The Relation Between Social Determinant of Health with Access to Health Services in Gonbad kavoos

  • Masoome Gholami Master of Health Services Management, Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran
  • Amir Ashkan Nasiripoor Associate Professor of Health Services Management, Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran
  • Mohammad Reza Maleki Associate Professor of Health Services Management, Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran
Keywords: Social determinants of health, Access, Health Care


Background and Objective: Today health perpectives has been changing widly. Now social determinants of health are more influence in disease rather than biological causes. If these determinants being ignored, achievement to health Golas would be impossible. This study was conducted to determine the relationship between Social determinants of health and access to health care in GonbadKavoos.

Materials and Methods: This study was a correlation and cross-sectional. The populations were urban residents of GonbadKavoos, and the sample size was four hundred households, and the data collection tool was a questionnaire. For statistical analyze between variables these tests were used: independent sample test, Pearson correlation and ANOVA.

Results: Among determinants of health, the variables like: socio-economic status of household (P<0.0001), educational level of household breadwinner (P<0.0001), family dimension (P<0.018), employment (P<0.003), residential area (P<0.001), access to internet (P<0.0001), doing exercise (P<0.0001), and having insurance (P<0.0001), had significant relationship with access to health care, spatially dental services and periodical checkup.

Conclusion: Social determinants of health have very important relationship with access to health care. Then to decline these inequities in access to health care, development of social and economic equality for all people is so crucial.


Motlagh.ME, Olyaee Manesh A, Beheshtain M. Health and Social Determinants: Movaffagh; 2009 Winter 2009. (Full text in Persian)

WHO. Social Determinants of Health. 2011; Available from:

Marmot M, Wilkinson R. Social Determinants of Health: OUP Oxford; 2005.

Seniori Costantini A, Gallo F, Pega F, Saracci R, Veerus P, West R. Population Health and Status of Epidemiology in Western European, Balkan and Baltic Countries. 2015: 1464-3685.

Eibich P, Krekel C Fau-Demuth I, Demuth I Fau-Wagner GG, Wagner GG. Associations between Neighborhood Characteristics, Well-Being and Health Vary Over the Life Course. 2016: 1423-0003.

Asadi-Lari M, Vaez-Mahdavi M. An overview on Urban-HEART Tehran Experience. World Health Organization. 2008.

Guendelman S, Angulo V, Oman D. Access to Health Care for Children and Adolescents in Working Poor Families: Recent Findings From California Medical Care. 2005;43 (1): 68-78.

Rajati F, Kamali K, Parvizy S. Public Health Customers’ Experiences of Health Accessibility: A Phenomenological Study. Iranian Journal of Epidemiology. 2011;7 (2): 17-24. (Full text in Persian)

Pinzón-Flórez CE, Fernández-Niño JA, Ruiz-Rodríguez M, Idrovo ÁJ, López AAA. Determinants of Performance of Health Systems Cncerning Maternal and Child health: A Global Approach. PLoS ONE. 2015;10 (3)

Saxena D, Vangani R, Mavalankar DV, Thomsen S. Inequity in Maternal Health Care Service Utilization in Gujarat: Analyses of District-level Health Survey Data. Glob Health Action. 2013; 6: 1654-9880.

Walker RJ, Gebregziabher M, Martin-Harris B, Egede LE. Relationship between Social Determinants of Health and Processes and Outcomes in Adults with Type 2 Diabetes: Validation of A Conceptual Framework. BMC endocrine disorders. 2014;14:82.

Vonneilich N, Jöckel K-H, Erbel R, Klein J, Dragano N, Weyers S, et al. Does Socioeconomic Status Affect the Association of Social Relationships and Health? A Moderator Analysis. International Journal for Equity in Health. 2011;10 (43).

Sangare A, Samba M, Bourgeois D. Illness-Related Behaviour and Sociodemographic Determinants of Oral Health Care use in Dabou, Cote d'Ivoire. Community Dental Health. 2012;29: 78-84.

