Journal of Preventive Medicine and Public Health

  • 제51권5호
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  • Pages.219-226
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  • 2018
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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What Explains Socioeconomic Inequality in Health-related Quality of Life in Iran? A Blinder-Oaxaca Decomposition

  • Rezaei, Satar (Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences) ;
  • Hajizadeh, Mohammad (School of Health Administration, Faculty of Health, Dalhousie University) ;
  • Salimi, Yahya (Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences) ;
  • Moradi, Ghobad (Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences) ;
  • Nouri, Bijan (Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences)
  • 투고 : 2018.01.18
  • 심사 : 2018.07.09
  • 발행 : 2018.09.30
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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.

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참고문헌

  1. Djarv T, Wikman A, Johar A, Lagergren P. Poor health-related quality of life in the Swedish general population: the association with disease and lifestyle factors. Scand J Public Health 2013;41(7):744-753. https://doi.org/10.1177/1403494813491031
  2. Arcaya MC, Arcaya AL, Subramanian SV. Inequalities in health: definitions, concepts, and theories. Glob Health Action 2015;8:27106. https://doi.org/10.3402/gha.v8.27106
  3. Rezaei S, Hajizadeh M, Kazemi A, Khosravipour M, Khosravi F, Rezaeian S. Determinants of health-related quality of life in Iranian adults: evidence from a cross-sectional study. Epidemiol Health 2017;39:e2017038. https://doi.org/10.4178/epih.e2017038
  4. Burstrom K, Johannesson M, Diderichsen F. Health-related quality of life by disease and socio-economic group in the general population in Sweden. Health Policy 2001;55(1):51-69. https://doi.org/10.1016/S0168-8510(00)00111-1
  5. Terwindt GM, Ferrari MD, Tijhuis M, Groenen SM, Picavet HS, Launer LJ. The impact of migraine on quality of life in the general population: the GEM study. Neurology 2000;55(5):624-629. https://doi.org/10.1212/WNL.55.5.624
  6. Kind P, Dolan P, Gudex C, Williams A. Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 1998;316(7133):736-741. https://doi.org/10.1136/bmj.316.7133.736
  7. Wahl AK, Rustoen T, Rokne B, Lerdal A, Knudsen O, Miaskowski C, et al. The complexity of the relationship between chronic pain and quality of life: a study of the general Norwegian population. Qual Life Res 2009;18(8):971-980. https://doi.org/10.1007/s11136-009-9515-x
  8. Karyani AK, Rashidian A, Sefiddashti SE, Sari AA. Self-reported health-related quality of life (HRQoL) and factors affecting HRQoL among individuals with health insurance in Iran. Epidemiol Health 2016;38:e2016046. https://doi.org/10.4178/epih.e2016046
  9. Ghafari R, Rafiei M, Taheri NM. Assessment of health related quality of life by SF-36 version 2 in general population of Qom city. Arak Med Univ J 2014;16(11):63-72 (Persian).
  10. Goudarzi R, Zeraati H, Akbari Sari A, Rashidian A, Mohammad K. Population-based preference weights for the EQ-5D health states using the visual analogue scale (VAS) in Iran. Iran Red Crescent Med J 2016;18(2):e21584.
  11. Osoba D, Rodrigues G, Myles J, Zee B, Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 1998;16(1):139-144. https://doi.org/10.1200/JCO.1998.16.1.139
  12. Rezaei S, Karami Matin B, Kazemi Karyani A, Woldemichael A, Khosravi F, Khosravipour M, et al. Impact of smoking on health-related quality of life: a general population survey in West Iran. Asian Pac J Cancer Prev 2017;18(11):3179-3185.
  13. Matute I, Burgos S, Alfaro T. Socioeconomic status and perceived health-related quality of life in Chile. MEDICC Rev 2017; 19(2-3):51-56.
