Decomposing socioeconomic inequality in poor mental health among Iranian adult population: results from the PERSIAN cohort study

• Main Authors: Farid Najafi, Yahya Pasdar, Behzad Karami Matin, Satar Rezaei, Ali Kazemi Karyani, Shahin Soltani, Moslem Soofi, Shahab Rezaeian, Alireza Zangeneh, Mehdi Moradinazar, Behrooz Hamzeh, Zahra Jorjoran Shushtari, Mansour sajjadipour, Saeid Eslami, Maryam khosrojerdi, Sahar Shabestari, Amir Houshang Mehrparvar, Zahra Kashi, Azim Nejatizadeh, Mohammadreza Naghipour, Shahrokh Sadeghi Boogar, Ali Fakhari, Bahman Cheraghian, Haydeh Heidari, Parviz Molavi, Mohammad Hajizadeh, Yahya Salimi
• Format: Article
• Language: English
• Published: BMC 2020-05-01
• Series: BMC Psychiatry
• Subjects: Mental health; Socioeconomic inequality; Concentration index; Decomposition
• Online Access: http://link.springer.com/article/10.1186/s12888-020-02596-y

Abstract Background Socioeconomic inequality in mental health in Iran is poorly understood. This study aimed to assess socioeconomic inequality in poor mental health among Iranian adults. Methods The study used the baseline data of PERSIAN cohort study including 131,813 participants from 17 geographically distinct areas of Iran. The Erreygers Concentration index (E) was used to quantify the socioeconomic inequalities in poor mental health. Moreover, we decomposed the E to identify factors contributing to the observed socioeconomic inequality in poor mental health in Iran. Results The estimated E for poor mental health was − 0.012 (95% CI: − 0.0144, − 0.0089), indicating slightly higher concentration of mental health problem among socioeconomically disadvantaged adults in Iran. Socioeconomic inequality in poor mental health was mainly explained by gender (19.93%) and age (12.70%). Region, SES itself, and physical activity were other important factors that contributed to the concentration of poor mental health among adults with low socioeconomic status. Conclusion There exists nearly equitable distribution in poor mental health among Iranian adults, but with important variations by gender, SES, and geography. These results suggested that interventional programs in Iran should focus on should focus more on socioeconomically disadvantaged people as a whole, with particular attention to the needs of women and those living in more socially disadvantaged regions.