Avoidable socioeconomic inequality in mental health distribution in Tehran: Concentration Index standardization approach

Abstract Background Promotion of mental health and well-being is recently recognized as a health priority at the global level. In Mongolia, mental health issues have been on the rise. However, less is known on socioeconomic inequality in mental health in the country. The aim of this study is to examine socioeconomic inequality in mental health in the adult population in Mongolia. Methods This study analyzed the data of 30,567 adults from the Household Socio-Economic Survey, collected in 2012 by the National Statistical Office of Mongolia. Self-reported mental health was used as a health outcome variable. Socioeconomic status was measured by household income. We employed the Wagstaff's concentration index to assess the degree of socioeconomic inequality in mental health. Results The results show that the prevalence of self-reported mental health was 1.17% among the respondents. The adults living in urban areas suffer significantly more with mental illness compared to the adults living in rural settlements. The Wagstaff's concentration index for mental health was significantly negative (-0.243), indicating that mental health problems were concentrated among the lower-income groups. The decomposition results show that education, economic activity status and marital status were the main contributors to socioeconomic inequalities in mental health after removing age-sex related contributions. Conclusions Socioeconomic inequality in mental health exists in the adult population in Mongolia, which was mainly explained by the education level, employment and marital status. Prospective policies are needed to reduce socioeconomic inequality in mental health in the country. Key messages Socioeconomic inequality in mental health exists in Mongolia. It calls for further policy actions.

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Socioeconomic inequality in intermittent preventive treatment using Sulphadoxine pyrimethamine among pregnant women in Nigeria

BMC Public Health ◽

10.1186/s12889-020-09967-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Fatima Mahmud Muhammad ◽

Reza Majdzadeh ◽

Saharnaz Nedjat ◽

Haniye Sadat Sajadi ◽

Mahboubeh Parsaeian

Keyword(s):

Pregnant Women ◽

Concentration Index ◽

Socioeconomic Inequality ◽

Intermittent Preventive Treatment ◽

Wealth Index ◽

Preventive Treatment ◽

Educational Status ◽

P Value ◽

Contributing Factors ◽

Sulphadoxine Pyrimethamine

Abstract Background Intermittent preventive treatment using Sulphadoxine pyrimethamine (IPTp-SP) for malaria prevention is recommended for all pregnant women in malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria and to decompose it into its contributing factors. Methods A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 21,621 pregnant women aged between 15 and 49 years and had live birth in the previous 2 years before the survey were included in this analysis. The study participants were recruited based on a stratified two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index. Result Totally 63.6% of pregnant women took at least one dose of IPTp-SP prophylaxis. Among IPTp-SP users, 35.1% took one dose, 38.6% took two doses and 26.2% took three doses and more. Based on both concentration index of 0.180 (p-value = < 0.001, 95% CI: 0.176 to 0.183) and Erreyger’s normalization concentration index 0.280 (p-value = < 0.001, 95% CI: 0.251 to 0.309), the IPTp-SP utilization was pro-rich. The largest contributors to the inequality in IPTp-SP uptake were wealth index (47.81%) and educational status (28.66%). Conclusion Our findings showed that IPTp-SP use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through free IPTp service expansion by targeting pregnant women from low socioeconomic status.

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Income-related inequality in mental health in Britain: the concentration index approach

Psychological Medicine ◽

10.1017/s003329170600969x ◽

2007 ◽

Vol 37 (7) ◽

pp. 1037-1045 ◽

Cited By ~ 31

Author(s):

ROSHNI MANGALORE ◽

MARTIN KNAPP ◽

RACHEL JENKINS

Keyword(s):

