An inequity in the distribution of health care services in big cities is the most significant problem in the public health sector. Tehran is a metropolis with a population of over 8 million and is geographically divided into 22 districts each with a different social and economic status.
The current study is the first of its kind, studying death rates caused by the top five death causes, that is, ischemic heart diseases, cerebrovascular diseases, hypertension, gastric cancer and respiratory diseases along with their distribution in different districts of Tehran.
In the year 1390, 13325 people died because of these diseases, which constitutes one fourth of the deaths in Tehran. The studies show that respiratory diseases with 11.32 percent and gastric cancer with 1.38 percent are respectively the most and least significant causes of death in the population.
Global studies on geographical distinctions have indicated that the individuals’ place of residence can cause the outbreak of certain diseases and the deaths caused by them. Since geographical clustering is an established tool for the zonation of disease and death in different geographical areas, this study uses statistical methods to geographically cluster these five causes of death in the city of Tehran. This clustering of diseases, which are also the causes of death, at different geographical or economic and social levels, can be an effective tool in hypothesizing about them.
The results of the clustering indicate differences among the 22 districts of Tehran concerning each of the five causes of death. In this study, concerning the rate of deaths attributed to each of the death causes, two high-risk and two low-risk clusters are recognized, and the results indicate that the high-risk clusters are located in the south of Tehran whereas the low-risk ones are concentrated in the north part of the city. The distribution of the studied diseases was different in different areas and districts 2, 3 and 5 had the lowest death rates compared to other districts whereas districts 16, 19 and 20 had the highest ones.
This study also showed that the number of deaths caused by ischemic heart diseases and respiratory diseases was higher among men than women. (34.57 And 31.57 percent)
Different factors can affect this distribution and among them economic and social status is the most significant, which have been emphasized by other studies as well. Social and economic status can affect the three health criteria:
Health care and hygiene
Also, similar studies indicate that lifestyle and constant exposure to air pollution are also effective causes of death. Similar studies show that these factors are not distributed evenly in the city of Tehran.
Such studies can be an indicator of health condition in different districts of big metropolises such as Tehran. The study of these top five death causes indicates a meaningful distribution of death rates in the 22 districts of Tehran, which can be a warning about an unfair distribution of health care services in these areas. Therefore, the results of this study can be used by health policy makers in order to dedicate equal resources to all districts