• Journal of Preventive Medicine and Public Health
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• v.50 no.3
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• pp.201-209
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• 2017

Objectives: The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Methods: Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Results: Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children's sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. Conclusions: This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.249-259
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• 2011

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.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.214-223
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• 2019

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.

• Journal of Preventive Medicine and Public Health
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• v.51 no.6
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• pp.289-297
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• 2018

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 ${\geq}30kg/m^2$. 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.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.31 no.3B
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• pp.253-264
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• 2011

Drought assessment is usually performed qualitatively and/or quantitatively after defining a drought from meteorological, agricultural, hydrological, and socioeconomic perspective. Most of the drought analyses focus on meteorological, agricultural, and hydrological droughts, whereas the socioeconomic drought evaluation has been not actively performed since it needs different aspects. In this study, after defining a socioeconomic drought applicable to assess droughts in Korea, we suggested Water Excess Deficiency Index (WEDI) as an useful tool to evaluate socioeconomic droughts, based on water demand condition and water supply condition. This study verified the validity of WEDI by comparing with other drought indices (SPI, PDSI) and historical drought condition in Gyeongsang-do in 2001. The results indicated that the WEDI can be used to assess regional droughts in a socioeconomic perspective.

• Korean Journal of Health Education and Promotion
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• v.23 no.2
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• pp.109-119
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• 2006

Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.17-22
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• 2000

Purpose: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. Methods: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170 girls and 205 boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents' education and occupation using a modified Hollingshead index. Results: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower calss). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). Conclusion: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.

• Journal of Korean society of Dental Hygiene
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• v.18 no.6
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• pp.979-986
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• 2018

Objectives: The purpose of this study was to investigate the relationship between socioeconomic status and periodontal disease. Methods: The data used for the analysis were obtained from the sixth Korean National Health and Nutrition Examination Survey (2015). A total of 5,632 adults, aged over 19 years, were included in the study. This study analyzed data relating to socioeconomic status and health behaviors. The socioeconomic status was defined as an exogenous factor. Periodontal disease was the endogenous variable. Health behavior was a mediating variable. The study hypotheses were tested using Structural Equation Modeling analysis with Mplus 7.0 software. Results: According to the model fit test, the associated root-mean-square error was 0.05 (90% CI: 0.046-0.059); comparative fit index was 0.93; Tucker-Lewis index was 0.88; and standardized root-mean-square residual was 0.03. We found that socioeconomic status had significant effects on health behaviors (${\beta}=0.304$, p<0.001) and periodontal disease (${\beta}=-0.289$, p=0.001). Moreover, health behaviors had significant effects on periodontal diseases (${\beta}=0.143$, p<0.001). The analysis of a possible relationship between socioeconomic status and periodontal disease using path analysis demonstrated health behaviors difficulties, along with direct and indirect effects, further increased the risk of periodontal disease. Conclusions: The findings suggest that future interventions for the prevention of periodontal disease should consider health behavior.

• Journal of Preventive Medicine and Public Health
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• v.50 no.5
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• pp.303-310
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• 2017

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.

• Journal of Nutrition and Health
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• v.35 no.3
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• pp.332-351
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• 2002

The purpose of this study was to investigate effect of living condition and aging on food intake in Korea. 98 free-meal receivers and 81 members in well-being center for the aged were asked about their food frequency and food consumption and their socioeconomic status by a questionnaire. All data were analyzed by SPSS (Statistical Packages for the Social Sciences) 10.0 program. There were statistical differences of living condition, marital status, former job and teeth status between free-meal receivers and people with stable lives. Moreover, all age groups of free-meal receivers had lower income, living expenses, educational period and frequency of physical activity than those of people with stable lives. But smoking and drinking was much higher in free-meal receivers. Arthritis was the most prevalent disease in both groups. And free-meal receivers had higher blood pressure and lower Body Mass Index than people with stable lives. Food consumption of free-meal receivers was definitely lower than that of people with stable lives in terms of food frequency and standard amount of food eaten. But noodles, bean sprouts and eggs were very important foods for free-meal receives. Food consumption of the aged was affected by age, educational period, income, blood pressure, duration after retirement, frequency of physical activity and Body Mass Index. Therefore, as various socioeconomic status affects on food intakes of the aged, more effective and practical nutritional programs which consider the receivers'socioeconomic status are needed for the nutritionally at-risk groups like the aging free-meal receivers.