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Zarghami M, Kharazmi O, Alipour A, Babakhanian M, Khosravi A, Mirtorabi SD. Time Series Modeling and Forecasting of Drug-Related Deaths in Iran (2014-2016). ADDICTION & HEALTH 2023; 15:149-155. [PMID: 38026723 PMCID: PMC10658097 DOI: 10.34172/ahj.2023.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/08/2021] [Indexed: 12/01/2023]
Abstract
Background Investigating the temporal variations and forecasting the trends in drug-related deaths can help prevent health problems and develop intervention programs. The recent policy in Iran is strongly focused on deterring drug use and replacing illicit drugs with legal ones. This study aimed to investigate drug-related deaths in Iran in 2014-2016 and forecast the death toll by 2019. Methods In this longitudinal study, Box-Jenkins time series analysis was used to forecast drug-related deaths. To this end, monthly counts of drug-related deaths were obtained from March 2014 to March 2017. After data processing, to obtain stationary time series and examine the stability assumption with the Dickey-Fuller test, the parameters of the Autoregressive Integrated Moving Averages (ARIMA) model were determined using autocorrelation function (ACF) and partial autocorrelation function (PACF) graphs. Based on Akaike statistics, ARIMA (0, 1, 1) was selected as the best-fit model. Moreover, the Dickey-Fuller test was used to confirm the stationarity of the time series of transformed observations. The forecasts were made for the next 36 months using the ARIMA (0,1,2) model and the same confidence intervals were applied to all months. The final extracted data were analyzed using R software, Minitab, and SPSS-23. Findings According to the Iranian Ministry of Health and the Legal Medicine Organization, there were 8883 drug-related deaths in Iran from March 2014 to March 2017. According to the time series findings, this count had an upward trend and did not show any seasonal pattern. It was forecasted that the mean drug-related mortality rate in Iran would be 245.8 cases per month until 2019. Conclusion This study showed a rising trend in drug-related mortality rates during the study period, and the modeling process for forecasting suggested this trend would continue until 2019 if proper interventions were not instituted.
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Affiliation(s)
- Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Omid Kharazmi
- Department of Statistics, Faculty of Mathematical Sciences, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Abbas Alipour
- Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoudeh Babakhanian
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Ardeshr Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
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Alipour A, Babakhanian M, Zarghami M, Khosravi A, Saberi M. Years of Life Lost (YLLs) due to drug-related deaths in the Islamic Republic Of Iran (2014-2017): a temporal and geographic pattern. CIENCIA & SAUDE COLETIVA 2022; 27:2843-2854. [PMID: 35730851 DOI: 10.1590/1413-81232022277.23252021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
The present study aimed to measure the mortality burden caused by premature death due to substance abuse in different geographical regions of Iran from 2014-17. In this serial cross-sectional study, the data related to individuals who had died of drug abuse were first collected from two sources (Iranian Ministry of Health and Medical Education and the Iranian Legal Medicine Organization). Then, using the capture-recapture method, the number of drug-related deaths was estimated. The years of life lost (YLLs) for all provinces of Iran was calculated based on age, sex, and year. During these four years, the total number of deaths was 12029. The mean age of the individuals was 37.3±14.1. The mean age of dead people was constant in women and men over this period; however, the mean age of dead women due to substance abuse was lower than that of men. The mean YLLs per dead person was 70131.3329 years for men and 9321.1125 years for women. The potential years of life lost (YLLs) showed an upward trend, which was stronger in women than men. It is necessary to perform more regional overviews for finding differences in the number of YLLs due to substance abuse so that specific regional policies can be adopted.
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Affiliation(s)
- Abbas Alipour
- Mazandaran University of Medical Sciences. Mazandaran Province Iran
| | - Masoudeh Babakhanian
- Social Determinants of Health Research Center, Semnan University of Medical Sciences. University Education and Research Campus, 5 km of Damghan road, JF62+4W5. Semnan Iran.
| | - Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences. Mazandaran Province Iran
| | - Ardeshir Khosravi
- Vice Chancellery for Health, Iranian Ministry of Health and Medical Education. Tehran Iran
| | - Mehdi Saberi
- Legal Medicine Research Center, Legal Medicine Organization, Tehran Iran
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Barati M, Bashirian S, Jormand H, Babamiri M, Rezapur-Shahkolai F. Can substance abuse media literacy increase prediction of drug use in students? BMC Psychol 2022; 10:147. [PMID: 35689253 PMCID: PMC9188191 DOI: 10.1186/s40359-022-00860-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/06/2022] [Indexed: 12/03/2023] Open
Abstract
Objective The present study aimed to determine the predictors of drug use among students based on the Extended Prototype willingness model (EPWM). Methods This cross-sectional study was performed at Hamadan universities. The participants were selected via multi-stage sampling. Finally, out of 721 students participated. The questionnaire consisted of four sections: (a) socio-demographic characteristics, (b) Questionnaire about the prototype willingness model constructs, (c) Questionnaire about the status of drug use behavior, (d) Substance Abuse Media Literacy (SAML) scale. Data were analyzed using a structural equations partial least squares confirmatory composite approach and SPSS-23. Results The mean age of students was of 23.47 ± 4.14 years. Based on results, behavioral willingness (β = 0.420, t-value = 9.010, p < 0.001) and behavioral intention (β = 0.291, t-value = 6.957, p < 0.001) significantly predicted drug use. The presented results of analysis, 66% of the variance of the drug use, 62% of the variable of the behavioral willingness, and 56% of the behavioral intention could be explained by the EPWM. Conclusion The present study demonstrated that EPWM could predict drug use in students. Therefore, designing and implementing educational and promotional intervention programs to reduce behavioral willingness and increase students’ skills in substance abuse media literacy is necessary to prevent drug use behavior.
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Affiliation(s)
- Majid Barati
- Health Education and Promotion, Department of Public Health, School of Health and Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran
| | - Saeed Bashirian
- Health Education and Promotion, Department of Public Health, School of Health and Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran
| | - Hanieh Jormand
- Health Education and Promotion, Autism Spectrum Disorders Research Center and Clinical Research Development Unit of Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, IR, Iran.
| | - Mohammad Babamiri
- Department of Ergonomics, School of Public Health and Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Forouzan Rezapur-Shahkolai
- Health Promotion, Department of Public Health, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Noroozi A, Kebriaeezadeh A, Mirrahimi B, Armoon B, Ahounbar E, Narenjiha H, Salehi M, Karamouzian M. Opium tincture-assisted treatment for opioid use disorder: A systematic review. J Subst Abuse Treat 2021; 129:108519. [PMID: 34119894 DOI: 10.1016/j.jsat.2021.108519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Some countries have used opioid agonist medications other than methadone and buprenorphine as a strategy to increase treatment diversity. In Iran and other countries where opium use is common and culturally tolerated, opium tincture (OT) has gained growing popularity and been approved to treat opioid use disorder (OUD). Given the increasing interest in this intervention, we conducted a systematic review of the literature to evaluate the safety and efficacy of OT-assisted treatment for OUD. METHODS We systematically searched international (MEDLINE, Embase, CINAHL, PsychInfo, Google Scholar, and clinicaltrials.gov) and Iranian (Scientific Information Database (SID), Iranmedex, IranDoc, digital library of Iran's Drug Control Headquarters and the Iranian Registry for Clinical Trials) databases on November 04, 2020 without any language or publication date limitations. Two reviewers screened the titles, abstracts, and full-text of the retrieved records to find clinical trials or observational studies that assessed the safety and efficacy of OT-assisted treatment for OUD. RESULTS We screened 1301 records and included 21 unique studies on assisted withdrawal (n = 5), maintenance (n = 9), and gradual dose reduction (n = 7) treatment regimens. Most studies included men and people with opium use disorder. We found only six randomized controlled trials (RCT). Our results showed that OT-assisted treatment is associated with comparable outcomes with methadone treatment in both assisted withdrawal and maintenance treatment regimens. We also found promising results for using gradual dose reduction regimen of OT-assisted treatment from observational studies. The overall quality of scientific evidence was low due to the limited number RCT and high risk of bias in the included studies. CONCLUSIONS The body of evidence supporting the safety and efficacy of OT-assisted treatment in assisted withdrawal, maintenance, and gradual dose reduction regimens is limited but somewhat promising, in particular among people with opium use disorder. Our review calls for higher-quality studies to investigate the comparative efficacy of these treatment methods with standard pharmacotherapies for OUD.
