Health Promot Perspect. 2016;6(4): 190-195.
doi: 10.15171/hpp.2016.31
PMID: 27766236
PMCID: PMC5071786
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Original Article

Economic inequalities amongst women with osteoporosis-related fractures: an application of concentration index decomposition

Rahmatollah Moradzadeh 1, Haidar Nadrian 2*, Farzaneh Golboni 3, Mohammad Hasan Kazemi-Galougahi 4, Nasrin Moghimi 5

1 Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
2 Department of Health Education & Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
3 Department of Midwifery, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
4 Department of Epidemiology and Biostatistics, School of Health and Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
5 Department of Rheumatology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran


Background: Considering the renewed emphasis on women’s health, attention to the new aspects of their health, such as equity, among different groups is warranted. The aim of this study was to investigate the economic inequalities among women with osteoporosis-related bone fractures (ORBFs) in Sanandaj, Iran.

Methods: In this cross-sectional study, convenient sampling was employed to recruit 220 women with osteoporosis referring to the only rheumatology clinic in Sanandaj (the center of Kurdistan province in Iran) from January to April 2013. Main outcome was the history of fractures due to osteoporosis. Concentration index decomposition (CID) and logistic regression were used for data analysis.

Results: In multivariate logistic analysis, the fourth and fifth quintiles of family economic status were found to be significantly associated with ORBFs. Risk difference and confidence interval (CI) for the relation between the history of bone fracture and family economic status was -0.115 (95% CI: -0.209, -0.021; P = 0.016), which reflected the higher prevalence of bone fractures among women with the lower economic levels. About 25% out of all ORBFs were happened among 20% of the women with low economic status.

Conclusion: It was concluded that economic status plays an important role in happening ORBFs among underprivileged women. A reorientation on women’s health care services in Iran with a focus on underprivileged postmenopausal women seems to be necessary. There is a need for inter-sectoral coalition between the policymakers of the health system and those of other organizations to reduce the economic inequalities among osteoporotic women.

Keywords: Economic status, Inequalities, Osteoporosis, Bone fracture
Citation: Moradzadeh R, Nadrian H, Golboni F, Kazemi-Galougahi MH, Moghimi N. Economic inequalities amongst women with osteoporosis-related fractures: an application of concentration index decomposition. Health Promot Perspect. 2016;6(4):190-195. doi:10.15171/hpp.2016.31.
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Submitted: 24 Feb 2016
Revision: 06 Aug 2016
Accepted: 08 Aug 2016
ePublished: 01 Oct 2016
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