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8 "Health equity"
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Original Article
A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran
Zahra Mohammadi Daniali, Mohammad Mehdi Sepehri, Farzad Movahedi Sobhani, Mohammad Heidarzadeh
J Prev Med Public Health. 2022;55(1):49-59.   Published online December 28, 2021
DOI: https://doi.org/10.3961/jpmph.21.401
  • 2,792 View
  • 141 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran.
Methods
First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties.
Results
It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider.
Conclusions
This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.
Summary

Citations

Citations to this article as recorded by  
  • Global burden and inequality of maternal and neonatal disorders: based on data from the 2019 Global Burden of Disease study
    R Peng, Y Tong, M Yang, J Wang, L Yang, J Zhu, Yu Liu, H Wang, Z Shi, Ya Liu
    QJM: An International Journal of Medicine.2024; 117(1): 24.     CrossRef
  • Epidemiology and Clinical Features of COVID-19 among 4,015 Neonates in Iran: Results of the National Study from the Iranian Maternal and Neonatal Network
    David A. Schwartz, Parisa Mohagheghi, Fereshteh Moshfegh, Nazanin Zafaranloo, Narjes Khalili, Mohammad Heidarzadeh, Abbas Habibelahi, Roya Ghafoury, Fatemeh Afrashteh
    American Journal of Perinatology.2023;[Epub]     CrossRef
  • An optimization model for equitable accessibility to magnetic resonance imaging technology in developing countries
    João Flávio de Freitas Almeida, Samuel Vieira Conceição, Virgínia Silva Magalhães
    Decision Analytics Journal.2022; 4: 100105.     CrossRef
Special Articles
Measuring the Burden of Disease in Korea, 2008-2018
Yoon-Sun Jung, Young-Eun Kim, Hyesook Park, In-Hwan Oh, Min-Woo Jo, Minsu Ock, Dun-Sol Go, Seok-Jun Yoon
J Prev Med Public Health. 2021;54(5):293-300.   Published online September 30, 2021
DOI: https://doi.org/10.3961/jpmph.21.478
  • 6,778 View
  • 375 Download
  • 25 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.
Summary
Korean summary
이 논문에서는 장애보정생존년수라는 지표를 활용하여 2008-2018년 한국인의 질병부담 산출결과를 제시하였으며, 성별·연령군별·질환별 질병부담 수준의 차이 뿐만 아니라 지역 및 소득수준의 사회경제적 수준에 따른 질병부담의 격차도 함께 제시하였다.

