Socioeconomic status as the strongest predictor of self-rated health in Iranian population; a population-based cross-sectional study

Abstract

Background: There is little evidence comparing the role of subjective versus objective indicators of socioeconomic status (SES) on individuals' self-rated health (SRH) in Iran. Objectives: We aimed to investigate underlying predictors of SRH including subjective and objective SES in Tehran, a multi-ethnic city. Method: This is an analysis of cross-sectional survey data on subjective and objective SES from a population-based case-control study conducted in Tehran, Iran (2015). We used random digit dialing for study sample recruitment. Linear regression models were used for estimating crude and adjusted coefficients (95 confidence intervals). Age, gender, SES as well as cigarette smoking were included as confounders. Results: 15-50 years old residents of Tehran were recruited in the study (n = 1057). High reported objective and subjective SES was consistently associated with a better SRH. Subjective current SES (p < .001), subjective adolescence SES (p = .018), change in subjective SES (current vs. adolescent) (p = .034) and participants' education years (p < .001). Improvements over time in current SES in comparison to SES rated during adolescence increased the participants' SRH after adjustment for potential confounders (coefficient = 0.170, 95 CI: (0.015, 0.325)). Female participants (coefficient = -0.305, 95 CI: (-0.418, -0.192)) and smokers (high category vs. never smokers) (coefficient = -0.456, 95 CI: (-0.714, -0.197)) reported significantly worse SRH. Increasing age - 0.008 (95 CI: -0.014, -0.002) was associated with decreased SRH. Conclusion: High subjective and objective SES consistently was the most important predictor of high SRH.