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Bazyar M, Kakaei H, Jalilian M, Mirzaei A, Mansournia MA, Pakzad R. Socioeconomic inequality in self-rated health and its determinants: an Oaxaca blinder decomposition in Ilam, West of Iran during 2023. BMC Health Serv Res 2023; 23:1203. [PMID: 37924069 PMCID: PMC10625218 DOI: 10.1186/s12913-023-10242-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
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.
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Affiliation(s)
- Mohammad Bazyar
- Department of Health Management and Economics, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Hojatollah Kakaei
- Department of Occupational Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohsen Jalilian
- Department of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Amin Mirzaei
- Department of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Pakzad
- Health and Environment Research Center, Ilam University of Medical Sciences, Ilam, Iran.
- Psychosocial Injuries Research Center, Ilam University of medical Sciences, Ilam, Iran.
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Banganjab, Pajouhesh Blvd, Ilam, Iran.
- Student Research Committee, Ilam University Medical Sciences, Ilam, Iran.
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Abdolalizadeh P, Mehrdad R, Saberzadeh-Ardestani B, Pouragha H, Alipour F, Esmaili M. Prevalence of uncorrected distance refractive errors and associated risk factors in employees of an academic centre. Clin Exp Optom 2023; 106:869-875. [PMID: 36372555 DOI: 10.1080/08164622.2022.2133988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/14/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Uncorrected refractive error (RE) may affect the work performance of adults in the workplace. The aim of current study was to determine the prevalence of corrected and uncorrected RE, and the determinants of uncorrected RE in adult employees of a university. METHODS This was a cross-sectional study of Tehran University Medical Sciences' staff. Besides demographic and some specific questionnaires, ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA), best spectacles corrected visual acuity (BCVA), and presenting visual acuity were performed for all participants. The need for spectacles was defined as UCVA worse than 6/12 in the better eye that could be corrected to better than 6/12 with spectacles based on subjective refraction. RESULTS In total, 4460 individuals with mean age of 42.32 ± 8.80 were included in the study. The VA of the better eye was 0.01 ± 0.05 logMAR for BCVA, 0.13 ± 0.26 for UCVA, and 0.05 ± 0.12 for presenting VA. Prevalence of RE was 15.7%, including uncorrected RE of 5% and spectacles coverage (corrected RE) of 10.7%. The proportion of individuals with elementary education and poor-fair status of general health were 1.62 times higher in the uncorrected group. In the univariate analysis, type of occupation (office versus non-office workers), socioeconomic status, and insurance of employees were not related to uncorrected RE (all P > 0.4). Myopia was the only factor associated with uncorrected RE in logistic regression analysis (odds ratio = 2.73, 95%CI = 1.02-7.31, P = 0.04). CONCLUSION The prevalence of uncorrected RE and spectacle coverage were 5% and 10.7%, respectively. Myopia was almost three times more likely to be associated among employees with uncorrected RE.
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Affiliation(s)
- Parya Abdolalizadeh
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Pouragha
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Esmaili
- Optometry Department, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Soleimani M, Saberzadeh-Ardestani B, Hakimi H, Fotouhi A, Alipour F, Jafari F, Lashay A, Hashemi H. Risk Factors for Uncorrected Refractive Error: Persian Cohort Eye Study - Rafsanjan Center. J Curr Ophthalmol 2022; 34:421-427. [PMID: 37180530 PMCID: PMC10170991 DOI: 10.4103/joco.joco_160_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 05/16/2023] Open
Abstract
Purpose To determine the prevalence of visually significant uncorrected refractive error (URE) in Rafsanjan and investigate the related factors. URE is the leading cause of visual impairment (VI) which causes the second-highest number of years lived with disability. The URE is a preventable health problem. Methods In this cross-sectional study participants from Rafsanjan who were 35-70 years were enrolled between 2014 and 2020. Demographic and clinical characteristics data were gathered, and eye examination was performed. Visually significant URE was defined as present if habitual visual acuity was (HVA; visual acuity with present optical correction) >0.3 logMAR in the best eye and the visual acuity of that eye showed >0.2 logMAR improvement after the best correction. Logistic regression was used to determine the association between predicting variables (age, sex, wealth, education, employment, diabetes, cataract, and refractive error characteristics) and outcome (URE). Results Among the 6991 participants of Rafsanjan subcohort of the Persian Eye Cohort, 311 (4.4%) had a visually significant URE. Diabetes was significantly more prevalent in the participants with visually significant URE, at 18.7% versus 13.1% in patients without significant URE (P = 0.004). In the final model, each year of increase in age was associated with 3% higher URE (95% confidence interval [CI]: 1.01-1.05). In comparison to low hyperopia, participants with low myopia had 5.17 times more odds of visually significant URE (95% CI: 3.38-7.93). However, antimetropia decreased the risk of visually significant URE (95% CI: 0.02-0.37). Conclusion Policymakers should pay special attention to elderly patients with myopia to effectively reduce the prevalence of visually significant URE.
