Extended Abstract
Introduction
In Iran, since 1979, various programs under the title "Healthy Village" have been implemented to improve living conditions in rural areas (Afrakhteh & Afkar, 1391/2012). These programs were designed and executed to enhance health in various dimensions, particularly in rural regions. Based on Articles 3, 29, and 43 of the Constitution of the Islamic Republic of Iran, the government is obligated to provide basic universal insurance services equitably to all segments of society (Islamic Consultative Assembly Research Center, 1381/2002). However, despite these efforts, social health, as a key dimension of health, particularly in rural areas surrounding cities (peri-urban), still faces challenges that require thorough examination and effective planning.
The rural areas around the city of Zanjan, due to their proximity to the urban center while retaining rural characteristics, possess significant economic potential and natural resources. Nevertheless, these areas face issues such as limited access to healthcare services, inadequate infrastructure, and problems related to social interactions. Social health in these regions depends on factors such as access to healthcare and medical services, safe drinking water, public health, health education, and environmental hygiene. The absence or weakness of these factors can adversely affect the quality of life of rural residents and hinder the achievement of sustainable development in these areas.
 
Methodology
The current research is applied in nature, descriptive-analytical in methodology, and employs a quantitative approach. The statistical population of this study consists of 20 peri-urban villages located within a 20-kilometer radius of the city of Zanjan. Eight villages were selected as the sample population using a probabilistic sampling method (lottery method). The studied villages comprise 3,047 households, and using the Cochran formula with an error margin of 0.05, the required sample size for completing the questionnaire was calculated to be 384 households. Additionally, a systematic method was used to distribute the questionnaires. Data collection was conducted through library-based and field methods (questionnaires), and data analysis was performed using descriptive statistics and neuro-fuzzy techniques. To extract social health indicators and develop questionnaire items, the standard Keyes questionnaire was utilized. To assess and identify factors affecting the social health of rural households, four categories of factors—individual, economic, social, and physical-environmental—were classified into 41 indicators. The reliability of the questionnaire was calculated using Cronbach’s alpha, with values ranging from 0.43 to 0.83 for different components and an overall value of 0.68 (Table 4), indicating acceptable reliability of the tool. For data analysis, quantitative methods, descriptive statistics (mean and frequency percentage), and inferential statistics (one-sample t-test and neuro-fuzzy) were used in the SPSS software.
 
Results and discussion
The results of the one-sample t-test indicated that social flourishing (t-statistic = 30.122, p < 0.001), social cohesion (t-statistic = 27.206, p < 0.001), and social participation (t-statistic = 28.274, p < 0.001) were significantly above the desirable threshold (3), suggesting dynamic social relationships and a strong sense of belonging in the peri-urban villages around Zanjan. In contrast, social acceptance (t-statistic = 0.232, p = 0.791) and social integration (t-statistic = -4.441, p < 0.001) were found to be suboptimal, indicating weaknesses in accepting social differences and the predictability of the social environment. The neuro-fuzzy model revealed that the economic factor (input = 12.14, output = 14.29) was the strongest predictor of social health, followed by the social factor (input = 10.77, output = 12.32), with individual factors (input = 8.16, output = 8.61) and physical-environmental factors (input = 7.9, output = 8.14) having less impact. The results from Table 7, which pertains to detailed indicators, showed that in the economic dimension, secondary employment (input = 11.27, output = 12.41) and income (input = 10.51, output = 11.84) had a significant impact, while in the social dimension, strong relationships among villagers (input = 10.91, output = 11.85) and nutritional culture (input = 10.24, output = 12.54) were prominent. Secondary employment and income increased social participation by reducing economic pressures, while strong relationships and nutritional culture improved the sense of belonging by strengthening social capital.
 
Conclusion
In this study, the social health status of households in the peri-urban villages around the city of Zanjan and the factors affecting it were examined. The results indicate that social health, as a key component of the quality of life for residents in these areas, is influenced by economic, social, individual, and physical-environmental factors. Based on the obtained data, the economic factor, with an input of 12.14 and an output of 14.29, was identified as the most influential factor, which aligns with the findings of previous research in this field. Various studies, including those by Gramit et al. (2023) and Connolly (2023), demonstrate that economic conditions directly impact individuals' social and psychological health.
Furthermore, social factors, with an input of 10.77 and an output of 12.32, ranked second in influence. This finding is consistent with the theories of Keyes (2004) and Swarbrick and Yudof (2015), which emphasize the importance of social relationships and strong community ties. The presence of robust social relationships can enhance social capital and foster a sense of belonging to the community, ultimately leading to improved social health.
Regarding individual factors, the results showed that these factors, with an input of 8.16 and an output of 8.61, had less impact compared to economic and social factors. This finding aligns with the theories of Erikson (1959) and Raff and Corey (1995), which highlight the importance of personal growth and positive relationships with others. Finally, physical and environmental factors, with an input of 7.9 and an output of 8.14, had the least impact on social health, which is also consistent with previous research, particularly those emphasizing the influence of the environment on social health.
 
Funding
There is no funding support.
 
Authors’ Contribution
Authors contributed equally to the conceptualization and writing of the article. All of the authors approved thecontent of the manuscript and agreed on all aspects of the work declaration of competing interest none.
 
Conflict of Interest
Authors declared no conflict of interest.
 
Acknowledgments
 We are grateful to all the scientific consultants of this paper.