Understanding determinants of socioeconomic inequality in mental health in Iran's capital, Tehran: a concentration index decomposition approach.
Understanding determinants of socioeconomic inequality in mental health in Iran's capital, Tehran: a concentration index decomposition approach.
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DOI：
10.1186/1475-9276-11-18
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发表时间：
2012-03-26
影响因子：
4.8
通讯作者：
Hosseinpoor AR
中科院分区：
文献类型：
--
作者：
Morasae EK;Forouzan AS;Majdzadeh R;Asadi-Lari M;Noorbala AA;Hosseinpoor AR
心理健康对于健康方面的社会经济不平等特别重要。一方面，心理健康状况在经济不平等与健康之间起中介作用;另一方面，心理健康作为一种“终态”，又受到社会因素和社会经济不平等的影响。尽管如此，在审查健康方面的社会经济不平等时，精神健康受到的关注少于身体健康。作为在伊朗的第一次尝试，本文的目标是衡量心理健康的社会经济不平等，然后解开和量化的心理健康的潜在决定因素的贡献测量的社会经济不平等。在一项横断面观察性研究中，心理健康数据来自2007年对22 300个德黑兰家庭进行的城市健康公平评估和应对工具（城市HEART）调查，涵盖15岁及以上的人。主成分分析被用来衡量家庭的经济状况。作为衡量社会经济不平等的一个指标，采用了精神健康集中指数，并将其分解为决定因素。德黑兰的精神卫生总体集中指数为-0.0673（95%CI = -0.070 ~-0.057）。集中指数的分解显示，经济地位对心理健康方面的社会经济不平等做出了最大的贡献（44.7%）。教育状况（13.4%）、年龄组（13.1%）、居住区（12.5%）和就业状况（6.5%）也证明是造成不平等的其他重要因素。伊朗首都德黑兰的精神健康状况存在社会经济不平等。由于这种可以避免的不平等的根源在于卫生系统以外的部门，因此应采取包括社会和经济决定因素在内的全面精神卫生政策办法，以纠正精神卫生分布不公平的现象。
Mental health is of special importance regarding socioeconomic inequalities in health. On the one hand, mental health status mediates the relationship between economic inequality and health; on the other hand, mental health as an "end state" is affected by social factors and socioeconomic inequality. In spite of this, in examining socioeconomic inequalities in health, mental health has attracted less attention than physical health. As a first attempt in Iran, the objectives of this paper were to measure socioeconomic inequality in mental health, and then to untangle and quantify the contributions of potential determinants of mental health to the measured socioeconomic inequality. In a cross-sectional observational study, mental health data were taken from an Urban Health Equity Assessment and Response Tool (Urban HEART) survey, conducted on 22 300 Tehran households in 2007 and covering people aged 15 and above. Principal component analysis was used to measure the economic status of households. As a measure of socioeconomic inequality, a concentration index of mental health was applied and decomposed into its determinants. The overall concentration index of mental health in Tehran was -0.0673 (95% CI = -0.070 - -0.057). Decomposition of the concentration index revealed that economic status made the largest contribution (44.7%) to socioeconomic inequality in mental health. Educational status (13.4%), age group (13.1%), district of residence (12.5%) and employment status (6.5%) also proved further important contributors to the inequality. Socioeconomic inequalities exist in mental health status in Iran's capital, Tehran. Since the root of this avoidable inequality is in sectors outside the health system, a holistic mental health policy approach which includes social and economic determinants should be adopted to redress the inequitable distribution of mental health.
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