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Revealing mental health status in Iran's capital: Putting equity and efficiency together

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  • Morasae, Esmaeil Khedmati
  • Forouzan, Ameneh Setareh
  • Asadi-Lari, Mohsen
  • Majdzadeh, Reza
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    Abstract

    Information about urban health is often based on averages, while to better understand health status in urban areas, inequality should also be included. In this paper, we applied an achievement index approach in order to surmount this defect and to examine mental health status in Iran's capital, Tehran. The data we required for this study were taken from the Urban Health Equity Assessment and Response Tool (Urban HEART) survey which was conducted in Tehran in 2007, covering people aged 15 and above. The concentration index, which is a commonly used measure of socioeconomic inequalities in health, was extended to enable the combination of inequality and averages and the formation of a mental health achievement index. Values from the standard concentration indices showed that mental disorders are concentrated disproportionately among the poor in Tehran. An extension of the standard concentration indices revealed that, in most of Tehran's districts, the mental health of populations in the poorest quintile is much worse than that of other groups. In addition, when we computed the achievement index and ranked districts according to this index, the ranking was different from the ranking by averages. These findings imply that mental health varies significantly across the economic groups of the population in Tehran and that efficiency-oriented strategies which target average level of mental health alone are not sufficient to improve mental health of all people especially mental health of the poor. Equity-oriented strategies which target the mental health inequalities should be considered as well.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 3 ()
    Pages: 531-537

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:3:p:531-537

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    Keywords: Health inequalities; Urban health; Measurements; Iran;

    References

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    1. Cristina Hernández Quevedo & Andrew M Jones & Ángel López Nicolás & Nigel Rice, 2005. "Socioeconomic inequalities in health: a comparative longitudinal analysis using the European Community Household Panel," Health, Econometrics and Data Group (HEDG) Working Papers 05/12, HEDG, c/o Department of Economics, University of York.
    2. Joan Costa-Font & Joan Gil, 2008. "Would Socio-Economic Inequalities in Depression Fade Away with Income Transfers?," Journal of Happiness Studies, Springer, vol. 9(4), pages 539-558, December.
    3. Almeida-Filho, Naomar & Lessa, Ines & Magalhães, Lucélia & Araújo, Maria Jenny & Aquino, Estela & James, Sherman A. & Kawachi, Ichiro, 2004. "Social inequality and depressive disorders in Bahia, Brazil: interactions of gender, ethnicity, and social class," Social Science & Medicine, Elsevier, vol. 59(7), pages 1339-1353, October.
    4. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities, and health achievement," Policy Research Working Paper Series 2765, The World Bank.
    5. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    6. Patel, Vikram & Araya, Ricardo & de Lima, Mauricio & Ludermir, Ana & Todd, Charles, 1999. "Women, poverty and common mental disorders in four restructuring societies," Social Science & Medicine, Elsevier, vol. 49(11), pages 1461-1471, December.
    7. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer, vol. 38(1), pages 115-132, February.
    8. Xu, Ke Tom, 2006. "State-level variations in income-related inequality in health and health achievement in the US," Social Science & Medicine, Elsevier, vol. 63(2), pages 457-464, July.
    9. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    10. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications, The World Bank, number 6896, October.
    11. Wildman, John, 2003. "Income related inequalities in mental health in Great Britain: analysing the causes of health inequality over time," Journal of Health Economics, Elsevier, vol. 22(2), pages 295-312, March.
    12. Harpham, Trudy, 1994. "Urbanization and mental health in developing countries: A research role for social scientists, public health professionals and social psychiatrists," Social Science & Medicine, Elsevier, vol. 39(2), pages 233-245, July.
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