تحلیل تأثیر اجرای طرح هدفمندی یارانه‌ها بر شاخص‌های سلامت شهری (سلامت تغذیه و امنیت غذایی) در منطقه‌های چهارگانة کلان‌شهر قم

نوع مقاله : مقاله علمی پژوهشی

نویسندگان

1 استاد جغرافیا و برنامه‌ریزی شهری، دانشگاه تهران

2 دانشجوی دکتری جغرافیا و برنامه‌ریزی شهری، دانشگاه تهران

3 دانشجوی دکتری دانشگاه اصفهان، مدرس مدعو گروه جغرافیا و برنامه‌ریزی شهری، دانشگاه پیام نور تهران

چکیده

توسعة جامعه در گرو بهره­مندی از آرمان سلامت و شاخص­های مختلف آن است که به­طور مستقیم و غیرمستقیم، از سیاست­های کلان و ملی تأثیر می­پذیرد. براین‌اساس، در بعضی از کشورها از جمله ایران، به یارانه و هدفمندی آن با توجه به وضعیت داخلی اقتصادی- اجتماعی توجه شده است که با موضوع مذکور ارتباطی تنگاتنگ دارد. پژوهش حاضر نیز با ذکر این مقدمه و با علم به عوامل (فاکتورهای) مختلف تأثیرگذار بر سلامت زیست‌ شهری، به مطالعة تأثیر طرح هدفمندی یارانه­ها بر وضعیت اقتصادی و اجتماعی شهروندان، سلامت تغذیه و امنیت غذایی می‌پردازد که یکی از شاخص­های اصلی سلامت ­شهری در منطقه‌های چهارگانة کلان‌شهر قم است. این پژوهش با هدف بررسی عینی و دستیابی به مصداقی واقعی در زمینة تأثیر طرح هدفمندی یارانه­ها بر سلامت شهری صورت گرفت. همچنین، در این پژوهش، تجزیه ‌و تحلیل توصیفی، مقایسه­ای و علی انجام می­شود و جمع­آوری اطلاعات آن بر مطالعه­های کتابخانه­ای و پژوهش میدانی استوار است. نتایج نشان می­دهد که بسیاری از شهروندان، نگرش مثبتی به اهداف عدالت‌خواهانة طرح دارند، اما بسیاری از شهروندان پس از گذشت چند سال از نتیجة اجرای این طرح، از بسیاری از ابعاد اقتصادی به‌ویژه دسترسی آسان به تغذیة مناسب و امنیت غذایی- که ضامن شادابی و سلامت آن‌هاست- رضایت ندارند و در اظهاراتی، اجرای نامناسب و تورم­زای طرح هدفمندی یارانه­ها را عامل اصلی تضعیف روزافزون امنیت غذایی و کیفیت نامناسب تغذیه­ای خود اعلام می­کنند.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Analysis of Iran Subsidy Plan and Its Influence on Health Nutrition and Food Security as One of the Urban Health Indices in the Tetraploid Regions of Qom Megalopolis

نویسندگان [English]

  • Ahmad Pourahmad 1
  • Ali Mahdi 2
  • Masoumeh Mahdian Bahnamiri 3
1 Full Professor of geography and urban planning, Faculty of Geography, University of Tehran, Tehran, Iran
2 PhD candidate in geography and urban planning, Faculty of Geography, University of Tehran, Tehran, Iran
3 PhD candidate in geography and urban planning, University of Esfahan, Invited teacher in Department of geography and urban planning, Payame Noor University, Tehran, Iran
چکیده [English]

