title: Is the status of diabetes socioeconomic inequality changing in Kurdistan province, west of Iran? A comparison of two surveys.
abstract: BACKGROUND
  About 80% of deaths in 350 million cases of diabetes in the world occur in low and middle income countries. The aim of this study was to determine the status of diabetes socioeconomic inequality and the share of determinants of inequalities in Kurdistan Province, West of Iran, using two surveys in 2005 and 2009.
  
  
  METHODS
  Data were collected from non-communicable disease surveillance surveys in Kurdistan in 2005 and 2009. In this study, the socioeconomic status (SES) of the participants was determined based on the residential area and assets using principal component analysis statistical method. We used concentration index and logistic regression to determine inequality. Decomposition analysis was used to determine the share of each determinant of inequality.
  
  
  RESULTS
  The prevalence of diabetes expressed by individuals changed from 0.9% (95% CI: 0.6-1.3) in 2005 to 3.1% (95% CI: 2-4) in 2009. Diabetes Concentration Index changed from -0.163 (95% CI: -0.301- -0.024) in 2005 to 0.273 (95% CI: 0.101-0.445) in 2009. The results of decomposition analysis revealed that in 2009, 67% of the inequality was due to low socioeconomic status and 16% to area of residence; i.e., living in rural areas.
  
  
  CONCLUSIONS
  The prevalence of diabetes significantly increased, and the diabetes inequality shifted from the poor people to groups with better SES. Increased prevalence of diabetes among the high SES individuals may be due to their better responses to diabetes control and awareness programs or due to the type of services they were provided during these years.
authors: MD, PhD, Assistant Professor of Epidemiology, Social Determinants of Health Research Center, Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran. moradi_gh@yahoo.com.
authors: Ghobad
authors: G
authors: Moradi
authors: PhD, Professor of Epidemiology, Knowledge Utilization Research Center (KURC), Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. rezamajd@tums.ac.ir.
authors: Reza
authors: R
authors: Majdzadeh
authors: PhD, Professor of Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. mohamadk@tums.ac.ir.
authors: Kazem
authors: K
authors: Mohammad
authors: MD, PhD, Professor of Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. malek179@gmail.com.
authors: Hossein
authors: H
authors: Malekafzali
authors: MSc Student of Epidemiology, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran. jafari.313333@yahoo.com.
authors: Saeede
authors: S
authors: Jafari
authors: PhD, Professor of Epidemiology, Iranian Epidemiological Association, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. holakoik@hotmail.com.
authors: Kourosh
authors: K
authors: Holakouie-Naieni
keywords: Concentration Index; Decomposition; Diabetes; Inequality; Iran; SES