Decomposing socioeconomic inequality in health literacy in Iran: A concentration index approach

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Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Report
Length: 3,640 words
Lexile Measure: 1470L

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Byline: Amir. Almasi-Hashiani, Mahmoud. Abbasi, Mohammad. Tavakol, Vali. Baigi, Mehri. Mohammadi, Javad. Nazari, Esmaeil. Morasae, Yahya. Shadi, Majid. Taheri

Background: Health literacy is a major factor for health promotion and well-being. In spite of several researches on health literacy, information on the subject of the status of health literacy in Asian countries such as Iran is inadequate. Therefore, this study aimed to assess the inequality of health literacy in an Iranian population and its influencing factors. Methods: In this cross-sectional study, 736 families were selected by cluster random sampling. A validated questionnaire was used to measure the health literacy of participants. Socioeconomic status (SES) was calculated by asset-based approach, and principal component analysis (PCA) was performed to estimate the families' SES. Concentration index and curve were used to measure SES inequality in health literacy, and after that decomposed into its determinants. The data were analyzed by Stata software. Results: The mean age of the participants was 34.81 years (standard deviation = 5.98 years). The value of concentration index for health literacy equals 0.2292 (95% confidence interval = 0.168-0.283), and this value indicates that there is inequality in distribution of health literacy in Iran and the inequality disfavors the poor. Conclusions: The results of this study revealed that there is inequality in distribution of health literacy in Iran, and people of higher economic status in Iran enjoy from better health literacy levels.


Health literacy is one of the aspects of society assessment where its effective factors are a reliable tool for health planner.[1] Health literacy is the ability of an individual to earn, interpret, and understand primary information and health service needed for suitable decision.[2] According to the importance of health literacy, the World Health Organization introduced it as health determinant.[3] The studies show that irregular and arbitrary use of drugs, failure to follow physician's orders, unfavorable blood glucose control, and low health knowledge are more prevalent in individuals with low health literacy.[4],[5]

Berkman et al .[6] in a systematic review of 111 studies concluded that poor health literacy is related to worse health outcomes (more hospitalizations, greater use of emergency care, higher mortality rates, etc.) and inferior use of healthcare services (lower influenza vaccine and mammography screening, etc.). The probable concentration of literacy health in some socioeconomic status (SES) groups is the hypothesis of this study.

Many studies have evaluated the effective factors on health literacy. Gender, education levels, location, and SES are some of these factors.[1],[7] SES is expressed as an important factor in health literacy.[8],[9] Also, some studies showed that health literacy increased with increase in economic status of household.[1],[10] The results of some studies show that SES is an important factor in health status. However, other studies showed SES is not a basic determinant factor in health literacy, but it can be have a fascinating role in health literacy alongside important factors such as education levels.

However, notwithstanding several researches regarding health literacy, information on the subject of the status of health literacy in Asian countries...

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Gale Document Number: GALE|A604880973