Extended abstract
Introduction
Recent changes and challenges in the field of urban health are considered greatly in world. Wide changes have been made in public health during the last century. One of the most important examples of public health such as nutrition is people's attention to the role and function of government policies. The past rulers of different countries had done actions according to their micro and macro targets.  One of the most important examples, especially in the developing countries that suffered from economic failure, is policy issue and the subsidy. Subsidy is the wish of all those who care about the health and welfare of the community, especially the vulnerable people. The law as a progressive design with a supreme goal can change the economic conditions, if it is implemented accurately and efficiently. In countries such as Iran where high levels of subsidy consumption and services are relying on oil income, to improve public welfare and gain political legitimacy and acceptability will be dependent on political issue and followed certain geographic and distribution system. This research has examined the effects of health indicators and explained nutrition and food security. The research necessity is due to attention and also researchers’ advice to priority of ideal health policies in urban investment. Ecology studies of comparative pathology address  association among mental - social and physical illness and types of pollution, population density, housing units, economic status, poverty, unemployment, illiteracy, non-standard housing units and unhealthy living conditions. Certainly, all of these cases have direct, indirect and undeniable relationship with government policies such as subsidies. Hence, in geography–health as a major branche of geography in study of public health; it is obvious that if a community is unaware of the matter, a vacuum is created in the public health. Therefore, it will be suitable to have extensive studies, planning, and investment by focusing on what affecting citizen’s health such as nutrition.
Methodology
The research has been done in Qom city during winter 2012. This is an analytical-descriptive research and data collection was based on field and library studies. We distributed 380 questionnaires among people (head of household) in each district based on Cochrane sampling. The questionnaires were designed and distributed among the population in three general characteristics (ethnicity, education, occupation, income and economic situation, the number of children and etc.) to satisfy the positive or negative impacts on the subsidies plan and its feedback on urban health (healthy nutrition and food security like meat, fruit vegetables and dairy products). Interview is one of the most important tools for analyzing public opinion regarding the implementation of subsidy and its effects on community health. With awareness of the issue of subsidy in the past years and its social and economic status, the researchers deal with the issue in Qom. The main objective of the research is study of impacts of the influence of social –economic processes on individuals and urban health.
Results and discussion
The research findings about the effects of subsidy on nutrition and food security as health indicators indicate meditative and disturbing results in 4 areas of Qom. Thus, the questionnaires and interviews which had been done by a 16 number group show that food availability and security in districts 2 and 3are not appropriate. In most cases, especially in districts 2 and 3, populations are immigrants. These conditions are completely affected by factors like education and the income of the head of household. This will eventually lead to poor quality in life such as a healthy nutrition and food security. These cases are in much better situation in districts 1 and 4. Besides the factors such as income, education and occupation of the head of households may affect quality of life for family members. Main goal of this research is evaluation of the impacts of subsidy on urban health and access of Qom citizens to healthy nutrition and food security. Many of the citizens are fully agreed with the reasons of subsidy. is the reasons are including a support for low income people and increase in their purchasing power, their enjoyment of national interests, reform in manufacturing structure and economic and ultimately establishment of social justice for the poor. More than 70 percent of citizens believe that after subsidy implementation their occupation condition is decreased and it had disproportionate impact on their lives. It is more being felt in district 2 of Qom where the heads of households are mainly workers. About 70 percent of populations believe that their income decrease due to the high inflation in these years and in many cases they fail to reserve money and spend their living. Therefore, more than 70 percent of populations are disagreed with continuation of subsidy and they believe that their life became more difficult after subsidy implication. Study about the consumption of meat, milk, fruits and vegetables among the 4 regions are the main steps of research. It shows that except district 4 all other areas are in an inappropriate situation.
Conclusion
One of the programs that have overshadowed people life for years is subsidy which its purpose is creation and establishment of the social justice for all classes. Analysis of the results show that a large number of populations are not satisfied with subsidy goal and its implications. In general, from 4 regions of Qom, districts 1 and 2 are in better life quality and more satisfied. In spite of all ideal sand insights that a lot of researchers, economists, politicians, and ordinary people are agreed; the studied issue has influenced people lives. Finally, besides its positive aspects, the most important principles in creation of a vibrant and healthy life are faced with many problems. One of the objective examples in research results is the rising trend of abortion, dead or defective new born or the problems of fertility may threaten population health in the future. With many problems such as inflation, unemployment and the sanctions; problems such as healthy nutrition and food security should not be ignored simply.