Mental Health ◽

Psychiatric Disorders ◽

Concentration Index ◽

Mental Health Problems ◽

Psychiatric Morbidity ◽

Demographic Composition ◽

Related Inequality ◽

Income Related Inequality ◽

Using Data ◽

The Uk

Background. Reduction of health inequalities is a major policy goal in the UK. While there is general recognition of the disadvantaged position of people with mental health problems, the extent of inequality, particularly the association with socio-economic characteristics, has not been widely studied. We aimed to measure income-related inequality in the distribution of psychiatric disorders and to compare with inequality in other health domains.Method. The concentration index (CI) approach was used to examine income-related inequality in mental health using data from the Psychiatric Morbidity Survey 2000 for Britain.Results. There is marked inequality unfavourable to lower income groups with respect to mental health disorders. The extent of inequality increases with the severity of problems, with the greatest inequality observed for psychosis. Income-related inequality for psychiatric disorders is higher than for general health in the UK. Standardized CIs suggest that these inequalities are not due to the demographic composition of the income quintiles.Conclusions. Income-related inequalities exist in mental health in Britain. As much of the observed inequality is probably due to factors associated with income and not due to the demographic composition of the income quintiles, it may be that these inequalities are potentially ‘avoidable’.

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Evaluating the Socioeconomic Inequality in Cigarette Smoking among the Rural Areas of Hamadan City (Using the Concentration Index)

Pajouhan Scientific Journal ◽

10.21859/psj.16.4.28 ◽

2018 ◽

Vol 16 (4) ◽

pp. 28-36

Author(s):

Mehran Rostami ◽

Hossein Amirian ◽

Batol Eskandari ◽

Mina Zarei ◽

◽

...

Keyword(s):

Cigarette Smoking ◽

Rural Areas ◽

Concentration Index ◽

Socioeconomic Inequality

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Socioeconomic inequalities in hypertension in Kenya: a decomposition analysis of 2015 Kenya STEPwise survey on non-communicable diseases risk factors

International Journal for Equity in Health ◽

10.1186/s12939-020-01321-1 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Samwel Maina Gatimu ◽

Thomas Wiswa John

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Body Mass Index ◽

Socioeconomic Factors ◽

Body Mass ◽

Concentration Index ◽

Socioeconomic Inequality ◽

Decomposition Analysis ◽

Socioeconomic Inequalities ◽

Non Communicable Diseases

Abstract Background One in four Kenyans aged 18–69 years have raised blood pressure. Despite this high prevalence of hypertension and known association between socioeconomic status and hypertension, there is limited understanding of factors explaining inequalities in raised blood pressure in Kenya. Hence, we quantified the socioeconomic inequality in hypertension in Kenya and decomposed the determinants contributing to such inequality. Methods We used data from the 2015 Kenya STEPwise survey for non-communicable diseases risk factors. We included 4422 respondents aged 18–69 years. We estimated the socioeconomic inequality using the concentration index (C) and decomposed the C using Wagstaff decomposition analysis. Results The overall concentration index of hypertension in Kenya was − 0.08 (95% CI: − 0.14, − 0.02; p = 0.005), showing socioeconomic inequalities in hypertension disfavouring the poor population. About half (47.1%) of the pro-rich inequalities in hypertension was explained by body mass index while 26.7% by socioeconomic factors (wealth index (10.4%), education (9.3%) and paid employment (7.0%)) and 17.6% by sociodemographic factors (female gender (10.5%), age (4.3%) and marital status (0.6%)). Regional differences explained 7.1% of the estimated inequality with the Central region alone explaining 6.0% of the observed inequality. Our model explained 99.7% of the estimated socioeconomic inequality in hypertension in Kenya with a small non-explained part of the inequality (− 0.0002). Conclusion The present study shows substantial socioeconomic inequalities in hypertension in Kenya, mainly explained by metabolic risk factors (body mass index), individual health behaviours, and socioeconomic factors. Kenya needs gender- and equity-focused interventions to curb the rising burden of hypertension and inequalities in hypertension.

