Citation

Naghavi M, Shahraz S, Sepanlou SG, Dicker D, Naghavi P, Pourmalek F, Mokdad A, Lozano R, Vos T, Asadi-Lari M, Sayyari AA, Murray CJL, Forouzanfar MH. Arch. Iran. Med. 2014; 17(5): 321-335.

Copyright

(Copyright © 2014, Academy of Medical Sciences of I.R. Iran)

DOI

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PMID

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Abstract

BACKGROUND: Drawing on the results of the country-level Global Burden of Diseases, Injuries, and Risk Factors 2010 Study, we attempted to investigate the drivers of change in the healthcare system in terms of mortality and morbidity due to diseases, injuries, and risk factors for the two decades from 1990 to 2010.

METHODS: We decomposed trends in mortality, cause of death, years of life lost due to disability, disability-adjusted life years (DALYs), life expectancy, health-adjusted life expectancy, and risk factors into the contribution of total increase in population size, aging of the population, and changes in age-specific and sex-specific rates.

RESULTS: We observed a decrease in age-specific mortality rate for both sexes, with a higher rate for women. The ranking of causes of death and their corresponding number of years of life lost remained unchanged between 1990 and 2010. However, the percentages of change indicate patterns of reduction for most causes, such as ischemic and hemorrhagic stroke, hypertensive heart disease, stomach cancer, lower respiratory infections, and congenital anomalies. The number of years lost due to disability caused by diabetes and drug use disorders has significantly increased in the last two decades. Major causes of DALYs, such as injuries, interpersonal violence, and suicide, showed increasing trends, while rates of communicable diseases, neonatal disorders, and nutritional deficiencies have declined significantly. Life expectancy and health-adjusted life expectancy increased for both sexes by approximately 7 years, with the highest rate of increase pertaining to females over the age 30.

CONCLUSIONS: Time trend information presented in this paper can be used to evaluate problems and policies specific to medical conditions or risk factors. Despite recent improvements, implementing policies to reduce the number of deaths and years of life lost due to road traffic injury remains the highest priority for Iranian policymakers. Immediate action by Iranian researchers is required to match Iran's decreasing mortality rate due to liver and stomach cancers to a rate comparable to the global level. Prevention and treatment plans for mental disorders, such as major depressive disorder, anxiety disorder, and particularly drug use disorders, should be considered in reforms of the health, education, and judiciary systems in Iran.

Language: en

Keywords

Humans; adolescent; Child; Adult; Child, Preschool; Infant; Infant, Newborn; Aged; Female; Male; Middle Aged; adult; disability; human; age; Adolescent; Cause of Death; suicide; Mortality; child; female; infant; male; newborn; epidemiology; Age Factors; Young Adult; Sex Factors; Aged, 80 and over; Iran; Cost of Illness; aged; dementia; Disability; sex difference; cause of death; mortality; traffic accident; Life expectancy; Chronic Disease; risk factor; maternal mortality; morbidity; article; mental disease; sex ratio; school child; middle aged; preschool child; chronic disease; Alzheimer disease; population dynamics; diabetes mellitus; heart disease; brain hemorrhage; quality adjusted life year; Quality-Adjusted Life Years; cost of illness; population growth; communicable disease; stomach cancer; nutritional disorder; young adult; newborn disease; disease surveillance; lower respiratory tract infection; very elderly; disability adjusted life year; Global burden of diseases (GBD); health care concepts; Health Transition; Healthcare system; non communicable disease