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    Asia Pacific Journal of Public Health.2024; 36(1): 78.     CrossRef
  • Widening disparities in the national prevalence of diabetes mellitus for people with disabilities in South Korea
    I. Hwang, S.Y. Kim, Y.Y. Kim, J.H. Park
    Public Health.2024; 226: 173.     CrossRef
  • Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008–2020): Analysis of a Nationwide Claims Database
    Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Measuring the Burden of Disease in Korea Using Disability-Adjusted Life Years (2008–2020)
    Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Opioid Prescription and Long-term Survival Outcomes in Adults: A Nationwide Cohort Study in Korea
    Tak Kyu Oh, In-Ae Song
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Changes in tuberculosis burden and its associated risk factors in Guizhou Province of China during 2006–2020: an observational study
    Yun Wang, Huijuan Chen, Xiaoqi Zeng, Long Liao, Xiaolong Lu, Aihua Zhang
    BMC Public Health.2024;[Epub]     CrossRef
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    Junghyun Kwon
    Religions.2023; 14(1): 90.     CrossRef
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    Yoon-Sun Jung, Seok-Jun Yoon
    Cancer Research and Treatment.2023; 55(2): 408.     CrossRef
  • Relevance Index Regional Variation by Each Disease and Its Essential Medical Field: A Retrospective Data Analysis From 2016-2020 in Korea
    Young-Eun Kim, Jeehee Pyo, Haneul Lee, HyeRan Jeong, Young-Kwon Park, Jeong-Wook Seo, Minsu Ock, Seok-Jun Yoon
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Min Ji Koo, Seong Ho Cho
    Life Cycle.2023;[Epub]     CrossRef
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    Ji Eun Park, Saerom Kim, Myoung-Hee Kim, Taemi Kim, Seung-Ah Choe, Hye Sook Min
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Outbreak of carbapenem-resistant Enterobacterales at a long-term care facility in Seoul, Korea: surveillance and intervention mitigation strategies
    Yoojin Park, Euncheol Son, Young June Choe, Cho Ryok Kang, Sangmi Roh, Young Ok Hwang, Sung-il Cho, Jihwan Bang
    Epidemiology and Health.2023; 45: e2023057.     CrossRef
  • Correlation of health-related quality of life for older adults with diabetes mellitus in South Korea: theoretical approach
    Gi Won Choi, Sun Ju Chang
    BMC Geriatrics.2023;[Epub]     CrossRef
  • Allergic diseases, COVID-19 pandemic, and underlying mechanisms
    Min Ji Koo, Seong Ho Cho, Stephen Turner, Jung-Hyun Kim, Nikolaos G. Papadopoulos
    Life Cycle.2023;[Epub]     CrossRef
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    Hee-kyoung Nam, Jungmi Park, Sung-il Cho
    BMC Public Health.2023;[Epub]     CrossRef
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    Thi Xuan Mai Tran, Soyeoun Kim, Huiyeon Song, Boyoung Park
    Epidemiology and Health.2023; 45: e2023080.     CrossRef
  • Incidence and case fatality rates of stroke in Korea, 2011-2020
    Jenny Moon, Yeeun Seo, Hyeok-Hee Lee, Hokyou Lee, Fumie Kaneko, Sojung Shin, Eunji Kim, Kyu Sun Yum, Young Dae Kim, Jang-Hyun Baek, Hyeon Chang Kim
    Epidemiology and Health.2023; : e2024003.     CrossRef
  • DALY Estimation Approaches: Understanding and Using the Incidence-based Approach and the Prevalence-based Approach
    Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon
    Journal of Preventive Medicine and Public Health.2022; 55(1): 10.     CrossRef
  • A Review of the Types and Characteristics of Healthy Life Expectancy and Methodological Issues
    Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon
    Journal of Preventive Medicine and Public Health.2022; 55(1): 1.     CrossRef
  • Measuring Trends in the Socioeconomic Burden of Disease in Korea, 2007-2015
    Tae Eung Kim, Ru-Gyeom Lee, So-Youn Park, In-Hwan Oh
    Journal of Preventive Medicine and Public Health.2022; 55(1): 19.     CrossRef
  • Burden of Cancer Due to Cigarette Smoking and Alcohol Consumption in Korea
    Yoon-Sun Jung, Seok-Jun Yoon
    International Journal of Environmental Research and Public Health.2022; 19(6): 3493.     CrossRef
  • Association Between Sleep Quality and Anxiety in Korean Adolescents
    Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
    Journal of Preventive Medicine and Public Health.2022; 55(2): 173.     CrossRef
  • Active Surveillance Versus Immediate Surgery for Low-Risk Papillary Thyroid Microcarcinoma Patients in South Korea: A Cost-Minimization Analysis from the MAeSTro Study
    Kyungsik Kim, June Young Choi, Su-jin Kim, Eun Kyung Lee, Young Ki Lee, Jun Sun Ryu, Kyu Eun Lee, Jae Hoon Moon, Young Joo Park, Sun Wook Cho, Sue K. Park
    Thyroid.2022; 32(6): 648.     CrossRef
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    Youjin Hong, Sangjun Lee, Sungji Moon, Soseul Sung, Woojin Lim, Kyungsik Kim, Seokyung An, Jeoungbin Choi, Kwang-Pil Ko, Inah Kim, Jung Eun Lee, Sue K. Park
    Journal of Preventive Medicine and Public Health.2022; 55(6): 529.     CrossRef
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    Roma Seol, Jin-Ho Chun
    International Journal of Environmental Research and Public Health.2022; 19(24): 16600.     CrossRef
The National Health Plan 2030: Its Purpose and Directions of Development
Yumi Oh
J Prev Med Public Health. 2021;54(3):173-181.   Published online May 7, 2021
DOI: https://doi.org/10.3961/jpmph.21.198
  • 3,606 View
  • 139 Download
  • 9 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDF
The National Health Plan 2030 (HP2030) started to be prepared in 2017 and was completed and announced in December 2020. This study presents an overview of how it was established, the major changes in policies, its purpose, and future directions. This study analyzed the steps taken in the past 4 years to establish HP2030 and reviewed major issues at the international and governmental levels based on an evaluation of HP2020 and its content. HP2030 establishes 6 divisions and 28 topic areas, and it will continue to expand investments in health with a total budget of 2.5 trillion Korean won. It also established goals to enhance health equity for the first time, with the goal of calculating healthy life expectancy in a way that reflects the circumstances of Korea and reducing the gap in income and healthy life expectancy between regions. The establishment of HP2030 is significant in that it constitutes a sustainable long-term plan with sufficient preparation, contains policy measures that everyone participates in and makes together, and works towards improvements in universal health standards and health equity. With the announcement of HP2030, which includes goals and directions of the national health policy for the next 10 years, it will be necessary to further strengthen collaboration with relevant ministries, local governments, and agencies in various fields to concretize support for prevention-centered health management as a national task and to develop a health-friendly environment that considers health in all policy areas.
Summary
Korean summary
본 연구는 지난 17년부터 4년간 준비한 국민건강증진종합계획2030이 발표됨에 따라 수립경과와 주요 변화정책을 분석하고, 수립의 의의를 검토하여 향후 추진방향을 제시하고자 한다. 국민건강증진종합계획2030의 수립은 충분한 준비기간을 통한 지속가능한 중장기 계획의 수립, 모든 사람에 함께 참여하고 만들어가는 정책으로서의 전환, 보편적인 건강수준 향상과 건강형평성 제고를 했다는데 그 의의가 있다 향후 10년간의 국가 건강정책의 목표와 방향을 담은 HP2030 발표를 계기로, 모든 정책 영역에서 건강을 고려하는 건강친화적 환경 구축을 위해 관련 부처와 지자체, 다양한 분야의 주체들과 협력을 강화해야 하겠다.

