Population health and burden of disease profile of Iran among 20 countries in the region: from Afghanistan to Qatar and Lebanon.
BACKGROUND
Population health and disease profiles are diverse across Iran's neighboring countries. Borrowing the results of the country-level Global Burden of Diseases, Injuries, and Risk Factors 2010 Study (GBD 2010), we aim to compare Iran with 19 countries in terms of an important set of population health and disease metrics. These countries include those neighboring Iran and a few other countries from the Middle East and North Africa (MENA) region.


METHODS
We show the pattern of health transition across the comparator countries from 1990 through 2010. We use classic GBD metrics measured for the year 2010 to indicate the rank of Iran among these nations. The metrics include disability-adjusted life years (DALYs), years of life lost as a result of premature death (YLLs), years of life lost due to disability (YLDs), health-adjusted life expectancy (HALE), and age-standardized death rate (ASD).


RESULTS
Considerable and uniform transition from communicable, maternal, neonatal, and nutritional (CMMN) conditions to non-communicable diseases (NCDs) was seen between 1990 and 2010. On average, ischemic heart disease, lower respiratory infections, and road injuries were the three principal causes of YLLs, while low back pain and major depressive disorders were the top causes of YLDs in these countries. Iran ranked 13th in HALE and 12th in ASD. The function of Iran's health care, measured by DALYs, was somewhat in the middle of the HALE spectrum for the comparator countries. This intermediate position becomes rather highlighted when Afghanistan, as outlier, is taken out of the comparison.


CONCLUSIONS
Effective policies to reduce NCDs need to be formulated and implemented through an integrated health care system. Our comparison shows that Iran can learn from the experience of a number of these countries to devise and execute the required strategies.
Heller School of Social Policy and Management , Brandeis University, Waltham, MA, USA. shahraz@brandeis.edu.
Saeid
S
Shahraz
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Hossein
MH
Forouzanfar
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Sadaf G
SG
Sepanlou
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Daniel
D
Dicker
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Paria
P
Naghavi
School of Population and Public Health, University of British Columbia, BC, Canada.
Farshad
F
Pourmalek
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ali
A
Mokdad
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Rafael
R
Lozano
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Theo
T
Vos
Oncopathology Research Centre, Ministry of Health and Medical Education, Tehran, Iran.
Mohsen
M
Asadi-Lari
Health deputy, Ministry of Health and Medical Education, Iran.
Ali-Akbar
AA
Sayyari
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Christopher J L
CJ
Murray
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Mohsen
M
Naghavi
D000367:Age Factors; D000368:Aged; D017281:Cost of Illness; D004813:Epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D009026:Mortality; D019057:Quality-Adjusted Life Years; D012737:Sex Factors