Ethics code: IR.IAU.SRB.REC.1403.508
1- Department of Social Science, Faculty of Literature, Humanities and Social, Science and Research Branch, Islamic Azad University, Tehran, Iran
2- Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
3- Department of Youths & Inter-generational Relationships in Institute of Humanities and Social Sciences, ACECR, Tehran, Iran
2- Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
3- Department of Youths & Inter-generational Relationships in Institute of Humanities and Social Sciences, ACECR, Tehran, Iran
Abstract: (51 Views)
Objective (s): Self-rated health (SRH) is a widely used and reliable indicator for assessing individual health status and health inequalities. Evidence suggests that socioeconomic conditions significantly shape individuals’ health perceptions. This study aimed to examine the association between key socioeconomic factors, including occupation, education, and income and SRH among adults in Tehran, Iran.
Methods: A cross-sectional survey was conducted among 400 adults aged 18–65 years in Tehran. Data were collected using a structured questionnaire covering demographic variables (age, gender, marital status), socioeconomic indicators (occupation, education, income), and SRH. Descriptive statistics and multivariable logistic regression analyses were applied to identify independent predictors of SRH.
Results: The mean (SD) age and years of education of participants were 38.06 (14.06) and 15.76 (3.36) years, respectively. Most participants reported their income as “faire” good nor bad” (53%). Multivariable logistic regression revealed that social class and age were the strongest predictors of SRH. Participants in the lower social class were more likely to report poor health compared to those in the upper class (OR=4.47, P=0.01). Additionally, increasing age was associated with a higher likelihood of reporting suboptimal health (OR=1.03, P=0.04). Other factors, including gender, education, occupation, and income, were not independently associated with SRH, although some showed associations in univariate analyses.
Conclusions: SRH appears to be predominantly influenced by social position and age rather than individual characteristics such as education, occupation, or income. These findings highlight the critical role of structural and social inequalities in shaping health outcomes. Public health policies should prioritize reducing social disparities and promoting social equity to improve population health.
Methods: A cross-sectional survey was conducted among 400 adults aged 18–65 years in Tehran. Data were collected using a structured questionnaire covering demographic variables (age, gender, marital status), socioeconomic indicators (occupation, education, income), and SRH. Descriptive statistics and multivariable logistic regression analyses were applied to identify independent predictors of SRH.
Results: The mean (SD) age and years of education of participants were 38.06 (14.06) and 15.76 (3.36) years, respectively. Most participants reported their income as “faire” good nor bad” (53%). Multivariable logistic regression revealed that social class and age were the strongest predictors of SRH. Participants in the lower social class were more likely to report poor health compared to those in the upper class (OR=4.47, P=0.01). Additionally, increasing age was associated with a higher likelihood of reporting suboptimal health (OR=1.03, P=0.04). Other factors, including gender, education, occupation, and income, were not independently associated with SRH, although some showed associations in univariate analyses.
Conclusions: SRH appears to be predominantly influenced by social position and age rather than individual characteristics such as education, occupation, or income. These findings highlight the critical role of structural and social inequalities in shaping health outcomes. Public health policies should prioritize reducing social disparities and promoting social equity to improve population health.
Keywords: self-rated health, socioeconomic status, occupation, education, income, health inequality, Tehran
type of study: Descriptive |
Subject:
Public Health
Received: 2026/01/8 | Accepted: 2026/01/20 | ePublished ahead of print: 2026/01/20
Received: 2026/01/8 | Accepted: 2026/01/20 | ePublished ahead of print: 2026/01/20
References
1. World Health Organization. World report on health equity and social determinants of health. Geneva: WHO Press; 2010. Available at: https://www.who.int/publications/i/item/world-report-on-health-equity-and-social-determinants-of-health [Access date 06/30/2026]
2. World Health Organization. World health statistics 2024: monitoring health for the SDGs. Geneva: WHO; 2024. Available at: https://www.who.int/data/gho/publications/world-health-statistics [Access date 06/30/2026]
3. Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Geneva: World Health Organization; 2010 Available at: https://www.who.int/publications/i/item/9789241500852 [Access date 06/30/2026]
4. Adler NE, Newman K. Socioeconomic disparities in health: pathways and policies. Health Affairs (Millwood) 2002; 21: 60-76 [DOI:10.1377/hlthaff.21.2.60]
5. Galea S, Putnam S. The role of macrosocial determinants in shaping the health of populations. In: Galea S, editor. Macrosocial Determinants of Population Health. 3st Edition, New York: Springer 2007:91-102 [DOI:10.1007/978-0-387-70812-6]
6. House JS, Lepkowski JM, Kinney AM, et al. The social stratification of aging and health. Journal of Health Social Behavior 1994; 35:213-234 [DOI:10.2307/2137277]
7. Idler EL, Benyamini Y. Self-rated health and mortality: a review of community studies. Journal of Health Journal of Health Social Behavior 1997; 38:21-37 [DOI:10.2307/2955359]
8. Adler NE, Stewart J. Health disparities across the lifespan: meaning, methods, and mechanisms. Journal New York Academy of Sciences 2010; 1186:5-23 [DOI:10.1111/j.1749-6632.2009.05337.x]
9. Stringhini S, Sabia S, Shipley M, et al. Association of socioeconomic position with health behaviors and mortality. Journal of the American Medical Association 2010; 303:1159-1166 [DOI:10.1001/jama.2010.297]
10. Moor I, Spallek J, Richter M. Explaining socioeconomic inequalities in self-rated health: a systematic review. Journal of Epidemiol Community Health 2017; 71: 565-575 [DOI:10.1136/jech-2016-207589]
11. Albano JD, Lawrence JA, Williams DR, et al. Socioeconomic position and self-rated health. International Journal of Epidemiology 2005; 34: 74-85
12. Shi L, Tsai J, Kao SY. Public health, social determinants of health, and public policy Journal of Medical Sciences 2009; 29:43-59
13. World Health Organization. Rio political declaration on social determinants of health. Rio de Janeiro; 2011.Available at: https://www.who.int/publications/i/item/9789241502450 [Access date 06/30/2025]
14. Bahadori M, Sanaeinasab H, Ghanei M, et al. social determinants of health in Iran: a systematic review. Journal of Public Health 2015; 44: 728-741 [DOI:10.1155/2015/524341]
15. Rezaei S, Hajizadeh M, Ahmadi S, et al. Socioeconomic-related inequalities in self-rated health in Iran. Journal of East Mediterr Health 2020; 26: 760-765 [DOI:10.26719/emhj.20.001]
16. Nouraei Motlagh S, Asadi Piri Z, Bajoulvand R, Rezaei S. Socioeconomic status and self-rated health in Iran. Journal of Cost Effectiveness and Resource Allocation 2022; 20: 30-41 [DOI:10.1186/s12962-022-00364-1]
17. Mahmood Tavousi, Jila Sadighi, Faranak Farzadi, Mahdi Ebadi, Sepideh Omidvari, Ali Azin, et al . Iranian's percpectives about health importance. Journal of Payesh 2012; 11:611-619[Persian]
18. Marmot M, Allen J, Goldblatt P, et al. Build back fairer: the COVID-19. Journal of Lancet 2022; 400:106-119
19. Garmaroudi GR, Moradi A. Socio-Economic status in Iran: a study of measurement index. Payesh 2010; 9:137-144 [Persian]
20. Nadi T, et al. Socioeconomic inequality in health literacy and self-rated health in Iran. Journal of BMC Public Health 2021; 21:12-34 [DOI:10.1186/s12889-021-11708-6]
21. Rezaei S, et al. Socioeconomic status as the strongest predictor of self-rated health in Tehran. Journal of Public Health 2019; 48:1496-1505
22. Can a single general self-rated health question mirror social determinants of health among Iranian employees? Journal of Public Health 2023; 52: e24875-24883
23. Salehnia N, Olyaeemanesh A, Sadeghi S. Social determinants of population health in Iran. Journal of Health Sciences 2023; 11:75-86
24. Social determinants of health inequity in Iran: a narrative review. Journal of Education and Health Promotion 2022; 11:345-361
25. Rezaei S, Hajizadeh M, Ahmadi S, Karyani AK, Khosravipour M, Khosravi F, Latifi A. Socioeconomic-related inequalities in self-rated health status in Kermanshah city, Islamic Republic of Iran: a decomposition analysis. Journal of East Mediterr Health 2020; 23:820-827 [DOI:10.26719/emhj.20.001]
26. Nouraei Motlagh S, Asadi Piri Z, Asadi H, Bajoulvand R, Rezaei S. Socioeconomic status and self-rated health in Iran: findings from a general population study. Journal of Cost Effectiveness and Resource Allocation 2022; 29:20-30 [DOI:10.1186/s12962-022-00364-1]
27. Bahadori M, Sanaeinasab H, Ghanei M, Mehrabi Tavana A, Ravangard R, Karamali M. The Social Determinants of Health (SDH) in Iran: A Systematic Review Article. Iran Journal of Public Health 2015; 44:728-41 [DOI:10.1155/2015/524341]
28. Goshtasebi A, Montazeri A, Vahdaninia M S, Rahimi Fouroshani A, Mohammad K. Self-reported health and socioeconomic status: results from a population-based study in Tehran, Iran. Journal of Payesh 2003; 2:187-193 [Persian]
29. Wu S, Wang R, Zhao Y, et al. The relationship between self-rated health and objective health status. Journal of BMC Public Health 2013; 13:320-337 [DOI:10.1186/1471-2458-13-320]
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