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Income-related inequalities in mental health in Sweden and the role of social determinants

European Journal of Public Health ◽

10.1093/eurpub/ckz185.633 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

S Fritzell ◽

H Källberg ◽

H Busch ◽

P Gustafsson

Keyword(s):

Mental Health ◽

Psychosocial Factors ◽

Social Determinants ◽

Concentration Index ◽

Decomposition Analysis ◽

Demographic Factors ◽

Economic Factors ◽

Income Inequalities ◽

Socio Economic Factors

Abstract Background Mental health is an increasing concern in all European countries as the burden of mental disorders continue to grow and cause substantial suffering and costs to societies. Furthermore, research shows there are social inequalities in the distribution of mental illness. This study aims to increase knowledge on income-related inequalities in mental health in Sweden and the role of social determinants. Methods Drawing on a national survey (Health on Equal Terms) representative of the population aged 16-84, years 2010-2015 (n = 57107) we quantify the income-related inequality in mental health and estimate the contribution of social determinants of the inequality. Poor mental health is defined as a value of at least 3, based on the general health questionnaire (GHQ)-12. Income is measured as yearly disposable income. Income related inequalities in mental health are quantified by the concentration index and decomposed using the Wagstaff-type decomposition analysis. Results Preliminary results show that the income inequalities in mental health, as measured by the overall concentration index in mental health was - 0,16 (95% CI -0.17 to -0.15), indicating income inequalities to the disadvantage of those less affluent. The determinants that contributed most to the inequalities were employment, financial strain and experiencing harassment. Together they explained 43 % of the income inequalities in mental health. Generally, socio-economic factors had highest importance for the inequalities found, while demographic factors and psychosocial factors were of smaller importance. Conclusions The income related inequalities in mental health are substantial in Sweden. Recently, a national target of reducing the preventable inequalities in health within a generation was adopted. To improve surveillance of inequalities and inform policy we need to closely follow the development of inequalities in mental health and to disentangle the contribution of specific social determinants. Key messages Income-related inequalities in mental health in Sweden are considerable. Socio-economic factors had highest importance for the inequalities found, while demographic factors and psychosocial factors were of smaller importance.

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Decomposing Socioeconomic Inequality Determinants in Suicide Deaths in Iran: A Concentration Index Approach

Korean Journal of Family Medicine ◽

10.4082/kjfm.2017.38.3.135 ◽

2017 ◽

Vol 38 (3) ◽

pp. 135 ◽

Cited By ~ 4

Author(s):

Yousef Veisani ◽

Ali Delpisheh ◽

Kourosh Sayehmiri ◽

Ghobad Moradi ◽

Jafar Hassanzadeh

Keyword(s):

Concentration Index ◽

Socioeconomic Inequality ◽

Index Approach

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Socioeconomic Inequality in Colorectal Cancer Stage at Diagnosis Time in Qazvin City during 2014-2016: Concentration Curve Approach

International Journal of Cancer Management ◽

10.5812/ijcm.101355 ◽

2020 ◽

Vol 13 (10) ◽

Author(s):

Ali Qandian ◽

Pedram Fattahi ◽

Mojtaba Vand Rajabpour ◽

Saeed Nemati ◽

Neda Nasirian ◽

...

Keyword(s):

