Interrelationship between underprivileged neighborhoods and health promotion lifestyles: insights from Kermanshah, Iran



Iran is facing the consequences of the hubristic period and the level of mortalities is affected by lifestyles. Residents of underprivileged neighborhoods of the Iranian Kermanshah Metropolis encounter numerous socioeconomic, physical, and cultural challenges. Hence, this study aims to investigate the ecocultural and physical conditions of underprivileged neighborhoods and their effects on the residents’ health promotion lifestyles in the neighborhoods in Kermanshah Metropolis, Western Iran.

Subjects and methods

In this cross-sectional study, the statistical population included the underprivileged neighborhoods of the Kermanshah Metropolis. The ecocultural and physical conditions of these neighborhoods were assessed using the population and housing census data, and lifestyle was measured using the Health Promoting Lifestyle Profile II (HPLP II). As for data analysis, the descriptive statistics analysis of variance (ANOVA) and the Pearson correlation coefficient were employed in SPSS v.21.


The results of the present study revealed that the total mean score of lifestyles in underprivileged neighborhoods was low (111.67 ± 23.59). It was shown that females had a better quality of life than males, and the highest and lowest mean scores belonged to interpersonal relations and physical activity, respectively. Comparison of the findings also indicated that the underprivileged neighborhoods were significantly different in terms of health promotion lifestyles. As for the economic, physical, and cultural indexes, it was demonstrated that only cultural indices were significantly correlated with health promotion lifestyles, with a correlation coefficient of 0.716. The negative correlation coefficient of the young population was indicative of the inverse relationship between the growth of the young population and health promotion lifestyles. A negative relationship was also observed between nutrition and the young population. It was also shown that interpersonal relations negatively and positively correlated with the young population and migration rate, respectively.


The findings of this study revealed the urgent need for attention and emphasis to be given to the planning of activities to improve residents’ conditions of health promotion lifestyle in underprivileged neighborhoods by the urban managers and policymakers in the health and associated fields.

This is a preview of subscription content, log in to check access.

Fig. 1


  1. Baum S, Kendall E, Muenchberger H, Gudes O, Yigitcanlar T (2010) Geographical information systems: an effective planning and decision-making platform for community health coalitions in Australia. Health Inf Manag 39(3):28–33

    PubMed  Google Scholar 

  2. Chalabi M, Amirkaphi M (2004) Multiple-level analysis of social isolation. J Sociol Iran 5(2):3–31

    Google Scholar 

  3. Cockerham WC, Abel T, Lüschen G (1993) Max Weber, formal rationality, and health lifestyles. Sociol Q 34(3):413–425.

    Article  Google Scholar 

  4. Cockerham WC, Snead MC, DeWaal DF (2002) Health lifestyles in Russia and the socialist heritage. J Health Soc Behav 43(1):42–55

    Article  Google Scholar 

  5. Dearden JS, Sheahan SL (2002) Counseling middle-aged women about physical activity using the stages of change. J Am Acad Nurse Pract 14(11):492–497.

    Article  PubMed  Google Scholar 

  6. Ezeh A, Oyebode O, Satterthwaite D, Chen YF, Ndugwa R, Sartori J, Mberu B, Melendez-Torres GJ, Haregu T, Watson SI (2017) The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet 389(10068):547–558.

    Article  PubMed  Google Scholar 

  7. Ferrini K, Ghelfi F, Mannucci R, Titta L (2015) Lifestyle, nutrition and breast cancer: facts and presumptions for consideration. Ecancermedicalscience 9:557–568.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ghasemi V, Rabbani Khorasgani R, Rabbani Khorasgani A, Alizadeh Aghdam M (2008) Structural and capital determinants of health-based lifestyle. Q Soc Res Iran 16(63):181–213.

    Article  Google Scholar 

  9. Goonetilleke A, Yigitcanlar T, Ayoko GA, Egodawatta P (2014) Sustainable urban water environment: climate, pollution and adaptation. Edward Elgar Publishing, Cheltenham

    Google Scholar 

  10. Hsiao CY, Chien MJ, Wu HS, Chiao CY (2017) Correlates of health-promoting lifestyle behaviors among Vietnamese female immigrants in Taiwan. Women Health 57(3):342–357.

