Irritable bowel syndrome is concentrated in people with higher educations in Iran: an inequality analysis / 한국역학회지

OBJECTIVES: Like any other health-related disorder, irritable bowel syndrome (IBS) has a differential distribution with respect to socioeconomic factors. This study aimed to estimate and decompose educational inequalities in the prevalence of IBS.METHODS: Sampling was performed using a multi-stage random cluster sampling approach. The data of 1,850 residents of Kish Island aged 15 years or older were included, and the determinants of IBS were identified using a generalized estimating equation regression model. The concentration index of educational inequality in cases of IBS was estimated and decomposed as the specific inequality index.RESULTS: The prevalence of IBS in this study was 21.57% (95% confidence interval [CI], 19.69 to 23.44%). The concentration index of IBS was 0.20 (95% CI, 0.14 to 0.26). A multivariable regression model revealed that age, sex, level of education, marital status, anxiety, and poor general health were significant determinants of IBS. In the decomposition analysis, level of education (89.91%), age (−11.99%), and marital status (9.11%) were the three main contributors to IBS inequality. Anxiety and poor general health were the next two contributors to IBS inequality, and were responsible for more than 12% of the total observed inequality.CONCLUSIONS: The main contributors of IBS inequality were education level, age, and marital status. Given the high percentage of anxious individuals among highly educated, young, single, and divorced people, we can conclude that all contributors to IBS inequality may be partially influenced by psychological factors. Therefore, programs that promote the development of mental health to alleviate the abovementioned inequality in this population are highly warranted.

Irritable bowel syndrome is concentrated in people with higher educations in Iran: an inequality analysis / 한국역학회지

OBJECTIVES: Like any other health-related disorder, irritable bowel syndrome (IBS) has a differential distribution with respect to socioeconomic factors. This study aimed to estimate and decompose educational inequalities in the prevalence of IBS. METHODS: Sampling was performed using a multi-stage random cluster sampling approach. The data of 1,850 residents of Kish Island aged 15 years or older were included, and the determinants of IBS were identified using a generalized estimating equation regression model. The concentration index of educational inequality in cases of IBS was estimated and decomposed as the specific inequality index. RESULTS: The prevalence of IBS in this study was 21.57% (95% confidence interval [CI], 19.69 to 23.44%). The concentration index of IBS was 0.20 (95% CI, 0.14 to 0.26). A multivariable regression model revealed that age, sex, level of education, marital status, anxiety, and poor general health were significant determinants of IBS. In the decomposition analysis, level of education (89.91%), age (−11.99%), and marital status (9.11%) were the three main contributors to IBS inequality. Anxiety and poor general health were the next two contributors to IBS inequality, and were responsible for more than 12% of the total observed inequality. CONCLUSIONS: The main contributors of IBS inequality were education level, age, and marital status. Given the high percentage of anxious individuals among highly educated, young, single, and divorced people, we can conclude that all contributors to IBS inequality may be partially influenced by psychological factors. Therefore, programs that promote the development of mental health to alleviate the abovementioned inequality in this population are highly warranted.

Social health status in Iran: an empirical study

As social health is a condition-driven, dynamic and fluid concept, it seems necessary to construct and obtain a national and relevant concept of it for every society. Providing an empirical back up for Iran's concept of social health was the aim of the present study. This study is an ecologic study in which available data for 30 provinces of Iran in 2007 were analyzed. In order to prove construct validity and obtain a social health index, an exploratory factor analysis was conducted on six indicators of population growth, willful murder, poverty, unemployment, insurance coverage and literacy. Following the factor analysis, two factors of Diathesis [made up of high population growth, poverty, low insurance coverage and illiteracy] and Problem [made up of unemployment and willful murder] were extracted. The diathesis and problem explained 48.6 and 19.6% of social health variance respectively. From provinces, Sistan and Balu-chistan had the highest rate of poverty and violence and the lowest rate of literacy and insurance coverage. In terms of social health index, Tehran, Semnan, Isfahan, Bushehr and Mazandaran had the highest ranks while Sistan and Balu-chistan, Lurestan, Kohkiloyeh and Kermanshah occupied the lowest ones. There are some differences and similarities between Iranian concept of social health and that of other societies. However, a matter that makes our concept special and different is its attention to population. the increase in literacy rate and insurance coverage along with reduction of poverty, violence and unemployment rates can be the main intervention strategies to improve social health status in Iran