Income-Related Inequality in Traffic Accident Health Outcomes (Injury, Disability and Mortality): Evidence from the Nationwide Survey in Iran

BACKGROUND: Despite many efforts, Iran continues to have a high rate of traffic accidents and poor health outcomes. This study aimed to measure income-related inequality for traffic accident health outcomes in Iran, a country with one of the highest rates of traffic accidents and related health problems. METHODS: The source of data was a national representative survey named the Iranian Multiple Indicator Demographic and Health Survey (IrMIDHS, 2010). Monthly household income is obtained through self-report in different quarters. Disparity rate ratio (DRR), slop index of inequality (SII) and the population attributable risk percentage measure (PAR%) were calculated. The concentration index (CI) of RTIs was used as our measure of socioeconomic inequality and decomposed into its determining factors. RESULTS: Using the DRR index, in the lowest income group, the risk of death from an accident was 2.3 times, greater and the risk of accidental disability was 11.7 times greater than for the third income quartet. The slope index also shows that the rate of road traffic deaths, disability and injury per 100,000 individuals decreased by 28, 82, and 392 moving from lower to higher incomes. This decrease in injury was about 581 for motorcyclists. CI was −0.04078643 (SE=.01424828, P-value 0.004). Male sex (68.9%), 15–29 yr old age (9.4%), employed activity status (20.8%) has a positive contribution in the RTIs concentration index. CONCLUSION: In addition to intervention related to the road safety and vehicles and reducing human errors, prevention of the road traffic ill health outcomes requires attention to reduction of inequality in society.