Investigating spatial inequality and inequity in health status and its social determinants in Iran

Health is a vital component of human well-being. Health justice is one of the political priorities of governments. Most region of the Iran are facing the problem of improving the level of health, which is a major obstacle to sustainable development in these regions. Recognizing and analyzing spatial health inequalities and their determinants at different scales (national, regional, local) is an effective step in policy making. The main purpose of this study is to analyze the spatial inequality in health status and its social determinants in the provinces of Iran. The required data collected through statistical yearbooks of Iran Statistics Center and medical universities. To measure the spatial pattern and spatial clustering, the global Moran’s I and Getis-Ord G statistics are used. Also, the two-variable Moran statistic was used to measure the relationship between health status and independent research variables. Findings show that health status and its determinants are distributed unequally among the provinces. In the health stats, the border provinces, especially in the east and southeast of the country are in an unfavorable situation. The provinces of Tehran, Alborz, Kurdistan and Ardabil achieved the highest values. In other words, they can be said to be in a good position. In contrast, the provinces of North Khorasan, Khuzestan, South Khorasan and Sistan and Baluchestan had the lowest scores, which they had poor condition. Health status and independent variables of the study showed significantly positive relationship with health status in the provinces. Highest coefficient values for health prediction status respectively are socio-economic status 0.222 (p = 0.000) physical 0.147 (p <0.001), human resources 0.142 (p <0.001) and environmental quality 0.135 (p <0.001). However, these relations are changing among the provinces, and not all provinces follow the same pattern. The influencing factors of research varies among provinces, which is higher in the southeastern and northwestern provinces of the country.