A Comparative Analysis of Distribution of Selected Urban Health Indices in Ahvaz Metropolis

Introduction  Nowadays it is important to mention that the acquisition of sustainability in the development process involves human being to ensure the health of the environment. Accordingly, the health component of the United Nations Development Program (UNDP) is highlighted as one of the main sources of human security in assessing the status of the country's progress and development. Health is the state of full enjoyment of physical, psychological and social conditions. It should not merely consider the absence of illness. This definition of health is a positive concept based on a social model of health treating health as the natural right of human beings and sees it as a natural right to all social groups. On the other hand, the conceptualization of health is based on the medical-based model. Meanwhile, in light of the worrying and growing threat of citizens' health, urban and health planners propose a relatively new "Health Planning" reform which seeks to link the urban environment with the physical and mental health of the urban population. To strengthen the decisions on some key issues such as urban environmental health, social welfare can improve quality of human life. Ahwaz City, as the most populous city of Khuzestan Province, has been slowly growing in recent years. It has experienced many demographic and physical changes due to natural population growth, migrant acceptance, expansion of services, provincial capital headquarters, social, economic and social changes. Therefore, because of its population density in recent decades, Ahwaz suffers from problems such as unemployment, poverty, lack of services and urban infrastructure, unequal access, environmental pollution, exhausted texture, informal housing, low quality of life, and so on. This process made imbalanced flow of services and facilities and raised the issues of social justice, spatial justice and urban sustainability. To this end, the present study seeks to adapt the urban health indices in the metropolitan city of Ahwaz. The significance of this problem is due to the fact that the city, according to the World Health Organization (WHO), is one of the most polluted cities in the world and has endangered the health of its citizens. Apart from discussing environmental issues, the difference in the availability of facilities and indicators of urban health among Ahwaz is another threat to citizens' health. Methodology  The present study is a descriptive-analytical research in terms of its nature, and theoretical-practical in terms of the research method. In this research, two types of library studies using articles, dissertation, internet, comprehensive and detailed plans of Ahwaz, etc. and field studies were employed to collect data and information of indicators. In the present study, by investigating health indices presented by the World Health Organization (WHO), we identified the indicators and indices for Ahwaz. For the aim of this study, which considers Ahwaz urban health indicators and urban health  indices were compiled via primary screening.  We have extracted 28 indicators whose degree of repeatability is more than other indices. The statistical population of this study is the population of seven municipalities of Ahwaz. To analyze the data for the comparative evaluation of urban health indices, the PROMETHEE decision making model and fuzzy inference system were used in MATLAB software. The PROMETHEE method: This technique, outlined first by Jean-Pierre Brans and Bertrand Mareschal in 1986, is used for enriching evaluations. The PROMETHEE technique is one of the MADM methods and as an efficient model using two preferred words to choose the best option. Fuzzy Inference System: generally speaking, it has a fuzzied input, a knowledge database providing the rationale necessary for the process of reasoning, and as the main stage of analysis, which is burdened with the task of approximate reasoning and fuzzy inference in the form of fuzzy rules (if = then) on the inputs of the model in its various stages. In the next step, the output of each step is used as the input of the next step until the last fuzzy output of the system is extracted. In the next step, final values are obtained through the non-fuzzy operation for the primary components and the base components (the research indices and components). Results and discussion    In the PROMETHEE method applied to the regions, priorities were finalized based on three (positive, negative, and pure) streams. According to the results, districts 2, 3 and 1 have the highest positive flow and the lowest negative value, while districts 4, 7, 6, 5 and 8 have net negative flow due to positive and negative flows. In the following, the method determines urban health indices according to the 8 districts of Ahwaz City based on the score of 1+ and 1. Indices with a score as + 1 are at the appropriate level and indices with a score of as -1 are at the inappropriate level. The results of creating rules in the fuzzy system in the Matlab environment also indicate that rules 14, 15, 17, 18, 23, 24, 26, and 27 are true for Ahwaz. This means that the rate of development of Ahwaz's urban health indices is moderate, low and very low. That is the low and very low membership indices in Ahwaz. Conclusion As the results illustrate, there are differences between the urban districts of Ahwaz in terms of the status of healthy indicators and indices such as climate conditions, urban accesses, employment status, etc. These are inappropriate as compared with other indices. In order to establish the spatial justice and equal access of the citizens of Ahwaz to the facilities, we presented suggestions including consideration of environmental issues such as quality of habitats, climate pollution, crime reduction, organization of urban exhausted texture and marginalization, increase of facilities and infrastructure services, increase of per capita municipal services, etc.