  14. Ramaul NK, Ramaul P. Determinants of industrial location choice in India: a polychoric principal component analysis approach. J Quant Econ 2016;14(1):29-56. https://doi.org/10.1007/s40953-015-0026-z
  15. Kolenikov S, Angeles G. Socioeconomic status measurement with discrete proxy variables: is principal component analysis a reliable answer? Rev Income Wealth 2009;55(1):128-165. https://doi.org/10.1111/j.1475-4991.2008.00309.x
  16. McKenzie DJ. Measuring inequality with asset indicators. J Popul Econ 2005;18(2):229-260. https://doi.org/10.1007/s00148-005-0224-7
  17. Williams B, Onsman A, Brown T. Exploratory factor analysis: a five-step guide for novices. J Emerg Prim Health Care 2010; 8(3):990399.
  18. Moreno-Betancur M, Latouche A, Menvielle G, Kunst AE, Rey G. Relative index of inequality and slope index of inequality: a structured regression framework for estimation. Epidemiology 2015;26(4):518-527. https://doi.org/10.1097/EDE.0000000000000311
  19. Oaxaca R. Male-female wage differentials in urban labor markets. Int Econ Rev (Philadelphia) 1973;14(3):693-709. https://doi.org/10.2307/2525981
  20. Jann B. The Blinder-Oaxaca decomposition for linear regression models. Stata J 2008;8(4):453-479.
  21. Sinning M, Hahn M, Bauer TK. The Blinder-Oaxaca decomposition for nonlinear regression models. Stata J 2008;8(4):480-492.
  22. O'Donnell O, van Doorslaer E, Wagstaff A, Lindelow M. Analyzing health equity using household survey data: a guide to techniques and their implementation; 2008 [cited 2018 Aug 30]. Available from: http://web.worldbank.org/archive/website01411/WEB/IMAGES/HEALTHEQ.PDF.
  23. Menati W, Baghbanian A, Asadi-Lari M, Moazen J, Menati R, Sohrabivafa M, et al. Health-related quality of life and socioeconomic status: inequalities among adults in West of Iran. Iran Red Crescent Med J 2017;19(7):e55571.
  24. Mielck A, Vogelmann M, Leidl R. Health-related quality of life and socioeconomic status: inequalities among adults with a chronic disease. Health Qual Life Outcomes 2014;12:58. https://doi.org/10.1186/1477-7525-12-58
  25. Esmailnasab N, Hassanzadeh J, Rezaeian S, Barkhordari M. Use of health care services and associated factors among women. Iran J Public Health 2014;43(1):70-78.
  26. Hajizadeh M, Connelly LB, Butler JR, Khosravi A. Unmet need and met unneed in health care utilisation in Iran. Int J Soc Econ 2012;39(6):400-422. https://doi.org/10.1108/03068291211224919
  27. Huguet N, Kaplan MS, Feeny D. Socioeconomic status and health-related quality of life among elderly people: results from the Joint Canada/United States Survey of Health. Soc Sci Med 2008;66(4):803-810. https://doi.org/10.1016/j.socscimed.2007.11.011
  28. Augustussen M, Sjogren P, Timm H, Hounsgaard L, Pedersen ML. Symptoms and health-related quality of life in patients with advanced cancer-a population-based study in Greenland. Eur J Oncol Nurs 2017;28:92-97. https://doi.org/10.1016/j.ejon.2017.03.004
  29. Kitaoka M, Mitoma J, Asakura H, Anyenda OE, Nguyen TT, Hamagishi T, et al. 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 2016;21(4): 193-214. https://doi.org/10.1007/s12199-016-0514-6
  30. Hajian-Tilaki K, Heidari B, Hajian-Tilaki A. 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 2016; 10(2 Suppl 1):S37-S42. https://doi.org/10.1016/j.dsx.2016.01.018
  31. Anokye NK, Trueman P, Green C, Pavey TG, Taylor RS. Physical activity and health related quality of life. BMC Public Health 2012;12:624. https://doi.org/10.1186/1471-2458-12-624
  32. Ross NA, Garner R, Bernier J, Feeny DH, Kaplan MS, McFarland B, et al. Trajectories of health-related quality of life by socio-economic status in a nationally representative Canadian cohort. J Epidemiol Community Health 2012;66(7):593-598. https://doi.org/10.1136/jech.2010.115378
  33. Buder I, Zick C, Waitzman N. Health-related quality of life associated with physical activity: new estimates by gender and race and ethnicity. World Med Health Policy 2016:8(4):409-420. https://doi.org/10.1002/wmh3.208