Abstract
Introduction: The large portion of burden of diseases, especially in the developing countries is attributed to hypertension. Identification of the potential risk factors of hypertension is essential for disease management. In this study we investigated the role of socio-economic inequality in the prevalence of hypertension in Ilam Province. Methods: Totally, 690 individuals aged over 15 were enrolled in this cross-sectional study, through systematic random sampling from March 1 to October 30, 2017. Socio-economic status (SES) score was calculated by 7 variables including; age, sex, job, marital status, educational level, and economic status, residency, then, it was divided to five levels. Concentration index was used to estimate the inequality in hypertension. To estimate the percentage contribution in final step elasticity divided to concentration index for each contributor and contributions to inequality is estimated. Results: The concentration index for hypertension was -0.154 95% CI (-0.02, -0.23), therefore hypertension was more prevalent in lower socioeconomic groups. The important socioeconomic contributors in inequality were job (P=0.008), educational level (P=0.005), and SES (P=0.003). According to concentration index decomposition, the main sources of inequality in hypertension were job (15%), educational level (18%), and SES (21%), respectively. Conclusion: Hypertension is more prevalent in lower SES groups and the job, education, and SES are important contributory factors of inequality. One substantial key point to achieve an effectiveness approach to deal with chronic diseases might be building partnership with disadvantaged populations.
Highlights
The large portion of burden of diseases, especially in the developing countries is attributed to hypertension
The concentration index for hypertension was -0.154 95% CI [-0.02, -0.23], hypertension was more prevalent in lower socio- economic groups (Figure 2)
The odds of hypertension in the age group of ≥66 was higher than the age group of 15-24
Summary
The large portion of burden of diseases, especially in the developing countries is attributed to hypertension. According to concentration index decomposition, the main sources of inequality in hypertension were job (15%), educational level (18%), and SES (21%), respectively. Conclusion: Hypertension is more prevalent in lower SES groups and the job, education, and SES are important contributory factors of inequality. The prevalence of hypertension will be 29.2% in 2025 in the world and 60% in adults.[1] Cardiovascular diseases and stroke are the consequences of hypertension[2] and the lower and middle-income societies are the victims of more than 80% of deaths from cardiovascular diseases.[3] Socio-economic status (SES) can be considered as a necessary factor for health based on lots of evidence; a few studies associated with SES have been conducted that were measured by the individual and country levels and cardiovascular risk factors among society.[4] The relationship between high blood pressure and lowlevel socio-economic condition was shown in the study by Riva et al in 2016.5 According to a study conducted in Iran in 2014, there was more prevalence of hypertension in low SES individuals. High-income countries showed a significant association and women showed high
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