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Affiliation(s)
- Alireza Noroozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Kebriaeezadeh
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Mirrahimi
- Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Armoon
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Elaheh Ahounbar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hooman Narenjiha
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Salehi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Gangi MF, Karamouzian M, Nedjat S, Rahimi-Movaghar A, Yazdani K, Shokoohi M, Mirzazadeh A. HIV prevention cascades for injection and sexual risk behaviors among HIV-negative people who inject drug in Iran. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 84:102868. [PMID: 32717706 PMCID: PMC7738401 DOI: 10.1016/j.drugpo.2020.102868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The HIV prevention cascade complements the HIV treatment cascade and helps evaluate the access to and use of harm reduction programs among HIV-negative individuals at risk for HIV, including people who inject drugs (PWID). This study aimed to estimate the HIV prevention cascades among PWID in Iran. METHODS Using data from the 2014 national bio-behavioral surveillance survey, 2,391 PWID were recruited from 31 harm reduction facilities and through outreach efforts across 10 major cities. PWID aged ≥18 years who reported drug injection in the past year were interviewed, and information regarding their demographic characteristics, sexual and drug injection practices, and access to services were gathered. PWID were also tested for HIV infection. We examined the prevention cascade framework among HIV-negative PWID. RESULTS The majority of PWID were male (97.6%) and more than half aged ≥ 35 years old (55.5%). Overall, 2,092 (92.5% [95% CI: 90.8, 93.9]) were HIV-negative; 93% of whom knew illicit drug injection could increase the risk of HIV transmission, 54% had access to free-of-charge sterile needles and syringes, 51% used sterile needles and syringes in their last injection practice, and 33% used sterile needles and syringes in all injection practices in the past month. Also, 87.8% (95% CI: 85.1, 90.0) of HIV-negative PWID had sex with any partner in the past year; 88% of whom knew using condoms could reduce the risk of HIV transmission, 35% had access to free-of-charge condoms, 32% used condoms in their last sexual practice, and 18% used condoms in all of their sexual practices in the past month. CONCLUSION The majority of HIV-negative PWID in Iran were at risk for HIV acquisition through unsafe drug injection or sexual practices. Harm reduction programs should improve access to free sterile needles, syringes, and condoms for PWID.
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Affiliation(s)
- Monireh Faghir Gangi
- Department of Epidemiology and Biostatistics, School of public health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Karamouzian
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Yazdani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.
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Babakhanian M, Zarghami M, Alipour A, Khosravi A, Hashemi-Nazari SS, Saberi M, Ghadirzadeh MR. An Estimation of Drug-Related Deaths in Iran, Using the Capture-Recapture Method (2014-2016). ADDICTION & HEALTH 2020; 12:87-97. [PMID: 32782731 PMCID: PMC7395932 DOI: 10.22122/ahj.v12i2.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background The Ministry of Health and Medical Education (MOHME) and the Legal Medicine Organization (LMO) are the 2 death registration systems in Iran for registering drug-related deaths. The aim of the present study was to assess the number of undercount and the overlap between the deaths registered by the 2 sources. Methods In this descriptive study, according to the ý10th revision of the International Classification of Diseases ý(ICD-10), the registered data on drug-related deaths in the years 2014-2016, as recorded by the MOHME and the LMO, were collected and the number of deaths was estimated using 2-source capture-recapture method and Excel and SPSS software. Findings The total number of drug-related deaths, as registered by the 2 sources, was 8639 during the 3 years. A major part of the drug-related deaths (75% of the data) had been registered by the LMO and only 25% of deaths had been registered by the MOHME. There was also a small overlap (7.7% of deaths) between the data from the 2 sources. The final estimation from the capture-recapture model and analysis of sensitivity showed that, during the 3 years, the total number of drug-related deaths was 14517 [95% confidence interval (CI):14498-14558]. Based on the complete overlap assumption and 50% of unidentified individuals in the 2 sources, the number of deaths was estimated at 11341 and 12418, respectively. The largest number of drug-related deaths had occurred within the age range of 25-39 years and in men. Kermanshah, Hamedan, and Zanjan Provinces (Iran) had the largest number of cumulative incidences of drug-related deaths. Based on the data provided by the MOHME, the most common cause of death was Methadone poisoning. Conclusion There was a small overlap between the MOHME and the LMO in the registration of drug-related deaths. Failure to enter accurate and correct information has led to miscalculations of these deaths in Iran.
