The Impact of Socioeconomic Inequality on Mental Health among Adolescents in Qazvin, Iran: Blinder-Oaxaca Decomposition Method

Background

Mental health is integral to public health in adolescents. Although previous studies have shown that low socioeconomic status (SES) is associated with mental disorders (MD), it is unclear which mental health domains are most important. Thus, our study aimed to investigate the associations between 5 domains of mental disorder and SES inequality in adolescents.

Methods

We conducted a cross-sectional study among adolescents (N = 1724). Associations between SES inequality with mental disorders, such as emotional symptoms, conduct problems, hyperactivity, peer relationship problems, and prosocial behavior, were examined. We used the concentration index (CI) to determine inequality. The gap between the low and high socioeconomic groups was decomposed into its determinants using the Blinder-Oaxaca decomposition method.

Results

Mental health's overall CI was -0.085 (P ˂ 0.001). The emotional problem was primarily caused by SES inequality (-0.094 [P = 0.004]). Decomposition of the gap between the 2 economic groups showed that physical activity, school performance, exercise, parents' smoking status, and gender were the most important determinants of inequality.

Conclusion

SES inequality plays a vital role in adolescents' mental health. It seems that the emotional problem domain of mental health might be more amenable to interventions than other domains.

The optimal vitamin D cut-off value associated with hyperglycemia in an Iranian population

Background

Vitamin D deficiency may accelerate the risk of type 2 diabetes mellitus. The association of vitamin D with hyperglycemia may be influenced by lifestyle.

Objective

To evaluate the relationship between vitamin D status and hyperglycemia among the workers' population.

Methods

This was a medical records review of 7054 Iranian factory workers participating in an annual health check-up for employees. Of those, potential participants were included in this analysis if data for serum 25-hydroxyvitamin D [25(OH) D] levels were also available.

Results

Data of 429 male participants were used for this analysis. Of those, 61.07% had serum 25(OH)D concentrations lower than the sufficient level [≥20 ng/ml]. Hyperglycemic participants had significantly lower 25(OH)D than those with normal fasting blood glucose (FBG). Regression analyses highlighted serum 25(OH)D as a significant determinant of hyperglycemia [OR: 0.943(0.901, 988); p = 0.01]. The association between 25(OH)D and FBG remained significant after adjustment for potential confounders (p = 0.008). Using the ROC analysis, the serum 25(OH)D value of 14.7 ng/ml was the optimal cut-off point to predict hyperglycemia in this population (sensitivity: 63.6%, specificity: 62.3%, p = 0.01).

Conclusion

Our results revealed a considerable proportion of participants with serum 25(OH)D below the optimal level as well as a significant inverse association between vitamin D status and hyperglycemia among the factory workers. These findings highlight the importance of including the evaluation of vitamin D status as a part of annual health examinations for employees, and may help health policy- makers prevent or delay type 2 diabetes mellitus among the workers' population.