An Assessment of the Social Health of the Residents of Lamerd, Fars Province in 2019

Received: 16 April 2021 Accepted: 10 June 202


Introduction
The residents of the southern cities of Iran were among the first people who confronted the manifestations of modernity. The changes occasioned by modernity entering these regions and establishing the industrial and developmental projects have led to changes in the residents' lifestyles. These changes have had many positive and negative consequences, and have influenced the residents' health. Traditionally, there have been two general approaches toward health and its definition. One is a disease-centered approach, which focuses on the presence and absence of illness in the physical and mental categories (1). From this perspective, health is a condition in which there are no illness symptoms in the person, and it is the ultimate goal of medical interventions. In this viewpoint, the role of environmental, social, and psychological determinant factors is usually ignored (2). The other approach, the healthoriented one, defines health as a state of high wellbeing. According to health theory, a healthy person is assumed to have excellent degrees of health indices. Davani et al. believe that true health is getting strong and capable, along with having a good life (3). The social dimension of health has been, especially recently, considered strongly alongside physical and mental health dimensions. Rafiey describes social health as wholesome social conditions and a community with social health as a society blessed with favorable conditions for people"s well-being (4).
Various definitions of social health have appeared that are adopted depending on the type and nature of the research. The definition used in this study, however, is the one proposed by Tavakol. Tavakol states that social health offers a summing up of the social conditions of society and is evaluated as per the relationship between the individual and others and society. This index can be an appropriate analytical tool for applied sociologists, social pathologists, and development strategists (5).
A reduction in social health will cause problems and abnormalities. Under such conditions, social and cultural injuries, insecurity, and mistrust increase, and at the same time, social capital decreases. Economic and livelihood problems increase, and the environment gets damaged. These consequences will eventually destroy societies.
Lamerd is a small city in Fars Province and is located near Asaluyeh in Bushehr Province and Bandar Parsian in Hormozegan Province (6). Regarding the present study, this city is located in the southernmost part of Fars Province. Due to its proximity to the Persian Gulf, it has been the focus of some planning and policymaking in the country and aimed to establish heavy and high-tech industries. Among the oil and gas industries of the country, Parsian Gas Refinery and its feeding gas fields, that is, Tabanak, Veravi, Homa, Shanol, and giant energy industries and the large south aluminum factory, Salco, are located in this region (7). These giant industries have brought changes in the residents' lives, including economic and environmental changes and alterations in population structure.
Considering the health conditions of the society in terms of economic, social, sanitary, demographic, educational, environmental, and social health parameters as various dimensions of social health in the context of a sparsely populated and partly traditional society such as Lamerd seems to be necessary. This study aims to evaluate the dimensions and components of social health in the form of the social health table of Lamerd residents.

Methods
The current study adopts a descriptive survey method, and in terms of purpose, it is applied research. The research population of the current study is 60319 residents of Lamerd city over 20 years of age in 2016. Using Cochran"s formula, the sample size for this study was determined approximately 382 individuals: N = population size. Z = 1.96, with a confidence level of 95%. d = 0/5, standard deviation. p,q = 0.5 The data collection method implemented in this study was the survey, and the questionnaire, designed and prepared by the researchers, was used for the same purpose. Moreover, the sampling techniques of the present study, firstly, was cluster sampling identified based on three counties of the city (Central County, Ashkanan County, Alamarvdasht County), and selecting a sample according to the quota percentage of each county. Secondly, the final sample was formed based on a fixed process of random sampling for each county. The researcher-made questionnaire included demographic information and was there to assess the social health dimensions.
In this study, social health has been evaluated in seven dimensions: welfare, economy, social status, social harms, health (physical and mental), population, education, and the environment (5). The components and indicators related to every dimension of social health are stated in Table 1. The impacts of noise, air, water, and soil contaminations Natural resources A change in the quality of farming and food products To determine the validity of the questionnaire designed for this study, a logical or face validity form was applied to the present research. Aiming to conduct the face validity of the study, university professors and some senior doctoral students were consulted, and their expert opinions were obtained. Finally, after reviewing and amending the original draft, the final questionnaire was designed, and the data was collected. Moreover, reliability evaluates the accuracy of the measuring instrument. It is the degree to which the research method produces stable and consistent results. Cronbach"s alpha, which is a measure of internal consistency, was used to evaluate the reliability of the research. The theoretical value of alpha varies from 0 to 1, since it is the ratio of two variances, and the variance in the denominator is always at least as large as the variance in the numerator.
Nevertheless, based on the estimation mechanism used, alpha estimations can get any value less than or equal to 1, even negative values, even though only positive values are logical (Ritter). Higher values of alpha are more favorable. Table 2 shows that the value of Cronbach"s alpha coefficients for social health questions is estimated at 78%.

Ethical considerations
The authors explained the present study's objectives and the processes and gained the oral consent of the respondents, as they were assured about the confidentiality of their information.

Statistical Analysis
This study assessed various aspects of social health, and 23 statements were used in a Likert scale survey questionnaire. The highest score for each statement was 5, and the lowest score was 1. In positive statements, 'strongly agree' responses were scored 5, and 'strongly disagree' were scored 1. To describe social health, central tendency indices, such as mean and standard deviation, were used in SPSS version 24. The significance level was set at 0.05.

