pocket Health Expenditure Among Rural Households in the Semi-Pastoral Community, Western Ethiopia: A Community-Based Cross-Sectional Study
Debelo Shikuro, Mezgebu Yitayal, Adane Kebede, Ayal Debie
ClinicoEconomics and Outcomes Research.2020; Volume 12: 761. CrossRef
- Changes in Contribution of Causes of Death to Socioeconomic Mortality Inequalities in Korean Adults
- Kyunghee Jung-Choi, Young-Ho Khang, Hong-Jun Cho
- J Prev Med Public Health. 2011;44(6):249-259. Published online November 14, 2011
- DOI: https://doi.org/10.3961/jpmph.2011.44.6.249
- 14,184 View
- 82 Download
- 20 Crossref
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Abstract
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Objectives This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults.
Methods Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality.
Results Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans.
Conclusions Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.
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Summary
Citations
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Kathryn Christine Beck, Mirza Balaj, Lorena Donadello, Talal Mohammad, Hanne Dahl Vonen, Claire Degail, Kristoffer Eikemo, Anna Giouleka, Indrit Gradeci, Celine Westby, Kam Sripada, Magnus Rom Jensen, Solvor Solhaug, Emmanuela Gakidou, Terje Andreas Eikem
BMJ Open.2022; 12(8): e059042. CrossRef - Socioeconomic Disparities in Cardiovascular Health in South Korea
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Journal of Cardiovascular Nursing.2021; 36(1): 8. CrossRef - Mainstreaming of Health Equity in Infectious Disease Control Policy During the COVID-19 Pandemic Era
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Journal of Preventive Medicine and Public Health.2021; 54(1): 1. CrossRef - Cancer Incidence by Occupation in Korea: Longitudinal Analysis of a Nationwide Cohort
Hye-Eun Lee, Masayoshi Zaitsu, Eun-A Kim, Ichiro Kawachi
Safety and Health at Work.2020; 11(1): 41. CrossRef - Mortality inequalities by occupational class among men in Japan, South Korea and eight European countries: a national register-based study, 1990–2015
Hirokazu Tanaka, Wilma J Nusselder, Matthias Bopp, Henrik Brønnum-Hansen, Ramune Kalediene, Jung Su Lee, Mall Leinsalu, Pekka Martikainen, Gwenn Menvielle, Yasuki Kobayashi, Johan P Mackenbach
Journal of Epidemiology and Community Health.2019; 73(8): 750. CrossRef - Measurement of Socioeconomic Position in Research on Cardiovascular Health Disparities in Korea: A Systematic Review
Chi-Young Lee, Yong-Hwan Lee
Journal of Preventive Medicine and Public Health.2019; 52(5): 281. CrossRef - Forty years of economic growth and plummeting mortality: the mortality experience of the poorly educated in South Korea
Jinwook Bahk, John W Lynch, Young-Ho Khang
Journal of Epidemiology and Community Health.2017; 71(3): 282. CrossRef - Increased breast cancer mortality only in the lower education group: age-period-cohort effect in breast cancer mortality by educational level in South Korea, 1983-2012
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International Journal for Equity in Health.2017;[Epub] CrossRef - Effects of Periodontal Disease on Cardio-Cerebrovascular Disease: A Focus on Personal Income and Social Deprivation
Min-Young Kim, Hosung Shin
Journal of Dental Hygiene Science.2017; 17(4): 375. CrossRef - Joint Symposium of Korean Cancer Association & UICC-ARO—Cross-boundary cancer studies: cancer and Universal Health Coverage (UHC) in Asia
Eun-Cheol Park, Norie Kawahara, Shinjiro Nozaki, Hasbullah Thabrany, Shunya Yoshimi, Sohee Park, Duk Hyoung Lee, Hideyuki Akaza, Jae Kyung Roh
Japanese Journal of Clinical Oncology.2017; 47(9): 889. CrossRef - Impact of Childhood Socioeconomic Position on Self‐Rated Health Trajectories of South Korean Adults
Joan P. Yoo, Min Sang Yoo
Asian Social Work and Policy Review.2016; 10(1): 142. CrossRef - Mortality rates by occupation in Korea: a nationwide, 13-year follow-up study
Hye-Eun Lee, Hyoung-Ryoul Kim, Yun Kyung Chung, Seong-Kyu Kang, Eun-A Kim
Occupational and Environmental Medicine.2016; 73(5): 329. CrossRef - Educational Inequality in Female Cancer Mortality in Korea
Mi-Hyun Kim, Kyunghee Jung-Choi, Hyoeun Kim, Yun-Mi Song
Journal of Korean Medical Science.2015; 30(1): 1. CrossRef - The population attributable fraction of low education for mortality in South Korea with improvement in educational attainment and no improvement in mortality inequalities
Dohee Lim, Kyoung Ae Kong, Hye Ah Lee, Won Kyung Lee, Su Hyun Park, Sun Jung Baik, Hyesook Park, Kyunghee Jung-Choi
BMC Public Health.2015;[Epub] CrossRef - Sex Differences Associated With Hepatitis B Virus Surface Antigen Seropositivity Unwareness in Hepatitis B Virus Surface Antigen-positive Adults: 2007‐2012 Korea National Health and Nutrition Examination Survey
Suk-Yong Jang, Sung-In Jang, Hong-Chul Bae, Jaeyong Shin, Eun-Cheol Park