Colorectal Cancer ◽

Socioeconomic Status ◽

Concentration Index ◽

Cancer Survival ◽

Socioeconomic Inequality ◽

Cancer Staging ◽

Late Diagnosis ◽

Iranian Women ◽

Early Diagnosis Of Cancer ◽

Diagnosis Of Cancer

Background: The impact of socioeconomic status on cancer survival has already been proven. Early diagnosis of cancer is one of the main reason of this improved survival among high socioeconomic status (SES) people. High SES people are more likely to take part in cancer screening programs for several reason and it seems that diagnosis of cancer is earlier among these people. Despite growing evidence on inequal in cancer survival, diagnosis, and treatment over the past decades there is a lack of evidence on volume and direction of socioeconomic inequality regarding early diagnosis of cancer in Iran. Objectives: To assess socioeconomic inequality in colorectal cancer stage at diagnosis time in Qazvin city, Iran during 2014 - 2016. Methods: A cross-sectional study was conducted on 200 patients who were diagnosed with colorectal cancer (CRC) at the Vellayat hospital of the Qazvin city. The Principal Component Analysis (PCA) approach was used to combine household assets as a proxy of SES. Cancer staging information was extracted from the patient's medical records and then a pathology specialist performed cancer staging. Descriptive statistics and a multiple logistic regression model were used to illustrate an association between CRC late diagnosis and socioeconomic status adjusted for age, sex, and residence of the area. We applied the standardized Concentration Index as a measure of socioeconomic inequality in CRC late diagnosis. Results: The overall percentage of late CRC diagnosis was 40.5% (95% confidence interval (CI) 33.8, 47.5), which was slightly higher among women (47.1%, 95% CI 36.8, 57.6) than men (35.4%, 95% CI, 27.0, 44.7). Logistic regression results spotted an association between SES and the late diagnosis of CRC. In Iranian women, CRC tended to be diagnosed at more advanced stages among the third (Odds Ratio (OR) = 7.68), forth (Low) (OR = 17.86) and fifth (Lowest) (OR = 25.60) SES quintiles, while in men it was only significant for the fifth quintiles (OR = 4.17). Furthermore, the concentration index implied that late CRC diagnosis is concentrated among deprived subgroups in Qazvin city, and it was statistically significant (Overall concentration index = -0.33, 95% CI -0.38, -0.28). It was estimated at -0.35 and -0.29 in Iranian women and men, respectively. Conclusions: According to this survey, CRC tends to be diagnosed at more advanced stages among low socioeconomic status groups, and the observed discrimination is more severe in Iranian women.

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Estimating income-related and area-based inequalities in mental health among nationally representative adolescents in Australia: The concentration index approach

PLoS ONE ◽

10.1371/journal.pone.0257573 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257573

Author(s):

Md Irteja Islam ◽

Gail M. Ormsby ◽

Enamul Kabir ◽

Rasheda Khanam

Keyword(s):

Mental Health ◽

Suicidal Ideation ◽

Mental Disorders ◽

Household Income ◽

Concentration Index ◽

Mental Health Problems ◽

Health Problems ◽

Socioeconomic Inequalities ◽

Bullying Victimization ◽

Self Harm

Despite the awareness of the importance of mental health problems among adolescents in developed countries like Australia, inequality has not been widely researched. This study, is therefore, aimed to measure and compare household income-related and area-based socioeconomic inequalities in mental health problems (bullying victimization, mental disorders–single and multiple, self-harm and suicidality–ideation, plan and attempt) among Australian adolescents aged 12–17 years. Young Minds Matter (YMM)—the 2nd national cross-sectional mental health and well-being survey involving Australian children and adolescents conducted in 2013–14, was used in this study to select data for adolescents aged 12–17 years (n = 2521). Outcome variables included: bullying, mental disorders, self-harm, and suicidal ideation, plan and attempt. The Erreygers’s corrected concentration index (CI) approach was used to measure the socioeconomic inequalities in mental health problems using two separate rank variables–equivalised household income quintiles and area-based Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) quintiles. The prevalence of mental health problems in the previous 12-months among these study participants were: bullying victimization (31.1%, 95% CI: 29%-33%), mental disorder (22.9%, 95% CI: 21%-24%), self-harm (9.1%, 95% CI: 8%-10%), suicidal ideation (8.5%, 95% CI: 7%-10%), suicidal plan (5.9%, 95% CI: 5%-7%) and suicidal attempt (2.8%, 95% CI: 2%-3%). The concentration indices (CIs) were statistically significant for bullying victimization (CI = -0.049, p = 0.020), multiple mental disorders (CI = -0.088, p = <0.001), suicidal ideation (CI = -0.023, p = 0.047) and suicidal attempt (CI = -0.021, p = 0.002), implying pro-poor socioeconomic inequalities based on equivalized household income quintiles. Similar findings revealed when adolescents mental health inequalities calculated on the basis of area based IRSAD (Index of Relative Socio-economic Advantage and Disadvantage) quintiles. Overall, adolescents from economically worse-off families experienced more mental health-related problems compared to those from economically better-off families. This has implications for prevention strategies and government policy in order to promote mental health and provide equitable healthcare facility.

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