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Affiliation(s)
- Masoudeh Babakhanian
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute AND Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Department of Social Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ardeshir Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Seyed Saeed Hashemi-Nazari
- Promotion and Injury Prevention Research Center AND Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Rostami M, Rezaeian S. Challenges of Estimates in Drug-Related Overdose Deaths in Iran: Evidence from the Literature. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1592-1593. [PMID: 33083345 PMCID: PMC7554398 DOI: 10.18502/ijph.v49i8.3914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Mehran Rostami
- Deputy of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Moradinazar M, Najafi F, Jalilian F, Pasdar Y, Hamzeh B, Shakiba E, Hajizadeh M, Haghdoost AA, Malekzadeh R, Poustchi H, Nasiri M, Okati-Aliabad H, Saeedi M, Mansour-Ghanaei F, Farhang S, Safarpour AR, Maharlouei N, Farjam M, Amini S, Amini M, Mohammadi A, Mirzaei-Alavijeh M. Prevalence of drug use, alcohol consumption, cigarette smoking and measure of socioeconomic-related inequalities of drug use among Iranian people: findings from a national survey. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:39. [PMID: 32503660 PMCID: PMC7275311 DOI: 10.1186/s13011-020-00279-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 05/28/2020] [Indexed: 02/06/2023]
Abstract
Background Drug use can lead to several psychological, medical and social complications. The current study aimed to measure and decomposes socioeconomic-related inequalities in drug use among adults in Iran. Methods This was a cross-sectional study The PERSIAN Cohort is the largest and most important cohort among 18 distinct areas of Iran. This study was conducted on 130,570 adults 35 years and older. A structured questionnaire was applied to collect data. The concentration index (C) was used to quantify and decompose socioeconomic inequalities in drug use. Results The prevalence experience of drug use was 11.9%. The estimated C for drug use was − 0.021. The corresponding value of the C for women and men were − 0.171 and − 0.134, respectively. The negative values of the C suggest that drug use is more concentrated among the population with low socioeconomic status in Iran (p < 0.001). For women, socioeconomic status (SES) (26.37%), province residence (− 22.38%) and age (9.76%) had the most significant contribution to socioeconomic inequality in drug use, respectively. For men, SES (80.04%), smoking (32.04%) and alcohol consumption (− 12.37%) were the main contributors to socioeconomic inequality in drug use. Conclusions Our study indicated that drug use prevention programs in Iran should focus on socioeconomically disadvantaged population. Our finding could be useful for health policy maker to design and implement effective preventative programs to protect Iranian population against the drug use.
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Affiliation(s)
- Mehdi Moradinazar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzad Jalilian
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ebraim Shakiba
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Malekzadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzeyeh Nasiri
- Modelling in health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Farhang
- Liver and gastrointestinal Diseases Research center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Ali Reza Safarpour
- Gastroenterohe Pathology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Maharlouei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Farjam
- Non-communicable diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Saeed Amini
- Health Services Management, Arak University of Medical Sciences, Arak, Iran
| | - Mahin Amini
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Mohammadi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Najafi F, Pasdar Y, Karami Matin B, Rezaei S, Kazemi Karyani A, Soltani S, Soofi M, Rezaeian S, Zangeneh A, Moradinazar M, Hamzeh B, Jorjoran Shushtari Z, sajjadipour M, Eslami S, khosrojerdi M, Shabestari S, Mehrparvar AH, Kashi Z, Nejatizadeh A, Naghipour M, Sadeghi Boogar S, Fakhari A, Cheraghian B, Heidari H, Molavi P, Hajizadeh M, Salimi Y. Decomposing socioeconomic inequality in poor mental health among Iranian adult population: results from the PERSIAN cohort study. BMC Psychiatry 2020; 20:229. [PMID: 32404081 PMCID: PMC7218818 DOI: 10.1186/s12888-020-02596-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/12/2020] [Indexed: 11/10/2022] Open
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.
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Affiliation(s)
- Farid Najafi
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- grid.412112.50000 0001 2012 5829Nutritional Sciences Department, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karami Matin
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Kazemi Karyani
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Soofi
- grid.412112.50000 0001 2012 5829Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Zangeneh
- grid.412112.50000 0001 2012 5829Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Jorjoran Shushtari
- grid.472458.80000 0004 0612 774XSocial Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mansour sajjadipour
- grid.411705.60000 0001 0166 0922South Tehran Health Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Eslami
- grid.411583.a0000 0001 2198 6209Pharmaceutical Research Center, Pharmaceutical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam khosrojerdi
- grid.412328.e0000 0004 0610 7204Cellular and molecular research center, school of medicine, Sabzevar university of medical sciences, Sabzevar, Iran
| | - Sahar Shabestari
- grid.488433.00000 0004 0612 8339Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Amir Houshang Mehrparvar
- grid.412505.70000 0004 0612 5912Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Kashi
- grid.411623.30000 0001 2227 0923Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azim Nejatizadeh
- grid.412237.10000 0004 0385 452XMolecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammadreza Naghipour
- grid.411874.f0000 0004 0571 1549Gastrointestinal and liver disease research center, Guilan University of medical sciences, Rasht, Iran
| | - Shahrokh Sadeghi Boogar
- grid.412571.40000 0000 8819 4698Gastroenterohepatology Research Center, Shiraz university of medical sciences, Shiraz, Iran
| | - Ali Fakhari
- grid.412888.f0000 0001 2174 8913Research Center of psychiatry and behavioral sciences, Tabriz University of Medical sciences, Tabriz, Iran
| | - Bahman Cheraghian
- grid.411230.50000 0000 9296 6873Department of Biostatistics and Epidemiology, school of public health, Ahvaz jundishapur university of medical sciences, Ahvaz, Iran
| | - Haydeh Heidari
- grid.440801.90000 0004 0384 8883Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Parviz Molavi
- grid.411426.40000 0004 0611 7226Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Hajizadeh
- grid.55602.340000 0004 1936 8200School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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