Gender disparity and risk of noncommunicable disease among adults in Islamic Republic of Iran

Abstract

Background: The relationship between gender disparity and the risk of developing noncommunicable disease and other social health determinants has not been well researched in the Islamic Republic of Iran. Aims: To assess how gender disparity contributes to the overall risk of noncommunicable disease in the Islamic Republic of Iran. Methods: This was a secondary analysis of data on about 11 000 adults aged 15–69 years from the 2011 WHO STEPwise approach to NCD risk factor surveillance (STEPS) survey in the Islamic Republic of Iran. The outcome variable in our analysis was the noncommunicable disease risk factor index. We used an extension of the Blinder-Oaxaca decomposition model to decompose the predicted mean difference in this index. Sampling method, study design and sex were considered in the analysis. The predictor variables were age, household assets index, education, employment status, ethnicity, and residence. Results: The overall mean (standard deviation) noncommunicable disease risk score was 39.26 (22.4). The risk score for women was significantly higher than for men (41.75 versus 36.84; P < 0.001). About 35% of gender disparity in risk score was due to the differences in distribution of the predictor variables (explained component); of these, age contributed the most (23.79%), followed by education (7.82%). The different gender effects on work status and age made the largest contributions to the unexplained component of the disparity, 36.40% and 14.82%, respectively. Conclusions: Policies to reduce the risk of noncommunicable diseases need to consider gender groups and how gender affects social determinants such as employment status to make some gender subgroups more vulnerable than others.