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Background Studies show that different socio-economic and structural factors can limit access to healthcare for women with disabilities. The aim of the current study was to review barriers in access to healthcare services for women with disabilities (WWD) internationally. Methods We conducted a systematic review of relevant qualitative articles in PubMed, Web of Science and Scopus databases from January 2009 to December 2017. The search strategy was based on two main topics: (1) access to healthcare; and (2) disability. In this review, women (older than 18) with different kinds of disabilities (physical, sensory and intellectual disabilities) were included. Studies were excluded if they were not peer-reviewed, and had a focus on men with disabilities. Results Twenty four articles met the inclusion criteria for the final review. In each study, participants noted various barriers to accessing healthcare. Findings revealed that WWD faced different sociocultural (erroneous assumptions, negative attitudes, being ignored, being judged, violence, abuse, insult, impoliteness, and low health literacy), financial (poverty, unemployment, high transportation costs) and structural (lack of insurance coverage, inaccessible equipment and transportation facilities, lack of knowledge, lack of information, lack of transparency, and communicative problems) factors which impacted their access healthcare. Conclusions Healthcare systems need to train the healthcare workforce to respect WWD, pay attention to their preferences and choices, provide non-discriminatory and respectful treatment, and address stigmatizing attitudinal towards WWD. In addition, families and communities need to participate in advocacy efforts to promote WWD’s access to health care.

Background Studies indicate that women with intellectual disabilities (ID) face various personal and socio-environmental barriers in their sexual lives. This study aimed to identify the concerns and sexual health needs experienced by women with ID. Method A systematic review of relevant qualitative articles was conducted in PubMed, Web of Science Scopus and PsycINFO databases from June 2018 to August 2018. We designed our search strategy according to two main foci: (1) sexuality; and (2) women with ID. In the study, searches were limited to articles published from January 2000 to December 2017. In this review, studies on women ages 16 and over were included. Results Within the four databases, the search found 274 unique articles. After three steps of screening (title, abstract and full text), 22 studies were included in the final review. The articles mentioned difficulties with lack of sexual experience, negative experiences with sexuality, negative attitudes towards sexuality by nondisabled individuals, limited cognitive capacities to understand sexual identity, difficulty with finding the right partner, lack of access to sexual health information, lack of school-based sexuality education, violence and sexual abuse, lack of support from families and caregivers about sexuality, fear of sexual acts and unwanted pregnancy, shyness in expressing sexual desires, and limited knowledge of sexual behaviors. Conclusion Our findings indicate that women with ID need to be provided with school-based sexuality education tailored to the level of understanding needed to attain the requisite knowledge to form relationships, understand sexual and romantic relationships, and practice safe sex when they choose this option. Families along with education and healthcare systems should provide opportunities for women with ID to talk about their sexual needs and make their own choices.

Introduction Disability is a multifaceted global public health issue that adversely affects individuals’ quality of life (QoL), especially in low- and middle-income countries such as Iran. Despite the increasing prevalence of disabilities due to aging populations and chronic diseases, limited data exist on the QoL and its determinants among people with disabilities (PWD) in Iran. This study aims to assess the QoL status and identify related factors among adults with physical disabilities in Iran. Methods A cross-sectional analytical study was conducted nationally from 2024 to 2025 involving 867 adults aged 16 years and older with physical disabilities who were members of the Iranian Society for People with Disabilities. Participants were selected via convenience sampling. Data were collected using demographic, socioeconomic, disability assessment (Washington Group Short Set), and WHOQOL-BREF questionnaires. Multiple linear regression analyses were performed to identify factors associated with QoL domains and overall QoL score, adjusting for confounders. Socioeconomic status was derived using Principal Component Analysis. Results The mean age of participants was 38.08 years; 63.44% were male. Higher education levels were positively associated with better QoL across all domains (physical, psychological, social, environmental) and total QoL scores ( p  < 0.001). Greater disability severity significantly decreased QoL scores in all domains ( p  < 0.001). Marital status negatively impacted physical health (β = -3.14, p  = 0.04). Wealth index showed positive associations with environmental QoL (β = 1.06, p  = 0.01) and a borderline effect on total QoL ( p  = 0.07). Age negatively influenced environmental QoL (β = -0.14, p  = 0.02). Other demographic variables showed no significant effects. Conclusion The study highlights that higher education and lower disability severity are key determinants of better QoL among Iranian adults with physical disabilities. Socioeconomic factors, particularly wealth and education, alongside disability level, significantly influence QoL outcomes. These findings underscore the importance of tailored policies and interventions focusing on education, rehabilitation, and socioeconomic support to enhance the well-being and social participation of PWD in Iran.

