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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2012

Open Access 01-12-2012 | Research

Understanding determinants of socioeconomic inequality in mental health in Iran's capital, Tehran: a concentration index decomposition approach

Authors: Esmaeil Khedmati Morasae, Ameneh Setareh Forouzan, Reza Majdzadeh, Mohsen Asadi-Lari, Ahmad Ali Noorbala, Ahmad Reza Hosseinpoor

Published in: International Journal for Equity in Health | Issue 1/2012

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.
Appendix
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Metadata
Title
Understanding determinants of socioeconomic inequality in mental health in Iran's capital, Tehran: a concentration index decomposition approach
Authors
Esmaeil Khedmati Morasae
Ameneh Setareh Forouzan
Reza Majdzadeh
Mohsen Asadi-Lari
Ahmad Ali Noorbala
Ahmad Reza Hosseinpoor
Publication date
01-12-2012
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2012
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/1475-9276-11-18

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