کلیدواژه‌ها [English]

  • Food security
  • health indexes
  • nutrition security
  • Qom megalopolis
  • subsidy plan
  • urban health
امینی، نجات، یداللهی، حسین و صدیقه اینانلو، 1385، رتبه­بندی سلامت استان‌های کشور، فصلنامة علمی- پژوهشی رفاه اجتماعی، سال پنجم، شمارة 20، صص 27- 48.
اعظم­زاده شورکی، مهدی و صادق خلیلیان، 1389، بررسی اثر سیاست­های پولی بر قیمت غذا در ایران، نشریة اقتصاد و توسعة کشاورزی (علوم و صنایع کشاورزی)، جلد 24، شمارة 2، صص 177-184.
امیراحمدی، بهرام، 1371، بررسی مصرف گوشت در ایران (گذشته، حال، آینده)، انتشارات مرکز تحقیقات کامپیوتری علوم اسلامی، شماره31، تهران.
 
بختیاری، صادق، نصراللهی، خدیجه و مصطفی عمادزاده، 1381، سیاست‌های تعدیل اجراشده در برنامة اول عمرانی و امنیت غذایی در استان اصفهان، پژوهشنامة بازرگانی،، شمارة 19، ص 99- 134.
 
بختیاری، صادق و زهرا حقی، 1382، بررسی امنیت غذایی و توسعة انسانی در کشورهای اسلامی، اقتصاد کشاورزی و توسعه، سال یازدهم، شمارة 44 و 43، صص 22- 52.
 
پیری، علی­حسن، 1378، بررسی مهاجرت‌های روستایی و تأثیرات آن بر چشم‌اندازهای شهری در بخش مرکزی شهرستان کامیاران، پایان‌نامة کارشناسی ارشد، دانشکدة جغرافیا، دانشگاه تهران، تهران.
 
پرمه، زورار، 1384، بررسی وضع تولید و مصرف شیر در ایران و سایر کشورها و هدفمندنمودن یارانة­ آن، مجلة بررسی‌های بازرگانی، شمارة سیزدهم، صص 25- 36.
 
حاتمی­نژاد، حسین، مهدی، علی و معصومه مهدیان بهنمیری، 1392، بررسی سلامت ­زیست ساکنین محلات حاشیه­نشین از ابعاد امنیت غذایی و سلامت تغذیه (مورد پژوهش: محلة شادقلی­خان شهر قم)، نگرش­های نو در جغرافیای انسانی، سال پنجم، شمارة 2، صص 53- 72.
 
خسروی‌نژاد، علی‌اکبر، 1388، اندازه‌گیری اثرات رفاهی حذف یارانة کالاهای اساسی بر خانوارهای شهری ایران، فصلنامة پژوهش‌های بازرگانی، شمارة 50، ص 1- 33.
 
دفتر آمار و اطلاعات معاونت برنامه‌ریزی و امور مجلس جهاد سازندگی در آیینة آمار، 1383 .
 
دفتر GIS شهرداری قم، 1391.
 
رحیمی، عباس و عباس کلانتری، 1371، تحلیل و بررسی اقتصاد سوبسید، انتشارات مؤسسة مطالعات و پژوهش­های بازرگانی، تهران.
 
سازمان مسکن و شهرسازی استان قم، 1389، مطالعة شاخص­های مسکن، جمعیت،‌ مهاجرت و حاشیه­نشینی در شهرستان قم.
 
سام­آرام، عزت­الله و مریم امینی یخدانی، 1388، بررسی وضعیت سلامت زنان سرپرست خانوار تحت پوشش سازمان بهزیستی قم، فصلنامة علمی- ترویجی بانوان شیعه، سال ششم، شمارة 21، صص 160- 134.
 
سلطان­زاده، محمدحسین، 1387، تغذیة سالم، ماهنامة آموزش، اطلاع‌رسانی کودک، شمارة 45، ص24-19.
شکوئی، حسین، 1382، فلسفه‌های محیطی و مکتب‌های جغرافیایی، چاپ اول، جلد دوم، انتشارات گیتاشناسی، تهران.
 
 ضیایی، محمود، 1379، نقش و جایگاه دولت در توسعة شهر و شهرنشینی در ایران، رسالة دکتری، دانشکدة جغرافیا، دانشگاه تهران، تهران.
 
