Regional Mental Health Inequality in a Limited Data Region in the Northeast of Iran: A Decomposition Analysis

Background and Objectives: Limited information still exists about the distribution of mental health (MH) in small districts. Considering the diversity in cultural specifications of entities in different societies, the current study aimed to assess the inequality of poor MH and corresponding socio-demographic components in a general population. Methods: This population-based cross-sectional study was conducted in Gonabad City, northeastern Iran. Data were collected by a 28-item general health questionnaire (GHQ-28) to assess MH status, considering a cut-off point of 23. The concentration index defines the inequality in the MH. Decomposition analysis was done to identify the contribution of each explanatory variable to the socioeconomic inequality in MH prevalence. Results: Eight hundred subjects were recruited (response rate=98%); approximately 41.6% were aged 30 years or younger, half of whom were females. The overall prevalence of poor MH was 24.7% (95% CI: 21.8 to 27.9%) and the age-adjusted prevalence of poor MH was 27.5% (95% CI: 24.2 to 31.2%). A concentration of poor MH prevalence was observed among the poorest people (concentration index: -0.15). Socioeconomic status (SES) (59.7%), age (24.1%), and gender (4.7%) were identified as the main contributors to socioeconomic-related inequality in poor MH prevalence. Conclusion: Poor MH is significantly concentrated among the poorest people. Therefore, SES appeared to play a key role in improving the health of individuals, which can lead to improved health status in a community. Furthermore, these data suggest that the MH initiative should target the elderly and women via a recently determined family physician plan in Iran.