Results
Considering the sampling, about 90% (342) of the respondents were men, and 66% (253) were single. 47% (180) of the population believed that they belong to the middle class. More than 51% (196) of respondents were between 30 and 40 years of age, and 43% (167) of them passed junior high school. A brief description of the personal characteristics of the research population is provided in Table 3. Descriptive statistics related to the main research variable, namely social health and its welfare, economic and social injuries, physicalmental health, demographic, educational, and environmental parameters, are presented in Table 4. Table 4 is a percentage frequency distribution display of data which is a standard and useful method of expressing the relative frequency of survey responses and other data. It shows the number of responses and their percentage for each aspect of the social dimension.

Discussion
Several studies have been conducted on assessing the social health of the citizens in each society. Each of those studies assessed one or more dimensions of social health. The present study has evaluated seven dimensions of social health based on Tavakkol"s study (5). Frequency and percentage data, along with each question's average evaluated rating, show that the majority of the answers were rated as medium, high, and very high. Therefore, it can be argued that the respondents hold a moderate view about the status of social health in Lamerd. The findings show that the arithmetic average of the educational dimension (3.14) was higher than that of the other subcomponents, and in all, the social health average (3.03) was at a medium level.
As reported in the frequency and percentage table, the data also show that in the economicwelfare dimension, more than 65% of respondents believe that job opportunities have increased, and local businesses have boosted after establishing oil and gas industries in the region. Most respondents rate the assumption as medium and high, indicating a favorable economic and welfare situation in the region. It agrees with the findings of Ogide (8), Miguel et al. (9), Saeedinia and Lobatfard (10), Abedifar (11), Tavakol and Nozari (10), Bazrafshan and Mohammadnia (12), and Keshavarzian (13). Thus, Miguel et al. (9) show that industry and factory establishment are strongly associated with increased income, employment, and consumption, indicating the region's positive industrialization.
In the social dimension of the region, the focus has been on social capital and more explicitly on social trust. This dimension was measured at two levels of interpersonal and institutional trust. The results showed that 74% of respondents rated trusting Islamic Council, Judicial Officers, Imam Jum"ah, the congressman, and oil and gas authorities as low or very low, which indicates a lack of institutional trust among the residents of the region. On the other hand, interpersonal trust among respondents, however, was rated as medium or high. It can be easily understood from the medium, high, and very high responses of the sampling to trust in "family, neighbors, and friends." This outcome agrees with the research conducted by Sabrina Habib et al. (14), Ogide (8) (11) and Dehghani (19).
The sampling responses on social harms show their undesirable status. The statements such as "mortal and conservative social harms (suicide, addiction, and murder)," "a feeling of inequality and insecurity," and "feeling insecure due to the presence of addicts, aliens, and immigrants", were rated mostly as medium and high. It is in agreement with the findings of Sabrina Habib et al. (14), Ogide (8) (19) and Talebian et al. (22).
In the dimension of physical and mental health, 56% of respondents knew someone around themselves that was sick due to the repercussions of oil and gas facilities in the region. The majority of the respondents rated physical and mental health as medium and high, which bears witness to the negative impacts of industry on the health of residents in Lamerd. This feature agrees with the findings of Granados (23) (7), Keshavarzian (13) and Anbari and Malaki (29). However, the assumption that mental and neurological problems (e.g., depression) had increased among the residents and the natives was rated as low or very low by 50% of the respondents. It indicates that the respondents consider the mental status of the residents of the region desirable.
The statements related to demographic dimensions and specifically life span, such as the statement which says, "the life span of the residents of Lamerd have decreased compared to that in the previous years," show the unfavorable condition of this dimension. More than 87% of respondents rated this statement as medium, high, and very high. Increased facilities resulting from the establishment of the petroleum industry also have not caused the respondents to hold a different view about the life span of the residents.
The results point out the respondents' interest in pursuing higher education and promoting it in the educational dimension. The respondents also mainly were interested in technical majors due to the presence of newly-established industries in the region. This tendency agrees with the findings of Seidlitz and Laska (18).
The last part of the questionnaire has been allocated to the environment, one of the main facets and dimensions of social health. The respondents mostly rated the noise level, air, and marine pollution as medium, high, and very high, which indicates an undesirable status of this dimension of social health for the respondents. This result is also consistent with the findings of Ramirez (24) (7), Keshavarzian (13), and Anbari and Malaki (29).
Obtaining the data for each social health table component is crucial in survey research on social health. Sadly, most organizations in charge of such data in Lamerd refused to provide the requested data or did not have any data.

Conclusion
Evaluating and measuring social health and its various dimensions in different regions and communities can be a good tool for policymakers and decision-makers to proceed from the current status to the optimal status. This research offers policymakers a panoramic perspective of the region under study to identify the strengths and weaknesses of the region and the problems and injuries of their residents to make proper plans. The effort to improve the social health of the residents of the regions is highly important. dissertation approved and completed in the Social Sciences Faculty of the University of Tehran, with reference code 1427807.

Authors' contribution
TM and MM conceived of the present idea, and developed the theoretical framework necessary for the work; MM collected the data, and performed computations. Both authors discussed the results and contributed to the final manuscript.