    Article  PubMed  Google Scholar 

  11. Irandoost K, Sarrafi M (2007) Despair and hope in informal settlements, case study: the city of Kermanshah. J Soc Welf 26(7):201–221

    Google Scholar 

  12. Jahanbakhsh E, Hashemi M (2014) Study health-based life style aspects in Shushtar residents. Nurs Dev Health 5(8/9):83–89

    Google Scholar 

  13. Jones P (2016) Informal urbanism as a product of socio-cultural expression: insights from the Island Pacific. In: Attia S, Shabka S, Shafik Z, Ibrahim A (eds) Dynamics and resilience of informal areas. Springer, Cham, pp 165–181.

    Google Scholar 

  14. Kavlak O, Atan SU, Sirin A, Sen E, Guneri SE, Dag HY (2013) Pregnant Turkish women with low income: their anxiety, health-promoting lifestyles, and related factors. Int J Nurs Pract 19(5):507–515.

    Article  PubMed  Google Scholar 

  15. Kelly DL, Lyon DE, Garvan C, Wingard JR (2016) Associations among health-promoting lifestyle behaviors, perceived stress, and inflammatory responses of individuals with chronic graft-versus-host disease (cGVHD) following allogeneic blood and marrow transplantation. Biol Blood Marrow Transpl 22(3):S470–S471.

    Article  Google Scholar 

  16. Khademi N, Reshadat S, Zanganeh A, Saeidi S, Ghasemi S, Zakiei A (2016) Identifying HIV distribution pattern based on clustering test using GIS software, Kermanshah, Iran. HIV AIDS Rev 15(4):147–152.

    Article  Google Scholar 

  17. Khademi N, Reshadat S, Zangeneh A, Saeidi S, Ghasemi SR, Rajabi-Gilan N, Zakiei A (2017) A comparative study of the spatial distribution of HIV prevalence in the metropolis of Kermanshah, Iran, in 1996−2014 using geographical information systems. HIV Med 18(3):220–224.

    CAS  Article  PubMed  Google Scholar 

  18. Mahmoud SA, Hanaa AA, Ismail SS (2011) Health promotion program to improve the lifestyle of school children living in slum areas in Helwan governorate. Life Sci J Acta Zhengzhou Univ Overseas Ed 8(4):618–627

    Google Scholar 

  19. Nugent R, Bertram MY, Jan S, Niessen LW, Sassi F, Jamison DT, Pier EG, Beaglehole R (2018) Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals. Lancet 391(10134):2029–2035.

    Article  PubMed  Google Scholar 

  20. Pang PCP, Wu CST (2019) The journey of service-learning: promoting health and quality of life for slum residents in Cambodia. In: Shek DTL, Ngai G, Chan SCF (eds) Service-learning for youth leadership. Springer, Singapore, pp 211–225.

    Google Scholar 

  21. Parsamehr M, Rasoulinezhad SP (2015) The study of the relationship between lifestyle and social health among people of Talesh City. Sci J Manage Syst 10(1):35–66.

    Article  Google Scholar 

  22. Puddu PE, Menotti A (2018) Lifestyle factors and the impact on lifetime incidence and mortality of coronary heart disease. In: Watson RR, Zibadi S (eds) Lifestyle in heart health and disease. Elsevier, London, pp 47–61.

    Google Scholar 

  23. Reshadat S, Saeidi S, Zangeneh AR, Khademi N, Khasi K, Ghasemi SR, Gilan NR (2015) Spatiotemporal distribution of gastrointestinal tract cancer through GIS over 2007–2012 in Kermanshah-Iran. Asian Pac J Cancer Prev 16(17):7737–7742.

    Article  PubMed  Google Scholar 

  24. Reshadat S, Zangeneh A, Saeidi S, Khademi N, Izadi N, Ghasemi SR, Rajabi-Gilan N (2016) The spatial clustering analysis of HIV and poverty through GIS in the metropolis of Kermansha, western Iran. Acta Med Mediterr 32(5):1995–1999

    Google Scholar 

  25. Reshadat S, Zangeneh A, Saeidi S, Izadi N, Ghasemi SR, Rajabi-Gilan N (2018a) A feasibility study of implementing the policies on increasing birth rate with an emphasis on socio-economic status: a case study of Kermanshah Metropolis, western Iran. Soc Ind Res 140(2):619–636.

  26. Reshadat S, Zangeneh A, Saeidi S, Teimouri R, Yigitcanlar T (2018b) Measures of spatial accessibility to health centers: investigating urban and rural disparities in Kermanshah, Iran. J Public Health 1–11.

