Document Type : Original Articles

Authors

1 Research Center for Health Sciences, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran;

2 Expert of Health Affairs, Shiraz University of Medical Sciences, Shiraz, Iran;

3 Expert of Vital Horoscope, Shiraz University of Medical Sciences, Shiraz Iran;

4 Vice-Chancellor of Health Affairs, Shiraz University of Medical Sciences, Shiraz, Iran;

5 HIV/AIDS Research Center, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: The dependency ratio (DR) is defined as the ratio of the non-working population to the economically active population. Dependency ratio is calculated by the sum of population under fifteen years and over 65 years divided by 15-64 year old population. The interpretation of DR variation gives us the impact of health care services and some reproductive interventions. This study analyzed a 23-year DR trend in rural population of Fars province and the effect of some fertility variables on it. Methods: In this study, using data from vital horoscope and regression analysis, we analyzed a 23-year period of DR and some fertility indicators. Results: The total DR significantly declined from 102.5% in 1990 to 41.4% in 2012 (P<0.001). Most of this reduction is attributed to reduction in young DR. Old dependency ratio (population of 65 years and more) was significantly growing (P<0.035). Number of rural health house, family planning coverage, total fertility rate and general fertility rate was significantly associated with total dependency ratio (P<0.009). Conclusion: We passed the first stage of demographic transition, i.e. young dependency ratio declining. But the old dependency ratio slowly increased; it is recommended that the health care services should be promoted in future, especially services for old age people.

Keywords

  1. World Health Organization. Primary health care.
  2. Available at URL: [http://www.who.int/topics/primary_
  3. health_care/en/] Cited Aug 10 2011.
  4. Coggon D, Rose G, Barker DP. Epidemiology for the
  5. Uninitiated. 5th ed. London: British Medical Journal
  6. Publications, 2003.
  7. Gerstman BB. Stratification and adjustment in
  8. epidemiology kept simple: An introduction to modern
  9. epidemiology. A John Willy & Sons, Inc. Publication.
  10. New York 1998; 108-120.
  11. Kogel T. Youth dependency and total factor productivity.
  12. Journal of Development Economics 2005; 76: 147- 73.
  13. Khosravi A, Najafi F, Rahbar MR, Motlagh ME, Kabir
  14. MJ. Health indicators in Islamic Republic of Iran, 2009,
  15. (Persian). Available at URL: [http://siasat.behdasht.
  16. gov.ir/uploads/291_1350_simayei-salamat.pdf?siteid
  17. =291&siteid=291&pageid=31805] Cited Aug 11 2011.
  18. Gapminder, World 2009. Wealth & Health of Nations.
  19. Available at UR: [http://www.gapminder.org/data]
  20. Cited Aug 17 2011.
  21. Kojima H. Aging in Japan: Population Policy
  22. Implications. Korea J Popul Dev 1995; 24(2): 197-214.
  23. United Nations. World population to 2300. ST/
  24. ESA/SER.A/236. Available at URL [http://www.
  25. un.org/esa/population/publications/longrange2/
  26. WorldPop2300final.pdf] Cited Aug 17 2011.
  27. UN 2001, World Population Prospects. The 2000
  28. Revision volume 1.
  29. USAID. Family Planning Improves Quality of Life
  30. and Opportunities for Women, issue brief. July 2009.
  31. Raleigh VS. World population and health in transition.
  32. BMJ 1999; 319: 981-4.
  33. Do Health and Longevity Create Wealth? ILC Working
  34. Paper (New York: ILCUSA, 2004).
  35. Lacomba JA, Lagos F. Population aging and legal
  36. retirement age. J Popul Econ 2006; 19: 507-19.
  37. United Nations. 1996. World Population Prospects:
  38. The 1996 revision. Annex I: Demographic indicators.
  39. United Nations Department for Economic and Social
  40. information and Policy Analysis, Population Division,
  41. New York.
  42. Gapminder, World 2009. Wealth & Health of Nations,
  43. Available at URL:[http://www.gapminder.org/data]
  44. Cited Aug 12 2011.
  45. Gauthier A, Hatzius J. Family Benefits and Fertility:
  46. An Economic Analysis. Population Studies 1997; 51:
  47. -306.
  48. Becker G, Barro R. A Reformulation of the Economic
  49. Theory of Fertility. The Quarterly Journal of Economics 1988; 103(1): 1-25.
  50. Peaٌ R, Wall S, Persson L. The effect of poverty, social
  51. inequality, and maternal education on infant mortality
  52. in Nicaragua, 1988-1993. Am J Public Health 2000;
  53. : 64-9.
  54. Khosravi K, Motlagh ME, Emami Razavi SH. The Iranian Vital Horoscope; Appropriate Tool to Collect
  55. Health Statistics in Rural Areas. Iranian J Publ Health
  56. ; 38: 74-80.
  57. Schwartz S. The fallacy of the ecological fallacy: the
  58. potential misuse of a concept and its consequences.
  59. Am J Public Health 1994; 84: 819-24.