Abstract
OBJECTIVE: The increasing demographic shift toward an aging population in Iran highlights the urgent need to understand how socioeconomic inequalities affect the ability of older individuals to access essential resources and services. This study examined socioeconomic inequalities in meeting the needs of older people in Hamadan, Iran. METHOD: This cross-sectional study was conducted on the 501 elderly people living in western Iran. Data collection was carried out from December 1, 2022 to March 31, 2023, among elderly individuals who were registered in the SIB (Unified Health System). system. Elderly were selected by stratified random sampling among 17 comprehensive urban health centers (CURHCs) in Hamadan province. The data collection process consisted of four sections, including: A demographic information questionnaire, the Abbreviated Mental Test (AMT) questionnaire to determine the absence of dementia, cognitive impairment and the Barthel Index questionnaire to measure functional independence status and 4) Camberwell Assessment of Need for the Elderly. Socio-economic inequalities were assessed using the concentration index and a decomposition approach, determining the contribution of each factor to the socio-economic inequality at 95% CI. RESULTS: The concentration index for met needs was 0.15 (95% CI: 0.12, 0.19), indicating a concentration of met needs among the elderly with higher economic status. Subgroup analysis (with statistically significant results) revealed that the lowest levels of met needs were observed among illiterate people (53.09% vs. 92.11% (p < 0.001)) and those with dyslipidemia (55.86% vs. 65.98, p = 0.050). Education (60.38%) and economic status (25.32%) were the primary contributors to inequality in elderly individuals' met needs. CONCLUSION: The findings reveal significant disparities in meeting the needs of the elderly, particularly among the wealthy, the illiterate, and those with dyslipidemia. To address these issues, public health initiatives should focus on expanding education and providing economic support to disadvantaged older adults. In addition, personalized health care for those with chronic conditions is essential. Proposed solutions include training health care workers in geriatric care, developing community-based programs with home care, and creating economic support packages for low-income seniors.