Current evidence suggests that non-traditional serum lipid ratios are more effective than traditional serum lipid parameters in predicting vascular diseases, and both of them are associated with dietary patterns. Therefore, this study aimed to investigate the relationship between the dietary inflammatory index (DII) and atherogenic indices using traditional serum lipid parameters (triglyceride (TG), total cholesterol (TC), LDL cholesterol (LDL–c), high-density lipoprotein cholesterol (HDL–c)) and non-traditional serum lipid ratios (atherogenic index of plasma (AIP), Castelli's index-I (CRI_I), Castelli's index-II (CRI_II), the lipoprotein combination index (LCI), and the atherogenic coefficient (AC)). Basic information from the Ravansar Non-Communicable Diseases cohort study was utilized in the present cross-sectional observational study. The study included 8870 adults aged 35–65 years. A validated food frequency questionnaire (FFQ) was used to measure DII. We compared the distributions of outcomes by DII score groups using multivariable linear regression. The difference between DII score groups was evaluated by the Bonferroni test. The mean ± SD DII was − 2.5 ± 1.43, and the prevalence of dyslipidemia was 44%. After adjusting for age, sex, smoking status, alcohol consumption status, physical activity, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), body mass index (BMI) and socioeconomic status (SES), participants in the highest quartile of DII had a greater risk for CRI_I (β = 0.11, CI 0.05, 0.18), CRI_II (β = 0.06, CI 0.01, 0.11), LCI (β = 0.11, CI 288.12, 8373.11), AC (β = 0.11, CI 0.05, 0.17) and AIP (β = 0.06, CI 0.02, 0.10). Moreover, according to the adjusted logistic regression model, the risk of dyslipidemia significantly increased by 24% (OR: 1.24, 95% CI 1.08–1.41), 7% (OR: 1.07, 95% CI 0.94, 1.21) and 3% (OR: 1.03, 95% CI 0.91, 1.16) in Q4, Q3 and Q2 of the DII, respectively. Finally, diet-related inflammation, as estimated by the DII, is associated with a higher risk of CRI-I, CRI-II, LCI, AC, and AIP and increased odds of dyslipidemia.

Background Persons with disabilities (PWD) generally experience various barriers in using health care compared to the general population, and these problems are more worsened for those with disabilities in lower socioeconomic status. The study aimed to estimate socioeconomic inequality in using rehabilitation services (URS) in adults with disabilities in Iran. Methods This cross-sectional study was conducted at a national level in Iran. 786 PWD (aged 18 years and older) participated in the study between September and December 2020. Socioeconomic-related inequality in URS was estimated by the Concentration Index (C). The C was decomposed to identify factors explaining the variability within the socioeconomic inequality in URS. Results In the present study 8.10% ( N  = 61) of the study population used rehabilitation services during the past three months. In this study, the value of the C was estimated 0.25 ( p -value = 0.025) that shows URS was unequally distributed, and concentrated among the higher SES groups. The results of decomposition analysis indicated that the wealth index was the largest contributor (94.22%) to the observed socioeconomic inequalities in URS among PWD. Following the wealth index, Age and marital status were the major contributors to the unequal distribution of URS among the study population. Conclusions Our findings revealed that socioeconomic inequality in using rehabilitation services was concentrated among well-off PWD. Accordingly, rehabilitation financing through appropriate mechanisms for individuals with low SES is suggested.

Background Ensuring equitable access to healthcare services for individuals with disabilities poses a significant challenge for healthcare systems. This research aimed to explore the factors affecting medical visits among this population. Method This cross-sectional study in Iran involved data from 766 adults with disabilities aged 18 and older. Unadjusted and adjusted logistic regression analyses were used to calculate the odds ratios for medical visits. Results The majority of participants were male (64.36%) and single (54.02%). In the adjusted model, participants with severe disabilities (OR: 1.901, p  = 0.025) were more likely to utilize medical visits compared to those with less severe disabilities. Conversely, individuals in the second (OR: 0.420, p  = 0.017), fourth (OR: 0.360, p  = 0.004), and fifth (OR: 0.319, p  = 0.001) wealth quintiles demonstrated a significantly lower likelihood of accessing medical visits in comparison to the reference group. Conclusions This study reveals critical disparities in healthcare access for individuals with disabilities in Iran. While individuals with severe disabilities demonstrate a higher likelihood of utilizing medical services, those in lower wealth quintiles face significant barriers to accessing care. These findings emphasize the urgent need for targeted interventions to enhance healthcare equity, ensuring that financial constraints do not hinder medical visits for this vulnerable population.

Background One of the key functions and ultimate goals of health systems is to provide financial protection for individuals when using health services. This study sought to evaluate the level of financial protection and its inequality among individuals covered by the Social Security Organization (SSO) health insurance between September and December 2023 in Iran. Methods We collected data on 1691 households in five provinces using multistage sampling to examine the prevalence of catastrophic healthcare expenditure (CHE) at four different thresholds (10%, 20%, 30%, and 40%) of the household’s capacity to pay (CTP). Additionally, we explored the prevalence of impoverishment due to health costs and assessed socioeconomic-related inequality in OOP payments for healthcare using the concentration index and concentration curve. To measure equity in out-of-pocket (OOP) payments for healthcare, we utilized the Kakwani progressivity index (KPI). Furthermore, we employed multiple logistic regression to identify the main factors contributing to households experiencing CHE. Findings : The study revealed that households in our sample allocated approximately 11% of their budgets to healthcare services. The prevalence of CHE at the thresholds of 10%, 20%, 30%, and 40% was found to be 47.1%, 30.1%, 20.1%, and 15.7%, respectively. Additionally, we observed that about 7.9% of the households experienced impoverishment due to health costs. Multiple logistic regression analysis indicated that the age of the head of the household, place of residence, socioeconomic status, utilization of dental services, utilization of medicine, and province of residence were the main factors influencing CHE. Furthermore, the study demonstrated that while wealthy households spend more money on healthcare, poorer households spend a larger proportion of their total income to healthcare costs. The KPI showed that households with lower total expenditures had higher OOP payments relative to their CTP. Conclusion The study findings underscore the need for targeted interventions to improve financial protection in healthcare and mitigate inequalities among individuals covered by SSO. It is recommended that these interventions prioritize the expansion of coverage for dental services and medication expenses, particularly for lower socioeconomic status household.