What Explains Socioeconomic Inequality in Health-related Quality of Life in Iran? A Blinder-Oaxaca Decomposition
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: This study aimed to explain the health-related quality of life (HRQoL) gap between the poorest and the wealthiest quintiles in the capitals of Kermanshah and Kurdistan Provinces (Kermanshah and Sanandaj), in western Iran. Methods: This was a cross-sectional study conducted among 1772 adults. Data on socio-demographic characteristics, socioeconomic status (SES), lifestyle factors, body mass index, and HRQoL of participants were collected using a self-administered questionnaire. The slope and relative indices of inequality (SII and RII, respectively) were employed to examine socioeconomic inequality in poor HRQoL. Blinder-Oaxaca (BO) decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of poor HRQoL between the wealthiest and the poorest groups. Results: The overall crude and age-adjusted prevalence of poor HRQoL among adults was 32.0 and 41.8%, respectively. The SII and RII indicated that poor HRQoL was mainly concentrated among individuals with lower SES. The absolute difference (%) in the prevalence of poor HRQoL between the highest and lowest SES groups was 28.4. The BO results indicated that 49.9% of the difference was explained by different distributions of age, smoking behavior, physical inactivity, chronic health conditions, and obesity between the highest and lowest SES groups, while the remaining half of the gap was explained by the response effect. Conclusions: We observed a pro-rich distribution of poor HRQoL among adults in the capitals of Kermanshah and Kurdistan Provinces. Policies and strategies aimed at preventing and reducing smoking, physical inactivity, chronic health conditions, and obesity among the poor may reduce the gap in poor HRQoL between the highest and lowest SES groups in Iran.
Abstract
Objectives: This study aimed to explain the health-related quality of life (HRQoL) gap between the poorest and the wealthiest quintiles in the capitals of Kermanshah and Kurdistan Provinces (Kermanshah and Sanandaj), in western Iran. Methods: This was a cross-sectional study conducted among 1772 adults. Data on socio-demographic characteristics, socioeconomic status (SES), lifestyle factors, body mass index, and HRQoL of participants were collected using a self-administered questionnaire. The slope and relative indices of inequality (SII and RII, respectively) were employed to examine socioeconomic inequality in poor HRQoL. Blinder-Oaxaca (BO) decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of poor HRQoL between the wealthiest and the poorest groups. Results: The overall crude and age-adjusted prevalence of poor HRQoL among adults was 32.0 and 41.8%, respectively. The SII and RII indicated that poor HRQoL was mainly concentrated among individuals with lower SES. The absolute difference (%) in the prevalence of poor HRQoL between the highest and lowest SES groups was 28.4. The BO results indicated that 49.9% of the difference was explained by different distributions of age, smoking behavior, physical inactivity, chronic health conditions, and obesity between the highest and lowest SES groups, while the remaining half of the gap was explained by the response effect. Conclusions: We observed a pro-rich distribution of poor HRQoL among adults in the capitals of Kermanshah and Kurdistan Provinces. Policies and strategies aimed at preventing and reducing smoking, physical inactivity, chronic health conditions, and obesity among the poor may reduce the gap in poor HRQoL between the highest and lowest SES groups in Iran.
