Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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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 (Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences) ;
  • Farid Najafi (Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences) ;
  • Shahin Soltani (Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences) ;
  • Behzad Karamimatin (Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences)
  • Received : 2022.08.23
  • Accepted : 2022.11.22
  • Published : 2023.01.31
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Abstract

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 middleaged 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.

Keywords

Acknowledgement

This study was funded by Kermanshah University of Medical Sciences (KUMS) (grant No. 980483).

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