Economic Inequality in Life Satisfaction and Self-perceived Health in Iranian Children and Adolescents: The CASPIAN IV Study

BACKGROUND: The purpose of this study was to assess socioeconomic status (SES) inequality in life satisfaction (LS) and good self-perceived health (SPH) in Iranian children and adolescents. METHODS: This nationwide study was conducted as part of a fourth national school-based surveillance program performed on 14880 students aged 6–18 years who were living in urban and rural areas of 30 provinces of Iran between 2011 and 2012. Using principle component analysis, the SES of participants was constructed as single variable. SES inequality in LS and good SPH across the SES quintiles was assessed using the concentration index (C) and slope index of inequality (SII). The determinants of this inequality are investigated by the Oaxaca Blinder decomposition method. RESULTS: Frequency of LS along with the SES quintiles shifted significantly from 73.28% (95% CI: 71.49, 75.08) in the lowest quintile to 86.57% (95% CI:85.20, 87.93) in the highest SES quintile. Frequency of favorable SPH linearly increased from lowest SES quintile (76.18% (95% CI: 74.45, 77.92)) to highest SES quintile (83.39% (95% CI: 81.89, 84.89)). C index for LS and good SPH was negative, which suggests inequality was in favor of high SES group. SII for LS and SPH was 15.73 (95% CI: 12.10, 19.35) and 8.21 (95% CI: 5.46, 10.96)]. Living area and passive smoking were the most contributed factors in SES inequality of LS. Also passive smoking and physical activity were the most contributed factors in SES inequality of SPH. CONCLUSIONS: SES inequality in LS and good SPH was in favor of high SES group. These findings are useful for health policies, better programming and future complementary analyses.