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Understanding determinants of unequal distribution of stillbirth in Tehran, Iran: a concentration index decomposition approach.

ABSTRACT: OBJECTIVE:The present inquiry set to determine the economic inequality in history of stillbirth and understanding determinants of unequal distribution of stillbirth in Tehran, Iran. METHODS:A population-based cross-sectional study was conducted on 5170 pregnancies in Tehran, Iran, since 2015. Principal component analysis (PCA) was applied to measure the asset-based economic status. Concentration index was used to measure socioeconomic inequality in stillbirth and then decomposed into its determinants. RESULTS:The concentration index and its 95% CI for stillbirth was -0.121 (-0.235 to -0.002). Decomposition of the concentration index showed that mother's education (50%), mother's occupation (30%), economic status (26%) and father's age (12%) had the highest positive contributions to measured inequality in stillbirth history in Tehran. Mother's age (17%) had the highest negative contribution to inequality. CONCLUSIONS:Stillbirth is unequally distributed among Iranian women and is mostly concentrated among low economic status people. Mother-related factors had the highest positive and negative contributions to inequality, highlighting specific interventions for mothers to redress inequality.

SUBMITTER: Almasi-Hashiani A

PROVIDER: S-EPMC5777464 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Understanding determinants of unequal distribution of stillbirth in Tehran, Iran: a concentration index decomposition approach.

Almasi-Hashiani Amir A Sepidarkish Mahdi M Safiri Saeid S Khedmati Morasae Esmaeil E Shadi Yahya Y Omani-Samani Reza R

BMJ open 20170517 5

<h4>Objective</h4>The present inquiry set to determine the economic inequality in history of stillbirth and understanding determinants of unequal distribution of stillbirth in Tehran, Iran.<h4>Methods</h4>A population-based cross-sectional study was conducted on 5170 pregnancies in Tehran, Iran, since 2015. Principal component analysis (PCA) was applied to measure the asset-based economic status. Concentration index was used to measure socioeconomic inequality in stillbirth and then decomposed i ...[more]

PMID: 28515186

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Project description:BACKGROUND:With increasing frequencies of non-fatal overdose in people who inject drugs (PWID), it is essential to improve our knowledge about associated risk factors for overdose to inform overdose prevention and assistance programs. The aim of present study was to determine the prevalence of non-fatal overdose and the associated risk factors among PWID in Tehran, Iran. METHODS:Snowball sampling was used to collect data from 465 participants in Tehran using a cross-sectional survey. Consenting participants who reported drug injecting in the past month and were able to speak and comprehend Farsi enough to respond to survey questions were interviewed. The endpoint of interest was non-fatal overdose in the previous 6 months, or answering "Yes" to the question: "In the last six months, have you ever overdosed by accident? (at least once)". We used STATA v. 14 for this analysis. Statistical significance was defined as p?<?0.05 for all analyses. RESULTS:Of 465 PWIDs who participated in this study, all were male, and about half had less than a high school education. The prevalence of self-reported non-fatal overdose in the past 6?months was 38% (CI95%: 34, 43%). Our findings indicate that characteristics and behaviors that were associated with an increased risk of experiencing an overdose in the past 6 months were drug use initiation under 22?years (AOR =2.2, P?<?0.05), using methamphetamine (AOR =2.8, P?< 0.05), and using multiple drugs at the same time (AOR =2.1, P?< 0.05). Also, more recent initiates to injecting (<?2?years) had an increased risk of experiencing an overdose in the past 6 months. The odds of experiencing a non-fatal overdose among PWIDs who regularly attended NSP were 0.6 times less than for those who did not attend regularly (OR?=?0.6,95% CI: 0.2-0.9). CONCLUSION:Methamphetamine and alcohol use were the most significant association for non-fatal overdose among PWIDs. Our results indicate that intervention and prevention initiatives seeking to reduce overdoses among PWIDs should not only be focused on the primary drug used but also the use of alcohol and poly-drug use.

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Understanding determinants of unequal distribution of stillbirth in Tehran, Iran: a concentration index decomposition approach.

Publications

Understanding determinants of unequal distribution of stillbirth in Tehran, Iran: a concentration index decomposition approach.

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