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COVID-19: Special Article
Mainstreaming of Health Equity in Infectious Disease Control Policy During the COVID-19 Pandemic Era
Hongjo Choi, Seong-Yi Kim, Jung-Woo Kim, Yukyung Park, Myoung-Hee Kim
J Prev Med Public Health. 2021;54(1):1-7.   Published online January 15, 2021
DOI: https://doi.org/10.3961/jpmph.20.593
  • 5,082 View
  • 301 Download
  • 8 Web of Science
  • 9 Crossref
AbstractAbstract AbstractSummary PDF
The Korean government’s strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.
Summary
Korean summary
"이 연구는 코로나19 대유행이 건강불평등에 미치는 영향을 검토하고, 불평등 완화 방안을 제시하고자 한다. 건강의 사회적 결정요인은 코로나19와 건강불평등을 이해하기 위한 출발점이다. 건강의 사회적 결정요인은 코로나19 감염과 그로 인한 사망 등 직접영향 경로와 코로나19 대응과정의 문제로 건강불평등을 야기하는 간접영향 경로에 모두 관여한다. 공중보건위기로 인한 건강불평등을 줄이기 위해서는 시민참여를 통한 협력적 거버넌스 강화와 모든 건강정책에서 사람중심돌봄의 관점을 견지하는 것이 필요하다."

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Original Articles
Household Overcrowding in Iran, a Low-middle-income Country: How Major of a Public Health Concern Is It?
Leila Jansar Hosseini, Ali Hussein Samadi, Abraha Woldemichael, Masoumeh Najaf Gharebelagh, Satar Rezaei, Enayatollah Homaie Rad
J Prev Med Public Health. 2021;54(1):73-80.   Published online January 11, 2021
DOI: https://doi.org/10.3961/jpmph.20.568
  • 3,735 View
  • 116 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Household overcrowding (HC) can contribute to both physical and mental disorders among the members of overcrowded households. This study aimed to measure the status of HC and its main determinants across the provinces of Iran.
Methods
Data from 39 864 households from the 2016 Iranian Household Income and Expenditures Survey were used in this study. The Equivalized Crowding Index (ECI) and HC index were applied to measure the overcrowding of households. Regression models were estimated to show the relationships between different variables and the ECI.
Results
The overall, urban, and rural prevalence of HC was 8.2%, 6.3%, and 10.1%, respectively. The highest prevalence of HC was found in Sistan and Baluchestan Province (28.7%), while the lowest was found in Guilan Province (1.8%). The number of men in the household, rural residency, the average age of household members, yearly income, and the household wealth index were identified as the main determinants of the ECI and HC.
Conclusions
The study demonstrated that the ECI and HC were higher in regions near the borders of Iran than in other regions. Therefore, health promotion and empowerment strategies are required to avoid the negative consequences of HC, and screening programs are needed to identify at-risk families.
Summary

