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"The Role of Social Vulnerability in Explaining Fertility Patterns: A Case Study of Mashhad The year 2023–2024
Ali Pezhhan1 , Vajihehe Shayesteh shiran *2 , Ehsan Mousa farkhani3 , Seyed reza Moini1
1- Islamic Azad University, Tehran , Iran
2- Islamic Azad University, Tehran , Iran & Mashhad University of Medical Sciences , shayestehv1@mums.ac.ir
3- Mashhad University of Medical Sciences
Abstract:   (319 Views)
Background and purpose: Fertility is one of the key demographic indicators influenced by economic, social, and cultural factors. In recent decades, Iran—particularly the city of Mashhad—has experienced significant fertility changes in which spatial and social inequalities play an important role. This study aimed to examine the relationship between social vulnerability indicators and fertility patterns in the urban areas of Mashhad.
Materials and methods: This mixed-method (qualitative–quantitative) study employed the Delphi technique with 27 experts to identify and prioritize 14 variables across six dimensions of social vulnerability, weighted through the Analytic Hierarchy Process (AHP). Quantitative data were collected from 277 service units and the SINA health system, covering a population of over 3.5 million people. Data were analyzed using descriptive statistics, Pearson correlation, multiple linear regression, and Z-score normalization in SPSS software.
Results: The findings revealed that socio-economic and family dimensions had the greatest influence on fertility. The composite index of social vulnerability explained 16.4% of the variance in the total fertility rate (F=23.20, df=6,268, P<0.001). Fertility rates were higher in disadvantaged areas than in central districts. Family structure (r=0.497) and socio-economic status (r=0.460) were positively correlated with fertility, while public health infrastructure showed a negative correlation (r=-0.363).
        Conclusion: Urban fertility patterns in Mashhad are simultaneously influenced by economic, social, familial, and spatial inequalities. Therefore, population policies and urban planning should focus on reducing these inequalities, improving spatial equity, and strengthening social and healthcare infrastructure. This study emphasizes that a comprehensive and multidimensional approach is necessary to accurately understand fertility changes and to design effective policies.
 
Keywords: Fertility, Social vulnerability, Spatial inequality
     
Type of Study: Original | Subject: Special
Received: 2026/02/21 | Accepted: 2024/07/31
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Ethics code: IR.IAU.CTB.REC.1404.235
Clinical trials code:


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Open Access Statement: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium or format, provided that the original work is properly cited. 

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Iranian journal of Health Research and Development
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