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Kyunghee Jung-Choi, Young-Ho Khang, Hong-Jun Cho, Sung-Cheol Yun
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Jong Won Min
Global Public Health.2014; 9(9): 1053. CrossRef - Cancer Control and the Communication Innovation in South Korea: Implications for Cancer Disparities
Minsoo Jung
Asian Pacific Journal of Cancer Prevention.2013; 14(6): 3411. CrossRef - Socioeconomic inequalities in health status in Korea
Kyunghee Jung-Choi, Yu-Mi Kim
Journal of the Korean Medical Association.2013; 56(3): 167. CrossRef - Difference of Area-based deprivation and Education on Cerebrovascular Mortality in Korea
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Korean Journal of Health Policy and Administration.2012; 22(2): 163. CrossRef
Review- Health Inequalities in Korea: Current Conditions and Implications.
- Yu Mi Kim, Myoung Hee Kim
- J Prev Med Public Health. 2007;40(6):431-438.
- DOI: https://doi.org/10.3961/jpmph.2007.40.6.431
- 5,485 View
- 150 Download
- 24 Crossref
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Abstract
PDF
- OBJECTIVES
The aim of this study is to summarize the current conditions and implications of health inequalities in South Korea. METHODS: Through a literature review of empirical studies and supplementary analysis of the data presented in the 1998, 2001, and 2005 KNHANEs, we evaluated the extent and trends of socioeconomic inequalities in both health risk factors, such as smoking, physical activity, and obesity, and outcomes, such as total mortality, subjective poor health status by self-reports and metabolic syndrome. Relative risks and odds ratios were used to measure differences across socioeconomic groups, and the relative index of inequality was used to evaluate the changes in inequalities over time. RESULTS: We found clear inequalities to various degrees in most health indicators. While little change was observed in mortality differences over time, the socioeconomic gaps in risk factors and morbidity have been widening, with much larger differences among the younger population. CONCLUSIONS: Socioeconomic inequalities are pervasive across various health indicators, and some of them are increasing. The trends in socioeconomic inequalities in health should be carefully monitored, and comprehensive measures to alleviate health inequalities are needed, especially for young populations. -
Summary
Citations
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International Journal of Environmental Research and Public Health.2022; 19(15): 9618. CrossRef - Analysis of energy intakes, physical activities and metabolic syndrome according to the income level in Korean elderly people: Korean National Health and Nutrition Examination Survey 2016‒2018
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International Journal of Environmental Research and Public Health.2019; 16(10): 1866. CrossRef - Recent Trends in Blood Pressure According to Economic Status: Korean National Health and Nutrition Examination Survey From 2005 to 2015
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Journal of Exercise Rehabilitation.2016; 12(1): 10. CrossRef - Socioeconomic Inequality in mortality using 12-year follow-up data from nationally representative surveys in South Korea
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International Journal for Equity in Health.2016;[Epub] CrossRef - Differences between middle-aged and older people in association between income level and remaining teeth
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English Abstract- What is the Origin of Inequalities in Work and Health?.
- Mi A Son
- J Prev Med Public Health. 2005;38(3):241-251.
- 1,956 View
- 35 Download
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Abstract
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- There has been an enormous increasing trend of widening gap of social inequalities since economic crisis at the end of 1997 in Korea. Since then, Korean society has deteriorated in economic and social conditions; the unemployment rate, temporary or casual workers and absolute poverty have increased. This paper presents the origin of inequalities in work and health in Korea. The origin of inequalities in work begins with the relationship between the capitalist and labourers in the capitalist mode of production. The conception and execution are dissolved in the work process in the capitalist mode of production. Thus, captitalists become control over ther labour process from workers. An alienation of the work process from the workers. The distribution of work is the majour source if inequalities in many countries as well as Korea. This paper presents the increasing tendency of unhealthy states such as mortality, early death, morbidity, physical work load, workplace injury amongst the under-privileged: ordinary workers, unemployed people, casual workers and socially deprived people in Korea.
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