عزیزی، جعفر، 1386، تحلیل تابع عرضة انواع گوشت در ایران با ستفاده از مدل بازار چندگانه، انتشارات پژوهش و سازندگی، امور دام و آبزیان، تهران.
 
فرید، یداله، 1381، جغرافیای تغذیه، انتشارات دانشگاه تبریز، تبریز.
 
کرم‌سلطانی، زهرا و دیگران، 1386، چاقی و امنیت غذایی در کودکان دبستانی شهر یزد، مجلة دانشکدة پزشکی دانشگاه تهران، دورة 65، شمارة 7، صص 68- 76.
 
کریمی، سعید، راسخی، سعید و مجتبی احسانی، 1387، بررسی مواد غذایی مشمول یارانه در مناطق شهری ایران با استفاده از مدل AIDS، به‌منظور اولویت‌بندی تحصیص یارانه، فصلنامة پژوهش‌های اقتصادی ایران، سال سیزدهم، شمارة 39، صص 147- 166.
 
گزارش روزنامة جهان صنعت با استناد به گزارش جداول قیمتی بانک مرکزی، 1389.
 
محمدپورکلده، محمود، فولادوند، مرادعلی و مهران آوخ کیسمی، 1389، عدم امنیت غذایی به‌عنوان عامل خطر جهت چاقی در خانم‌های کم‌درآمد بوشهری، فصلنامة طب جنوب، سال سیزدهم، شمارة 4، صص 263- 272.
 
محلاتی، صلاح­الدین، 1380، ارتباط تنگاتنگ و خطرناک فرهنگ، اقتصاد، سیاست و نظام غذایی، مجلة دانشکدة ادبیات و علوم انسانی دانشگاه تهران، شمارة 185 و 159، ص 615- 630.
 
مهدی، علی، 139۰، بررسی و تحلیل سلامت زیست و دسترسی به شاخص‌های سلامت در مناطق حاشیه‌نشین (مورد مطالعاتی: محلة شادقلی‌خان قم)، پایان‌نامة کارشناسی ارشد، دانشکدة جغرافیا، دانشگاه تهران، تهران.
 
یوسفی، مهدی و دیگران، 1389، روش‌های تخصیص مبتنی بر نیاز منابع نظام سلامت و ارزیابی وضع موجود تخصیص به استان­های ایران، مجلة پژوهشی حکیم، دورة سیزدهم، شمارة 2، صص 10- 20.
 
هیل، مایکل، 1387، محیط‌زیست و سیاست اجتماعی، ترجمة حسین حاتمی­نژاد و سهراب امیریان، چاپ اول، انتشارات دانشگاه تهران، تهران.
 
 
According to the newspaper report, The Industry Price Charts Central Bank, 1389. (In Persian)
 
Amini, N., Yadollahi, H. and Inanloo, S., 2006, Ranking of HealthProvinces of the Country, Social Welfare, Vol. 5, No. 20, PP. 27-48. (In Persian)
 
Amirahmade, B., 1992, The Survey of MeatConsume in Iran(Past, Present, Future), Computer Research Center of Islamic Sciences Publication, Tehran. (In Persian)
 
Asthana, Sh., 1995, Variation in Poverty and Health Between Slum Settlement: Contadictiory Findings From Visakhapantnam, India, Social Science & Mediciene, Vol. 40, No. 2, PP. 177-188.
 
Azamzadeh Shoorke, M. and Khalieyan, S., 2010, The Effect of Monetary Policy on Food Prices in Iran, Economics and Agricultural Development (Agricultural Sciences and Technology), Vol. 24, No. 2, PP. 148-177. (In Persian)
 
Azizi, J., 2007, Analysis of the Supply of Meat in the Use of Multi-Market Models, Publications, Research and Development, Animal and Fisheries, Tehran. (In Persian)
 
Bakhteyari, S. and Haghi, Z., 2003, Survey of Food Security and Human Development in Muslim Countries, Economics and Agricultural Development, Vol. 11, No. 43 & 44, PP. 22-52. (In Persian)
 
Bakhtiyari, S., Nasrollahe, Kh. and Emadzadeh, M., 2002, Adjustment Policies Implemented in the First Program of Development and Food Security in Isfahan Province, Journal of Commerce, PP. 99-134. (In Persian)
 
Barr, N., 2004, Economic of the Welfare State, Oxford University Press, New York.
 