참고문헌 (33)
- Djarv T, "Poor health-related quality of life in the Swedish general population: the association with disease and lifestyle factors", Scand J Public Health, 41(7), pp.744~753 (2013)[DOI]
- Arcaya MC, "Inequalities in health: definitions, concepts, and theories", Glob Health Action, 8, pp.27106~ (2015)[DOI]
- Satar Rezaei, "Determinants of health-related quality of life in Iranian adults: evidence from a cross-sectional study", Epidemiology and Health, 39, pp.1~8 (2017), 한국역학회[DOI]
- Burstrom K, "Health-related quality of life by disease and socio-economic group in the general population in Sweden", Health Policy, 55(1), pp.51~69 (2001)[DOI]
- Terwindt GM, "The impact of migraine on quality of life in the general population: the GEM study", Neurology, 55(5), pp.624~629 (2000)[DOI]
- Kind P, "Variations in population health status: results from a United Kingdom national questionnaire survey", BMJ, 316(7133), pp.736~741 (1998)[DOI]
- Wahl AK, "The complexity of the relationship between chronic pain and quality of life: a study of the general Norwegian population", Qual Life Res, 18(8), pp.971~980 (2009)[DOI]
- Ali Kazemi Karyani, "Self-reported health-related quality of life (HRQoL) and factors affecting HRQoL among individuals with health insurance in Iran", Epidemiology and Health, 38, pp.1~8 (2016), 한국역학회[DOI]
- Ghafari R, "Assessment of health related quality of life by SF-36 version 2 in general population of Qom city", Arak Med Univ J, 16(11), pp.63~72 (2014)
- Goudarzi R, "Population-based preference weights for the EQ-5D health states using the visual analogue scale (VAS) in Iran", Iran Red Crescent Med J, 18(2), pp.e21584~ (2016)
- Osoba D, "Interpreting the significance of changes in health-related quality-of-life scores", J Clin Oncol, 16(1), pp.139~144 (1998)[DOI]
- Rezaei S, "Impact of smoking on health-related quality of life: a general population survey in West Iran", Asian Pac J Cancer Prev, 18(11), pp.3179~3185 (2017)
- Matute I, "Socioeconomic status and perceived health-related quality of life in Chile", MEDICC Rev, 19(2-3), pp.51~56 (2017)
- Ramaul NK, "Determinants of industrial location choice in India: a polychoric principal component analysis approach", J Quant Econ, 14(1), pp.29~56 (2016)[DOI]
- Kolenikov S, "Socioeconomic status measurement with discrete proxy variables: is principal component analysis a reliable answer?", Rev Income Wealth, 55(1), pp.128~165 (2009)[DOI]
- McKenzie DJ, "Measuring inequality with asset indicators", J Popul Econ, 18(2), pp.229~260 (2005)[DOI]
- Williams B, "Exploratory factor analysis: a five-step guide for novices", J Emerg Prim Health Care, 8(3), pp.990399~ (2010)
- Moreno-Betancur M, "Relative index of inequality and slope index of inequality: a structured regression framework for estimation", Epidemiology, 26(4), pp.518~527 (2015)[DOI]
- Oaxaca R, "Male-female wage differentials in urban labor markets", Int Econ Rev (Philadelphia), 14(3), pp.693~709 (1973)[DOI]
- Jann B, "The Blinder-Oaxaca decomposition for linear regression models", Stata J, 8(4), pp.453~479 (2008)
- Sinning M, "The Blinder-Oaxaca decomposition for nonlinear regression models", Stata J, 8(4), pp.480~492 (2008)
- O'Donnell O, "Analyzing health equity using household survey data: a guide to techniques and their implementation" (2008)
- Menati W, "Health-related quality of life and socioeconomic status: inequalities among adults in West of Iran", Iran Red Crescent Med J, 19(7), pp.e55571~ (2017)
- Mielck A, "Health-related quality of life and socioeconomic status: inequalities among adults with a chronic disease", Health Qual Life Outcomes, 12, pp.58~ (2014)[DOI]
- Esmailnasab N, "Use of health care services and associated factors among women", Iran J Public Health, 43(1), pp.70~78 (2014)
- Hajizadeh M, "Unmet need and met unneed in health care utilisation in Iran", Int J Soc Econ, 39(6), pp.400~422 (2012)[DOI]
- Huguet N, "Socioeconomic status and health-related quality of life among elderly people: results from the Joint Canada", United States Survey of Health, 2008, pp.66(4), 803~810
- Augustussen M, "Symptoms and health-related quality of life in patients with advanced cancer-a population-based study in Greenland", Eur J Oncol Nurs, 28, pp.92~97 (2017)[DOI]
- Kitaoka M, "The relationship between hypertension and health-related quality of life: adjusted by chronic pain, chronic diseases, and life habits in the general middle-aged population in Japan", Environ Health Prev Med, 21(4), pp.193~214 (2016)[DOI]
- Hajian-Tilaki K, "Solitary and combined negative influences of diabetes, obesity and hypertension on health-related quality of life of elderly individuals: a population-based cross-sectional study", Diabetes Metab Syndr, 10(2 Suppl 1), pp.S37~S42 (2016)[DOI]
- Anokye NK, "Physical activity and health related quality of life", BMC Public Health, 12, pp.624~ (2012)[DOI]
- Ross NA, "Trajectories of health-related quality of life by socio-economic status in a nationally representative Canadian cohort", J Epidemiol Community Health, 66(7), pp.593~598 (2012)[DOI]
- Buder I, "Health-related quality of life associated with physical activity: new estimates by gender and race and ethnicity", World Med Health Policy, 8(4), pp.409~420 (2016)[DOI]