ABSTRACT
Objectives@#Our aim was to answer the following questions: (1) Can mental health variance be partitioned to individual and higher levels (e.g., neighborhood and district); (2) How much (as a percentage) do individual-level determinants explain the variability of mental health at the individual-level; and (3) How much do determinants at the neighborhood- or district-level explain the variability of mental health at the neighborhood- or district-level? @*Methods@#We used raw data from the second round of the Urban Health Equity Assessment and Response Tool in Tehran (in 2012-2013, n=34 700 samples nested in 368 neighborhoods nested in 22 districts) and the results of the official report of Tehran’s Center of Studies and Planning (in 2012-2013, n=22 districts). Multilevel linear regression models were used to answer the study questions. @*Results@#Approximately 40% of Tehran residents provided responses suggestive of having mental health disorders (30-52%). According to estimates of residual variance, 7% of mental health variance was determined to be at the neighborhood-level and 93% at the individual-level. Approximately 21% of mental health variance at the individual-level and 49% of the remaining mental health variance at the neighborhood-level were determined by determinants at the individual-level and neighborhood-level, respectively. @*Conclusions@#If we want to make the most effective decisions about the determinants of mental health, in addition to considering the therapeutic perspective, we should have a systemic or contextual view of the determinants of mental health.
ABSTRACT
Background: Health and nutrition are important aspects in the analysis of households' multidimensional poverty. The present research investigated poverty in Tehran's households through a cohort approach. In this regard, households' financial participation about health costs and food intake calories were analyzed
Methods: Households' data of costs - income survey were then collected. Health and nutrition poverty trend was investigated through generational approach, index of poverty "Foster, Greer, Turbak", and in the period of 1984-2014 by dividing Tehrany families into eight various age groups. Excell and Stata11 were applied to process and calculate the indices
Results: During the study years, the highest level of health poverty [29%] in 1999 was in age range of 21-26 and the highest level of nutrition poverty in 1984 [65%] was in age range of 42-46. There has been an ascending trend of health and nutrition poverty at the end of the Fourth Development Plan [2009] up to 2013 for all age groups
Conclusion: Generally, rate and severity of health and nutrition poverty had many fluctuations among different age groups of Tehrani households' heads. This rate has raised during recent years which indicates lack of stable and coherent social policies to reduce households' exposures with catastrophic health care costs and funding of the food aid needs
ABSTRACT
Objectives: Low birth weight [LEW] is one of the major health problems worldwide. It is important to identify the factors that play a role in the incidence of this adverse pregnancy outcome. This study aimed to develop a tool to measure mothers' lifestyles during pregnancy with a view to the effects of social determinants on health and develop a correlation model of mothers' lifestyles with LBW
Methods: This study was conducted using methodological and case-control designs in four stages by selecting 750 mothers with infants weighing less than 4000 g using multistage sampling
The questionnaire contained 160 items. Face, content, criterion, and construct validity were used to study the psychometrics of the instrument
Results: After psychometrics, 132 items were approved in six domains. Test results indicated the utility and the high fitness of the model and reasonable relationships adjusted for variables based on conceptual models. Based on the correlation model of lifestyle, occupation [-0.263] and social relationships [0.248] had the greatest overall effect on birth weight
Conclusions: The review of lifestyle dimensions showed that all of the dimensions directly, indirectly, or both affected birth weight. Thus, given the importance and the role of lifestyle as a determinant affecting birth weight, attention, and training interventions are important to promote healthy lifestyles