Chakraborty, R., Bose, K. and Bisai, S., 2009, Relationship of Family Income and House Type to Body Mass Index and Chronic Energy Deficiency Among Urban Bengalee Male Slum Dwellers of Kolkata, India, Journal of Comparative Human Biology, Vol. 60, No. 1, PP. 45-75.
 
Curvy, L., et al, 2010, Achieving Large Ends with Limited Means: Grand Strategy in Global Health, International Health, PP. 82-86.
 
Farid, Y., 2002, Geography ofNutrition, University of Tabriz. (In Persian)
 
Habib, R. R., et al, 2009, Housing Quality and Ill Health in a Disadvantaged Urban Community, Public Health, Vol. 123, No. 2, PP. 174-181.
 
Hataminazhad, H., Mahdi, A. and Mahdian Bahnamiri, M., 2013, The Survey of Residents Health-Life Slum Areas of Food Security and Nutrition Health (Case Study: District of ShadqoliKhan Qom City), Quarterly of New Attitudes in Human Geography, Vol 4, No. 2, PP. 53-72. (In Persian)
 
Hil, M., 2008, Environmental and Social Policy, Translated by: Hataminezhad, H. and Amirian, S., Tehran University Press, 1st Ed, Tehran. (In Persian)
 
Holzweher, M., 2002, Sport for all as a Social Change and Fitness Development, Institute of sport science, Vienna University, Australia.
 
Horton, R., 2009, Global Science and Social Movements: Towards a Rational Politics of Global Health, International Health, Vol. 1, No. 1, PP. 26-30.
 
Housing and Urban Department in Qom, 2010, Study of Indicators of Housing, Population, Migration and Marginalization in Qom City. (In Persian)
 
Karamsoltani, Z., et al, 2007, Obesity and Food Security in Schoolchildren in the City of Yazd, Medical School, Tehran University, Vol. 65, No. 7, PP. 76-68. (In Persian)
 
Karimi, S., Rasekhi, S. and Ehsani , M., 2008, Analysis of Subsidized Food in Urban Areas of Iran Rarely Model of AIDS to Prioritize the Efficient Allocation of Subsidies, Journal of the Iranian Economy, Vol. 13, No. 39, PP. 166-147. (In Persian)
 
Khosravinezhad, A., 2009, Measuring the Welfare Effects of the Removal of Basic Products Subsidies on Urban Households in Iran, Commercial Research, Vol 2, No. 50, PP. 1-33. (In Persian)
 
Mahallati, S., 2001, Interconnected and Dangerous, Culture, Economy, Politics and Food Systems, Journal of Faculty of Letters and Human Sciences, Tehran University, Vol 3, No. 185 & 159, PP. 630-615. (In Persian)
 
Mahdi, A., 2011, Analysis of Environmental Health and Access to Health Indicators in Marginal Areas; Case Study: Neighborhood Shadqly Khan Qom, MS Thesis, Geography and Urban Planning, Tehran University. (In Persian)
 
Mohammadpoor kaldeh, M., Fooladvand, M. and Avekh Kismi, M., 2010, Food Insecurity as a Risk Factor for Obesity among Low-Income Women in Boushehr, Southern Medical Journal, Vol. 13, No. 4, PP. 272-263. (In Persian)
 
Nafziger, E. W., 1990, The Economic of Development Countries, 2nd Ed, Prentice- Hall International edition, Tokyo.
 
Ngoasong, M. Z., 2009, The Emergence of Global Health Partnerships as Facilitators of Access to Medication in Africa: A Narrative Policy Analysis, Social Science & Medicine, Vol. 65. No. 5, PP. 556-949.
 
OECD, 2005, Bank Profiability, OESD Paris.
 
