Table 2 Adjusted count ratios (PRs). Models were applied to analyze 162,425 observations, with reported ratios of medication counts along with their corresponding 95% confidence intervals and P-values for our four primary independent variables. Adjustment was conducted for age, gender, residence, ethnicity, marital status, body mass index, physical activity level, being smoker, opium use, Hookah use, and alcohol consumption

Individual SES

 Low

Ref

Ref

 Low-middle

1.05 (1.02–1.08)

< 0.001

1.08 (1.03–1.14)

0.003

 Middle-high

1.04 (1.01–1.08)

0.026

1.02 (0.95–1.09)

0.617

 High

1.05 (1.01–1.1)

0.027

0.97 (0.88–1.08)

0.614

Community Level SES

 Low

Ref

Ref

 Middle

0.88 (0.85–0.91)

< 0.001

0.9 (0.59–1.38)

0.634

 High

1.04 (0.99–1.11)

0.003

1.02 (0.66–1.58)

0.918

Individual Level Education

 Low

Ref

Ref

 High

0.92 (0.88–0.96)

< 0.001

0.85 (0.79–0.91)

< 0.001

Community Level Education

 Low

Ref

Ref

 Middle

1.14 (1.08–1.21)

< 0.001

1.27 (0.84–1.91)

0.265

 High

1.70 (1.62–1.78)

< 0.001

1.81 (1.16–2.81)

0.008