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Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults
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Pardis Mohammadzadeh, Farhad Moradpour, Bijan Nouri, Farideh Mostafavi, Farid Najafi, Ghobad Moradi
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Epidemiol Health. 2023;45:e2023083. Published online September 3, 2023
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DOI: https://doi.org/10.4178/epih.e2023083
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Abstract
Summary
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Abstract
OBJECTIVES The worldwide incidence of metabolic syndrome (MetS) has increased in recent decades. In this study, we investigated the socioeconomic inequalities associated with MetS and its components in a sample of the Iranian Kurdish population.
METHODS We used data from 3,996 participants, aged 35 years to 70 years, from the baseline phase of the Dehgolan Prospective Cohort Study (February 2018 to March 2019). The concentration index and concentration curve were used to measure inequality and the Blinder-Oaxaca decomposition method was used to examine the contribution of various determinants to the observed socioeconomic inequality in MetS and its components.
RESULTS The prevalence of MetS was 34.44% (95% confidence interval [CI], 32.97 to 35.93). The prevalence of MetS was 26.18% for those in the highest socioeconomic status (SES), compared with 40.51% for participants in the lowest SES. There was a significant negative concentration index for MetS (C=-0.13; 95% CI, -0.16 to -0.09), indicating a concentration of MetS among participants with a lower SES. The most prevalent component was abdominal obesity (59.14%) with a significant negative concentration index (C=-0.21; 95% CI, -0.25 to -0.18). According to decomposition analysis, age, gender, and education were the highest contributing factors to inequality in MetS and its components.
CONCLUSIONS This study showed socioeconomic inequality in MetS. People with a low SES were more likely to have MetS. Therefore, policymakers and health managers need to develop appropriate strategies to reduce these inequalities in MetS across age groups, genders, and education levels, especially among women and the elderly.
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Summary
Key Message
This study sheds light on the presence of socioeconomic inequalities in metabolic syndrome (MetS) among Iranian Kurds. Lower socioeconomic status (SES) is associated with a higher prevalence of MetS and its components. Addressing these socioeconomic factors is crucial to reduce health inequalities. Recognizing this association helps us understand the social determinants of health and design targeted interventions. Policymakers and health managers should prioritize developing strategies to reduce these inequalities in MetS across different age groups, genders, and educational levels, with a particular focus on vulnerable populations like women and the elderly.
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Dietary patterns, nutrition, and risk of breast cancer: a case-control study in the west of Iran
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Behjat Marzbani, Javad Nazari, Farid Najafi, Behnaz Marzbani, Sara Shahabadi, Mahin Amini, Mehdi Moradinazar, Yahya Pasdar, Ebrahim Shakiba, Saeed Amini
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Epidemiol Health. 2019;41:e2019003. Published online January 24, 2019
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DOI: https://doi.org/10.4178/epih.e2019003
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23,733
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38
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Abstract
OBJECTIVES Unhealthy dietary patterns are the most important changeable risk factors for breast cancer. The aim of this study was to assess the relationship between dietary patterns and the risk of breast cancer among under-50 year women in the west of Iran.
METHODS All women under 50 years old with pathologically confirmed breast cancer between 2013 and 2015 who were referred to oncology clinics in the west of Iran, and 408 under-50 women referred to other outpatient clinics who were without breast or other cancers at the time of the study and 2 years later were selected as the control group. The data were collected using the middle-aged periodical care form of the Iranian Ministry of Health and analyzed using univariate and multivariate logistic regression in Stata.
RESULTS The most powerful risk factor for breast cancer was fried foods; the odds ratio of consuming fried foods more than once a month for breast cancer was 4.5 (95% confidence interval, 2.1 to 9.4). A dose-response model indicated that increasing vegetable and fruit consumption up to 90 servings per month decreased the odds of breast cancer, but consuming more than 90 servings per month increased the risk.
CONCLUSIONS Inadequate consumption of vegetables and consumption of soft drinks, industrially produced juices, fried foods, and sweets were identified as risk factors for breast cancer. In response to these findings, it is necessary to raise awareness and to provide education about healthy diets and the need to change unhealthy dietary patterns.
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Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015
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Mehdi Moradinazar, Farid Najafi, Mohammad Reza Baneshi, Ali Akbar Haghdoost
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Epidemiol Health. 2017;39:e2017023. Published online June 15, 2017
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DOI: https://doi.org/10.4178/epih.e2017023
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14,420
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Abstract
OBJECTIVES Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran.
METHODS We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n<sub>0</sub> , was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level.
RESULTS The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population.
CONCLUSIONS Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.
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