  27. Roustaei S, Ahadnezhad M, Asghari Zamani A, Zangeneh AR, Saeidi S (2015) Evaluation of urban poverty in informal settlements across Kermanshah, Iran through factor analysis (a case study of Dolat Abad & Shater Abad settlements in 2006). J Geogr Plan 19(53):137–166

    Google Scholar 

  28. Simler KR, Harrower S, Massingarela C (2004) Estimating poverty indices from simple indicator surveys. In: Proceedings of the conference on growth, poverty reduction and human development in Africa, Centre for the Study of African Economies, University of Oxford. Citeseer, 24 pp

  29. Stock C, Wille L, Krämer A (2001) Gender-specific health behaviors of German university students predict the interest in campus health promotion. Health Promot Int 16(2):145–154.

    CAS  Article  PubMed  Google Scholar 

  30. Ulla Díez SM, Pérez-Fortis A (2010) Socio-demographic predictors of health behaviors in Mexican college students. Health Promot Int 25(1):85–93.

    Article  PubMed  Google Scholar 

  31. Vaeztavakoli A, Lak A, Yigitcanlar T (2018) Blue and green spaces as therapeutic landscapes: health effects of urban water canal areas of Isfahan. Sustainability 10(11):4010.

    Article  Google Scholar 

  32. Varì R, Scazzocchio B, D’Amore A, Giovannini C, Gessani S, Masella R (2016) Gender-related differences in lifestyle may affect health status. Ann Ist Super Sanita 52(2):158–166

    PubMed  Google Scholar 

  33. Von Bothmer MIK, Fridlund B (2005) Gender differences in health habits and in motivation for a healthy lifestyle among Swedish university students. Nurs Health Sci 7(2):107–118.

    Article  Google Scholar 

  34. Walker D (1997) Psychometric evaluation of Health-Promoting Lifestyle Profile II. Unpublished manuscript. College of Nursing, University of Nebraska Medical Center, Lincoln

  35. World Health Organization (WHO) (1998) Health promotion glossary. Available online at:

  36. World Health Organization (WHO) (2013) A global brief on hypertension: silent killer, global public health crisis. Available online at:

  37. Yigitcanlar T, Kamruzzaman M (2014) Investigating the interplay between transport, land use and the environment: a review of the literature. Int J Environ Sci Technol 11(8):2121–2132.

    Article  Google Scholar 

  38. Yigitcanlar T, Kamruzzaman M, Teriman S (2015) Neighborhood sustainability assessment: evaluating residential development sustainability in a developing country context. Sustainability 7(3):2570–2602.

    Article  Google Scholar 

  39. Yigitcanlar T, Sabatini-Marques J, Lorenzi C, Bernardinetti N, Schreiner T, Fachinelli A, Wittmann T (2018) Towards smart Florianópolis: what does it take to transform a tourist island into an innovation capital? Energies 11(12):3265.

    Article  Google Scholar 

  40. Zhao Y, Hu Y, Smith JP, Strauss J, Yang G (2014) Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol 43(1):61–68.

    Article  PubMed  Google Scholar 

Download references


This study was supported by the Kermanshah University of Medical Sciences under grant number 93461. The authors acknowledge the financial and emotional support provided by the Deputy Head of the Research and Technology Department of the Kermanshah University of Medical Sciences.

Author information




SR and AZ apprehended the research idea. AZ, RT, and SS designed the study and analyzed the data. SR, MT, MG, AZ, SS, RT, and TY interpreted the results and drafted the manuscript. SS and AZ participated in re-revision of the manuscript. All the authors took responsibility for the integrity of the work as a whole, from inception to published article. SR is the guarantor. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Alireza Zangeneh.

Ethics declarations

This study was approved by the institutional ethics committee of the Kermanshah University of Medical Sciences with ID 93461. Research involving human participants.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.


(DOC 39 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Reshadat, S., Tohidi, M., Ghasemi, M. et al. Interrelationship between underprivileged neighborhoods and health promotion lifestyles: insights from Kermanshah, Iran. J Public Health (Berl.) 28, 693–702 (2020).

Download citation


  • Health promotion lifestyle
  • Public health
  • Health policy
  • Underprivileged neighborhoods
  • Kermanshah
  • Iran