Socioeconomic Inequalities in Different Types of Disabilities in Iran
AbstractBackground: This study measured socioeconomic inequalities in different types of disabilities in Iran. We also examined the prevalence of disabilities across different socio-demographic groups in Iran in 201
Methods: This was cross-sectional study using secondary data analysis on all Iranian. Data related to disability prevalence and socioeconomic status (SES) of each province was extracted from the 2011 National Census of Population and Housing (NCPH) and the 2011 Households Income and Expenditure Survey (HIES), conducted by Statistical Center of Iran (SCI). The concentration index and concentration curve were used to measure and illustrate socioeconomic inequalities in different types of disabilities. Chi-squared test was also used to examine the relationship between the socio-demographic variables (age-groups, sex, education level, employment status) and disability.
Results: The results suggested the existence of socioeconomic inequalities in blindness, deafness, vocal disorders and hand disorders in Iran. The concentration index for these four disabilities were -0.0527 (95% confidence interval [CI]: -0.0881, -0.0173), -0.0451 (CI: -0.0747, -0.0156), -0.0663 (CI: -0.1043, -0.0282) and -0.0545 (CI: -0.0940, -0.0151), respectively. There were also significant associations between the demographic variables such as age-groups, sex, education level, employment status and disability (P<0.05).
Conclusion: There were significant socioeconomic inequalities in different types of disabilities in Iran with poorer provinces having higher prevalence of disabilities in blindness, deafness, vocal disorders and hand disorders. Strategies to address the higher prevalence of different types of disabilities among poorer provinces should be considered a priority in Iran.
World Health Organization (2011). World report on disability. World Health Organization, Geneva. http://www.who.int/disabilities/world_report/2011/report.pdf
Üstün TB, Chatterji S, Bickenbach J et al (2003). The International Classification of Functioning, Disability and Health: a new tool for understanding disability and health. Disabil Rehabil, 25 (11-12):565-71.
Kondo N, Kawachi I, Hirai H et al (2009). Relative deprivation and incident functional disability among older Japanese women and men: prospective cohort study. J Epidemiol Community Health, 63 (6):461-7.
Hosseinpoor AR, Williams JS, Jann B et al (2012). Social determinants of sex differences in disability among older adults: a multi-country decomposition analysis using the World Health Survey. Int J Equity Health, 11:52.
Sen A (2011). The Idea of Justice. 1st ed. Harvard University Press, USA, pp.: 62-88.
Burkhauser RV, Daly MC, McVicar D, Wilkins R (2014). Disability benefit growth and disability reform in the US: lessons from other OECD nations. IZA Labor Policy, 3:4.
Trani JF, Barbou-des-Courieres C (2012). Measuring equity in disability and healthcare utilization in Afghanistan. Med Confl Surviv, 28 (3):219-46.
Watermeyer B, Swartz L, Lorenzo T, Schneider M, Priestley M (2006). Disability and social change: A South African agenda. 1st ed. Human Sciences Research Council Press, South Africa, pp.: 102-118.
Emerson E, Hatton C (2007). Contribution of socioeconomic position to health inequalities of British children and adolescents with intellectual disabilities. Am J Ment Retard, 112 (2):140-50.
Piroozi B, Moradi G, Nouri B et al (2016). Catastrophic health expenditure after the implementation of health sector evolution plan: a case study in the west of Iran. Int J Health Policy Manag, 5 (7):417-423.
Kavosi Z, Rashidian A, Pourreza A et al (2012). Inequality in household catastrophic health care expenditure in a low-income society of Iran. Health Policy Plan, 27 (7):613-23.
Veisani Y, Delpisheh A, Moradi G et al (2017). Inequality in addiction and mental disorders in 6818 suicide attempts: determine of positive contribution of determinants by decomposition method. Iran J Public Health, 46(6):796-803.
Soltani S, Khosravi B, Salehiniya H (2015). Prevalence of intellectual disability in Iran: Toward a new conceptual framework in data collection. J Res Med Sci, 20 (7):714-5.
Statistical Centre of Iran (2011). Population and Housing Censuses. https://www.amar.org.ir/english/Population-and-Housing-Censuses
O'Donnell O, Van Doorslaer E, Wagstaff A, Lindelow M (2008). Analyzing health equity using household survey data: a guide to techniques and their implementation. 1st ed. Washington, DC: World Bank Publication, pp.: 109-114.
Wagstaff A (2005). The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality. Health Econ, 14 (4):429-32.
O'Donnell O, O'Neill S, Van Ourti T, Walsh B (2016). conindex: Estimation of concentration indices. Stata J, 16 (1):112-138.
Entezarmahdi R, Majdzadeh R, Foroushani AR et al (2014). Inequality of leprosy disability in Iran, clinical or socio-economic inequality: an extended concentration index decomposition approach. Int J Prev Med, 5 (4):414.
Durkin M, Gottlieb C, Maenner M et al (2008). Monitoring child disability in developing countries: results from the Multiple Indicator Cluster Surveys. New York and Madison: UNICEF and University of Wisconsin School of Medicine and Public Health, pp.: 40-41.
Mitra S, Posarac A, Vick BC (2011). Disability and poverty in developing countries: A snapshot from the World Health Survey. 1st ed. World Bank Publication, pp.: 5-10.
Contreras D, Ruiz-Tagle J, Garcés P, Azócar I (2006). Socio-economic impact of disability in Latin America: Chile and Uruguay. 1st ed. Departement of Economics, University of Chile, Santiago, pp.: 58-64.
de Jong PR (2011). Sickness, disability and work: Breaking the barriers—A synthesis of findings across OECD countries–By OECD. Int Soc Secur Rev, 64 (3):103-4.
Trani J, Bah O, Bailey N, Browne J, Groce N, Kett M (2009). Disability in and around urban areas of Sierra Leone. 1st ed. UCL; Leonard Cheshire Disability, pp.: 36-37
Lafortune G, Balestat G (2007). Trends in severe disability among elderly people: Assessing the Evidence in 12 OECD Countries and the Future Implications. OECD Health Working Papers, No. 26, OECD Publishing, Paris, pp.: 4-8
Marmot M, Friel S, Bell R et al (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Lancet, 372 (9650):1661-9.
Buddelmeyer H, Verick S (2008). Understanding the drivers of poverty dynamics in Australian households. Econ Rec, 84 (266):310-21.
Houtenville AJ (2009). Counting working-age people with disabilities: what current data tell us and options for improvement. 1st ed. W.E. Upjohn Institute. Upjohn Press, pp.: 83-97
Üstün T, Chatterji S, Mechbal A, Murray CJ (2003). The world health surveys. Health systems performance assessment: debates, methods and empiricism. World Health Organization, Geneva.