Office of GIS in Qom Municipal, 2012. (In Persian)
 
Office of Statistics and Information Planning and Parliamentary Affairs Jahad Sazandegee in Statistics, 2009. (In Persian)
 
Ortega-Alvareza, R. and ForsI, M. G., 2011, Dsting-off the File: A Review of Knowledge on Urban Ornithology in Latin America, Journal of landscape and Urban Planning, Vol. 101, No. 1, PP. 1-10.
 
Perme, Z., 2005, Study of the Production Situation and Milk Consumption in Iran and Other Countries and its Subsidies, Reviews of Commerce, Vol 2, No. 13, PP. 25-36. (In Persian)
 
Pieri, A., 1999, Study of Rural Migration and its Effects on Urban Landscapes in the Central Part of the Kamyaran Town, MS Thesis, Faculty of Geography, Tehran University. (In Persian)
 
Rahimee, A. and Kalantari, A., 1992, Analysis and Survey of Subsidies Economic, Institute of commercial Studies and Research Publication, Tehran. (In Persian)
 
Saam Aram, E. and Aminee Yakhdanee, A., 2006, Evaluate the Health Status of Women Heads of Household Welfare Organization in Qom, Womens Shi, Vol. 6, No. 21, PP. 134-160. (In Persian)
 
Schouten, M. A. and Mathenge, R. W., 2010, Communal Sanitation Alternatives for Slums: A Case Study of Kibera, Kenya, Physics and Chemistry of the Earth, Parts A/B/C, Vol. 35, No. 13-14, PP. 815-822.
 
Shakuei, H., 2003, Environmental Philosophy and Geographic Schools, 1st Ed, Vol. II, Construction supply chain economics Publications, Tehran. (In Persian)
 
Soheyl Rana, M. D., 2009, Status of Water Use Sanitation and Hygienic Condition of Urban Slums: A Study on Rupsha Ferighat Slum, Khulna, Desalination, Vol. 246, No. 1-3, PP. 322-328.
 
Soltanzadeh, M., 2008, Healthy Eating, Child Magazine, Education, Information Science, Vol 3., No. 45, PP.1-26 (In Persian)
 
Stephans, C., 1992, Training Urban Traditional Birth Attendants Balancing International Policy and Local Reality, Social Science & Medicine, Vol. 35, No. 6, PP. 811-817.
 
Su, M. D., Fath, Brian and Zhifeng Yang, 2010, Urban Ecosystem Health Assessment: A Review, Science of The Total Environment, Vol. 408, No. 12, PP. 2452-2434.
 
Temmerman, M., et al, 2006, European Journal of Obstetrics and Reproductive Health Indicators in the European Union: The Reprostat Project, Gynecology and Reproductive Biology, Vol. 126, No. 1, PP. 3-10.
 
Tzoulas, K., Korpela, K., Ven, S. and Vesa Yli-Pelkonen, 2007, Promoting Ecosystem and Human Health in Urban Areas Using Green Infrastructure: A Literature Review, Journal Landscape and Urban Planning, Vol. 81, No. 3, PP. 167-178.
 
Vearey, J., Palmary, I., Thomas b, L., Nunez, L. and Scott Drimie., 2010, Urban Health in Johannesburg: The Importance of Place in Understanding Intra-urban Inequalities in a Context of Migration and HIV, Health Place, Vol. 16, No. 4, PP. 694- 702.
 
Verhagen, H., Vos, E., Francl, Sh., Heinonen, M. and Henk van Loveren, 2010, Status of Nutrition and Health Claims in Europe, Archives of Biochemistry and Biophysic, Vol. 501, No. 1, PP. 6-15.
 
Youssefi, M., et al, 2010, Allocation Methods Based on the Need to Allocate Resources in the Health Sector and Assess the Current Status of the Provinces of Iran, Hakim Research Journal, Vol. 13, No. 2, PP. 10 -20. (In Persian)
 
Zhao, Y. S., et al, 2010, Basic Public Health Services Delivered in an Urban Community: A Qualitative Study, Public Health, Vol. 125, No.1, PP. 1-10.
 
Ziaei, M., 2000, Role of Government in the City and Urban Development in Iran Dissertation, Department of Geography, Tehran University. (In Persian)