Baldani MH, Mendes YBE, Lawder JAdC, De Lara API, Rodrigues MMAdS, Antunes JLF. Inequalities in Dental Services Utilization among Brazilian low-Income Children: the Role of Individual Determinants. Journal of Public Health Dentistry. 2011;71

Kimani JK, Ettarh R, Kyobutungi C, Mberu B, Muindi K. Determinants for Participation in a Public Health Insurance Program among Residents of Urban Slums in Nairobi, Kenya: Results from a Cross-Sectional Survey. BMC Health Services Research 2012;12: 1472-6963.

Zhuo Chen, Crawford CAG. The Role of Geographic Scale in Testing the Income Inequality Hypothesis as an Explanation of Health Disparities. Social Science & Medicine. 2012;75: 1873-5347.

Treanor C, Donnelly M. An International Review of the Patterns and Determinants of Health Service Utilisation by Adult Cancer Survivors. BMC Health Services 2012;12: 1472-6963.

Maxwell AE, Young S, Crespi CM, Vega RR, Cayetano RT, Bastani R. Social Determinants of Health in the Mixtec and Zapotec Community in Ventura County, California. 2015: 1475-9276.

Payab M, Dorosty Motlagh A, Eshraghian M, Siassi F. The Association Between Food Insecurity, Socio-economic Factors and Dietary Intake in Mothers Having Primary School Children Living in Ray 2010. Iranian Journal of Nutrition Sciences & Food Technology. 2012;7 (1). (Full text in Persian)

Kimani JK, Ettarh R, Warren C, Bellows B. Determinants of Health Insurance Ownership among Women in Kenya: Evidence from the 2008-09 Kenya Demographic and Health Survey. Int J Equity Health. 2014;13:27. Epub 2014/04/01.

Kolasa K, Rybnik T. [Socio-Demographic Determinants of Inequity of Access to Health Care in Poland in 2011-Based on Social Diagnosis]. Przeglad Epidemiologiczny. 2012;66.

Kimbro RT, Bzostek S, Goldman N, Rodríguez G. Race, Ethnicity, and The Education Gradient In Health. Health Affairs. 2013;27 (2).

Wabiri N, Chersich M, Zuma K, Blaauw D, Goudge J, Dwane N. Equity in Maternal Health in South Africa: Analysis of Health Service Access and Health Status in a National Household Survey. PLoS One. 2013;8 (9): e73864. Epub 2013/09/17.

Mohsen Shoja, Shahnaz Rimaz , Mohsen Asadi-Lari , Seyed Abbas Bagheri Yazdi, Govhari Mr. Mental Health of Older People and Social Capital. Iranian Institute for Health Sciences Research. 2013;12 (4):345-53. (Full text in Persian)

Urbanos-Garrido RM. Social Inequalities in Health: Measuring the Contribution of Housing Deprivation and Social Interactions for Spain. International Journal for Equity in Health. 2012;11 (77).

Fereshtehnejad S-M, Asadi-Lari M, Moradi Lakeh M, Vaez-Mahdavi MR, Motevalian SA, Afkari ME. Estimation of Life Expectancy and its Association with Social Determinants of Health (SDH) in Urban Population of Different Districts of Tehran in 2008. Teb va Tazkieh. 2010;19 (2):25-40. (Full text in Persian)

Lahana E, Pappa E, Niakas D. Do Place of Residence and Ethnicity Affect Health Services Utilization? Evidence from Greece. International Journal for Equity in Health. 2011;10 (16).

Chandola T. Spatial and Social Determinants of Urban Health in Low-, Middle- and High-Income Countries. Public Health Reports. 2010;126 (3): 1476-5616.

Milloy M-J, Marshall BDL, Montaner J, Wood E. Housing Status and the Health of People living with HIV/AIDS. Current HIV/AIDS Report. 2012;9: 1548-3576.

Baum F, Newman L, Biedrzycki K. Vicious Cycles: Digital Technologies and Determinants of Health in Australia. Health Promotion International. 2012;9: 1460-2245.

Original Research Article