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Child mortality inequalities and socioeconomic determinants of health in Iran, 2016–2018

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Abstract

Measuring health inequalities is essential to inform policy making and for monitoring implementation to reduce avoidable and unfair differences in health status. We conducted a geospatial analysis of child mortality in Iran using death records from the Ministry of Health and Medical Education from 2016 to 2018 stratified by sex, age, province, and district, and household expenditure and income survey data from the Statistical Center of Iran collected in 2017. We applied multilevel mixed-effect models and detected significant inequality in child mortality and the impact of socioeconomic factors, especially household income. We advocate for using mortality rate for young children (< 5 years old) as an indicator for assessing the impact of interventions to reduce inequalities among various socioeconomic groups. We also recommend to design and implement comprehensive and longitudinal data collection systems for accurate, regular, and specific monitoring of health inequalities.

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Acknowledgements

We wish to thank all organizations particularly Center for Health Network Management and individuals involved in the funding, planning, design, and conducting this research.

Funding

This research was funded by the Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS).

Author information

Authors and Affiliations

  1. Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Ardeshir Khosravi, Efat Mohamadi, Alireza Olyaeemanesh & Amirhossein Takian

  2. Iranian Ministry of Health and Medical Education, Tehran, Iran

    Ardeshir Khosravi

  3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Ali Sheidaei & Ramin Heshmat

  4. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Gita Shafiee

  5. National Institute of Health Research, Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Alireza Olyaeemanesh

  6. Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Poursina Avenue, Qods Street, Enqelab Square, Tehran, Iran

    Amirhossein Takian

  7. Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Amirhossein Takian

  8. National Center for Health Insurance Research, Tehran, Iran

    Amirhossein Takian

Authors
  1. Ardeshir Khosravi
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  2. Efat Mohamadi
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  3. Ali Sheidaei
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  4. Gita Shafiee
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  5. Ramin Heshmat
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  6. Alireza Olyaeemanesh
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  7. Amirhossein Takian
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Contributions

AKh, RH, AT, AO, ASh, and GSh contributed toward conception and design of the study. AKh, ASh, RH, and EM contributed toward statistical analysis. AKh, EM, ASh, AT, and AO contributed toward manuscript preparation and revision. AKh, ASh, RH, and EM contributed toward data acquisition and analysis. All authors have read and approved all versions of the manuscript. AT is guarantor.

Corresponding authors

Correspondence to Ramin Heshmat or Amirhossein Takian.

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Conflict of interest

The authors have no conflict of interest.

Ethical approval

This study was evaluated and approved by the ethics committee of School of Public Health & Allied Medical Sciences at Tehran University of Medical Sciences (IR.TUMS.VCR.REC.1397.230).

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Khosravi, A., Mohamadi, E., Sheidaei, A. et al. Child mortality inequalities and socioeconomic determinants of health in Iran, 2016–2018. J Public Health Pol 44, 535–550 (2023). https://doi.org/10.1057/s41271-023-00448-z

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