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Affiliation(s)
| | | | - Hamid Hakimi
- Non-Communicable Disease Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Address for correspondence: Fateme Alipour, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Ghazvin Sq., Kargar Street, Tehran, Iran. E-mail:
| | - Fatemeh Jafari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Lashay
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Cao H, Cao X, Cao Z, Zhang L, Han Y, Guo C. The prevalence and causes of pediatric uncorrected refractive error: Pooled data from population studies for Global Burden of Disease (GBD) sub-regions. PLoS One 2022; 17:e0268800. [PMID: 35776717 PMCID: PMC9249246 DOI: 10.1371/journal.pone.0268800] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 05/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background
There are limited systematic reviews on the prevalence of uncorrected refractive errors in children. We aimed to summarize the prevalence and causes of pediatric uncorrected refractive error (URE) from studies in the Global Burden of Disease (GBD) sub-regions.
Methods
The pooled analysis used the individual participant data (ages less than 20 years old) from population-based studies around the world by regions. URE was defined as presenting VA < 6/18 and improving to ≥ 6/18 or ≥1 line on using a pinhole in either eye, with main causes of myopia, hyperopia or astigmatism. Each study provided data on any URE, myopia, hyperopia or astigmatism by age, gender, and ethnicity. Prevalence rates were directly age and gender standardized to the 2020 world population with all age groups. Estimates were calculated by study and sub-regions after pooling. Summary estimates included studies in which URE was assessed from a pinhole-corrected refraction in the better eye.
Results
The combined pooled data contained 302,513,219 patients including 8 963 URE cases individuals from 57 studies. Prevalence varied by age and GBD sub-regions and differed by gender. The age- and region-standardized prevalence of URE was 3.41 per 1000 (CI, 1.53~7.62) in Western Pacific region (12 studies), 2.26 per 1000 (CI, 0.85~6.01) in South-East Asia region (14 studies), 5.85 per 1000 (CI, 3.75~9.13) in Americans (11 studies) and 4.40 per 1000 (CI, 3.0~6.45) in Eastern Mediterranean region (13 studies). On the basis of these data, myopia was the first-leading cause in female children with 12~17 age group, with the prevalence rate 18.2 per 1000 (CI, 11.52~23.61). Astigmatism was detected in 27.2 per 1000 male children with 6~11 age group (CI: 19.12–30.68).
Conclusions
Prevalence of URE available data within these sub-regions are widely disparate. Myopia and astigmatism in young age children continue as the leading cause of URE worldwide. Providing appropriate refractive correction to those individuals whose vision can be improved is an important public health endeavor with implications for safety and quality of life.
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Affiliation(s)
- He Cao
- Department of Ophthalmology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, People’s Republic of China
| | - Xiang Cao
- Emergency Department, The First Affiliated Hospital of Jiamusi University, Heilongjiang Province, People’s Republic of China
| | - Zhi Cao
- VPL Department, Mentor Graphics Technology (Shenzhen) CO. LTD., Guangdong Province, People’s Republic of China
| | - Lu Zhang
- Department of Ophthalmology, No. 4 Hospital of Xi’an City, Xi’an, Shanxi Province, People’s Republic of China
| | - Yue Han
- Nangang Branch, The Second Hospital of Heilong jiang Province, Harbin City, Heilongjiang Province, People’s Republic of China
| | - Changchun Guo
- Pingshan District People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of China
- * E-mail:
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Hashemi H, Pakzad R, Khabazkhoob M. Decomposition of Economic Inequality in Cataract Surgery Using Oaxaca Blinder Decomposition: Tehran Geriatric Eye Study (TGES). Ophthalmic Epidemiol 2021; 29:401-410. [PMID: 34233572 DOI: 10.1080/09286586.2021.1946827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: The aim of this study was to investigate economic inequality in cataract surgery and to decompose it into its determinants using Oaxaca-Blinder decomposition.Methods: The Tehran Geriatric Eye Study is a population-based cross-sjal study that was done on individuals above 60 years using stratified cluster random sampling. All subjects underwent full optometric, slit lamp, and fundoscopic examinations. Then, after pupil dilation, the history of cataract surgery, including PC and AC IOL, was determined.Results: The age and sex-standardized prevalence of cataract surgery was 33.51% (95% CI: 31.45 to 35.62). Cataract surgery had a significant positive association with age (OR: 14.06; p < .001 for >80 vs 60-64 years) and a significant inverse association with education level (OR: 0.55, p: 0.006 for college education vs being illiterate) and economic status (OR: 0.64, p: 0.003 for rich vs poor). A significant difference was found in cataract surgery between the rich and poor (26.22%) disfavoring the poor (p < .001). The explained and unexplained portions comprised 95.99% and 4.01% of the difference (p < .001 and p = .336, respectively). Among study variables, age (p < .001), education (p = .003), economic status (p = .002), insurance (p = .011), and eye examination (p < .001) were significant determinants of inequality in the explained portion.Conclusion: There was a marked difference in the prevalence of cataract surgery between the rich and poor that was mostly caused by the explained portion. Age, economic status, and education had the largest effects on increasing the inequality and history of eye examination by an ophthalmologist and insurance coverage had the largest effects on reducing this inequality.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ramke J, Logan NS. Seeing beyond 2020: what next for refractive error care? Ophthalmic Physiol Opt 2021; 41:457-460. [PMID: 33826167 DOI: 10.1111/opo.12820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jacqueline Ramke
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.,International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
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