Socioeconomic Inequalities in Gastroesophageal Reflux Disorder: Results from an Iranian Cohort Study

• Published in: Middle East journal of digestive diseases Vol. 10; no. 3; pp. 180 - 187
• Main Authors: Farjam, Mojtaba, Sharafi, Mehdi, Bahramali, Ehsan, Rezaei, Satar, Hassanzadeh, Jafar, Rezaeian, Shahab
• Format: Journal Article
• Language: English
• Published: Iran Shiraz University of Medical Sciences 01-07-2018; Iranian Association of Gastroerterology and Hepatology; Iranian Association of Gastroenterology and Hepatology, Shiraz University of Medical Sciences
• Subjects: Cohort analysis; Concentration index; Epidemiology; Gastroesophageal reflux; Health disparities; Health risk assessment; Inequality; Original; PERSIAN Cohort; Socioeconomic factors; Systematic review; Iran; Gastroesophageal reflux; Concentration index; Iran; PERSIAN Cohort; Inequality
• ISSN: 2008-5230; 2008-5249
• DOI: 10.15171/mejdd.2018.108

BACKGROUND Despite progress in the health indexes in recent years, health inequalities remain as a global challenge within and between regions and countries. This study is the first to quantify the socioeconomic inequity in gastroesophageal reflux disease (GERD) using the concentration index. METHODS In this cross-sectional study, we used baseline data (7012 subjects) from the Fasa Cohort Study (the Southern Iran). The principal component analysis was used to construct socioeconomic status of the participants. The concentration index and concentration curve were used to measure socioeconomic-related inequality in GERD. Decomposition of concentration index was also done to identify the contribution of each explanatory variable to the wealth-related inequality in GERD prevalence. RESULTS The prevalence of GERD was 16.9% (95% CI: 15.9-17.7%). The overall concentration index for GERD was 0.093 (95% CI: 0.062-0.166]. Correspondingly, this figure for men and women were 0.116 (95% CI: 0.062-0.171%) and 0.091 (95% CI: 0.044-0.137%), respectively. The main contributors of socioeconomic-related inequality in GERD prevalence were socioeconomic status (64.4%), alcohol drinking (29%), and age (8.4%). CONCLUSION GERD is significantly more concentrated among richest people. There was significant socioeconomic inequality in GERD according to some individual factors. These inequalities need to be addressed by policy makers to identify the vulnerable subgroups and to reduce the disease burden in the community.