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Socioeconomic Inequality in Self-Rated Health and Its Determinants: An Oaxaca Blinder Decomposition in Ilam, West of Iran During 2023 Publisher Pubmed



Bazyar M1 ; Kakaei H2 ; Jalilian M3 ; Mirzaei A3 ; Mansournia MA4 ; Pakzad R5, 6, 7, 8
Authors
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Authors Affiliations
  1. 1. Department of Health Management and Economics, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
  2. 2. Department of Occupational Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
  3. 3. Department of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
  4. 4. Department of Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Health and Environment Research Center, Ilam University of Medical Sciences, Ilam, Iran
  6. 6. Psychosocial Injuries Research Center, Ilam University of medical Sciences, Ilam, Iran
  7. 7. Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Banganjab, Pajouhesh Blvd, Ilam, Iran
  8. 8. Student Research Committee, Ilam University Medical Sciences, Ilam, Iran

Source: BMC Health Services Research Published:2023


Abstract

Aim: To determine inequality and decompose it’s in Self-Rated Health (SRH). Method: This population-based cross-sectional study was undertaken on the entire population of the city of Ilam, Iran, in 2023. Multi-stage stratified cluster random sampling with proportion-to-size approach was used to select the participants. Oaxaca-Blinder decomposition technique was used to show the amount of inequity in SRH and to decompose of the gap of SRH between the poor and the rich group of participants. Results: 1370 persons participated in the study. The 59.38% of participants stated good SRH status and just 8.86% of participants had poor SRH status. The results of the Oaxaca-Blinder decomposition revealed a considerable gap (15.87%) in the poor status of SRH between the rich and the poor. A large proportion (89.66%) of this difference was described by explained portion of the model. The results of decomposition showed that economic status was directly responsible for explaining 27.98% of overall inequality gap between rich and poor people. Moreover, hopelessness to future (32.64%), having an underlying disease (18.34%) and difference in the education level (10.71%) were associated with an increase in inequality disfavoring the poor. Conclusion: For people suffering from underlying disease, it is suggested to devise policies to improve access to/and remove healthcare utilization barriers. To address hopelessness to future, it is recommended to carry out further studies to reveal factors which affect it in more details. This can help policy makers to formulate more realistic and evidence-informed policies on order to lessen the current socioeconomic inequity in SRH. © 2023, The Author(s).
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