Citations

Citations to this article as recorded by  
  • Social determinants of health and diabetes: Results from a cohort study in Iran
    SeyedJalal Hashemi, Mehrnoosh Jasemzadeh, Nader Saki, Bahman Cheraghian, Sara Sarvandian, Ali Montazeri, Maedeh Raeisizadeh, Marzieh Araban
    Asian Journal of Social Health and Behavior.2023; 6(2): 86.     CrossRef
  • Inadequate housing and pulmonary tuberculosis: a systematic review
    Ju-Yeun Lee, Namhee Kwon, Ga-yeon Goo, Sung-il Cho
    BMC Public Health.2022;[Epub]     CrossRef
Measuring and Decomposing Socioeconomic Inequalities in Adult Obesity in Western Iran
Farid Najafi, Yahya Pasdar, Behrooz Hamzeh, Satar Rezaei, Mehdi Moradi Nazar, Moslem Soofi
J Prev Med Public Health. 2018;51(6):289-297.   Published online October 29, 2018
DOI: https://doi.org/10.3961/jpmph.18.062
  • 6,293 View
  • 175 Download
  • 13 Crossref
AbstractAbstract PDF
Objectives
Obesity is a considerable and growing public health concern worldwide. The present study aimed to quantify socioeconomic inequalities in adult obesity in western Iran.
Methods
A total of 10 086 participants, aged 35-65 years, from the Ravansar Non-communicable Disease Cohort Study (2014-2016) were included in the study to examine socioeconomic inequalities in obesity. We defined obesity as a body mass index ≥30 kg/m2 . The concentration index and concentration curve were used to illustrate and measure wealth-related inequality in obesity. Additionally, we decomposed the concentration index to identify factors that explained wealth-related inequality in obesity.
Results
Overall, the prevalence of obesity in the total sample was 26.7%. The concentration index of obesity was 0.04; indicating that obesity was more concentrated among the rich (p<0.001). Decomposition analysis indicated that wealth, place of residence, and marital status were the main contributors to the observed inequality in obesity.
Conclusions
Socioeconomic-related inequalities in obesity among adults warrant more attention. Policies should be designed to reduce both the prevalence of obesity and inequalities in obesity by focusing on those with higher socioeconomic status, urban residents, and married individuals.
Summary

Citations

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  • Worse becomes the worst: obesity inequality, its determinants and policy options in Iran
    Fatemeh Toorang, Parisa Amiri, Abolghassem Djazayery, Hamed Pouraram, Amirhossein Takian
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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
    Journal of Preventive Medicine and Public Health.2023; 56(1): 50.     CrossRef
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The Role of Social Support and the Neighborhood Environment on Physical Activity in Low-income, Mexican-American Women in South Texas
Jennifer J. Salinas, Marisol McDaniel, Deborah Parra-Medina
J Prev Med Public Health. 2018;51(5):234-241.   Published online July 25, 2018
DOI: https://doi.org/10.3961/jpmph.18.052
  • 5,331 View
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AbstractAbstract PDF
Objectives
To determine the relationships between physical activity (PA), the neighborhood environment support for PA, and social support for PA among Mexican-American women living in South Texas. The Enlace study was a randomized controlled trial that tested the effectiveness of a promotora-led PA intervention among low-income Mexican origin women (n=614) living in colonias.
Methods
The dependent measures included accelerometer-measured average moderate to vigorous physical activity (MVPA) and sedentary breaks and the Community Health Activities Model Program for Seniors PA 41-item questionnaire. The independent measures included the Physical Activity and Neighborhood Environment Scale (PANES) and the 13-item Physical Activity Social Support (PASS) scale.
Results
Enlace participants were on average 40.4 (standard deviation, 10.3) years old, born in Mexico (86.1%), and uninsured (83.1%). Adjusted linear regression results indicated that each 1-point increment in the PANES overall score was associated with 0.050 (p<0.001) unit increase in sedentary break and a −0.043 (p=0.001) unit decrease in sedentary break duration. Both PANES (β=0.296; p=0.002) and PASS scores (β=0.076; p<0.001) were associated with weekly average self-reported MVPA. Interaction effects were observed between PASS scores and accelerometer-measured frequency of sedentary breaks and sedentary time duration.
Conclusions
The findings of this study indicate that the relationships between PA and built environment and social support are measure-dependent and suggest that reducing sedentary time in this population may require a closer assessment of social support for PA.
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Socioeconomic Inequalities in the Oral Health of People Aged 15-40 Years in Kurdistan, Iran in 2015: A Cross-sectional Study
Ghobad Moradi, Ardavan Moinafshar, Hemen Adabi, Mona Sharafi, Farideh Mostafavi, Amjad Mohamadi Bolbanabad
J Prev Med Public Health. 2017;50(5):303-310.   Published online July 25, 2017
DOI: https://doi.org/10.3961/jpmph.17.035
  • 6,383 View
  • 188 Download
  • 16 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. Methods: This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. Results: The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents’ education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). Conclusions: An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.
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JPMPH : Journal of Preventive Medicine and Public Health