Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010.
BACKGROUND
we aimed to recap and highlight the major results of the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 by mortality and morbidity to clarify the current health priorities and challenges in Iran.


METHODS
We estimated Iran's mortality and burden of 289 diseases with 67 risk factors and 1160 sequelae, which were used to clinically present each disease and its disability or cause of death. We produced several measures to report health loss and status: all-cause mortality, cause-specific mortality, years of life lost due to death (YLL), healthy years of life lost due to disability (YLD), disability-adjusted life years (DALYs), life expectancy, and healthy life expectancy, for three time periods: 1990, 2005, and 2010.


RESULTS
We found out that life expectancy at birth was 71.6 years in men and 77.8 years in women. Almost 350 thousand deaths occurred in both sexes and all age groups in 2010. In both males and females and all age groups, ischemic heart disease was the main cause of death, claiming about 90 thousand lives. The main contributors to DALYs were: ischemic heart disease (9.1%), low back pain (9.0%), road injuries (7.3%), and unipolar depressive disorders (6.3%). The main causes of death under 5 years of age included: congenital anomalies (22.4%), preterm birth complications (18.3%), and other neonatal disorders (13.5%). The main causes of death among 15 - 49 year olds in both sexes included: injuries (23.6%) and ischemic heart disease (12.7%) The highest rates of YLDs were observed among 70+ year olds for both sexes (27,365 per 100,000), mainly due to low back pain, osteoarthritis, diabetes, falls, and major depressive disorder. The main risk factors to which deaths were attributable among children under 5 years included: suboptimal breast feeding, ambient PM pollution, tobacco smoking, and underweight. The most important risk factors among 15 to 49 year olds were: dietary risks, high blood pressure, high body mass index, physical inactivity, smoking, and ambient PM pollution. The pattern was similar among 50+ year olds.


CONCLUSIONS
Although non-communicable diseases had the greatest burden in 2010, the challenge of communicable and maternal diseases for health system is not over yet. Diet and physiological risk factors appear to be the most important targets for public health policy in Iran. Moreover, Iranians would greatly benefit from effective strategies to prevent injury and musculoskeletal disorders and expand mental care. Persistent improvement is possible by strengthening the health information system to monitor the population health and evaluate current programs.
Institute for Health Metric and Evolution, Seattle, WA, USA. forouzan@uw.edu.
Mohammad Hossein
MH
Forouzanfar
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Sadaf G
SG
Sepanlou
Heller School of Social Policy and Management, Brandeis University, Waltham, MA, USA.
Saeid
S
Shahraz
Institute for Health Metric and Evolution, Seattle, WA, USA.
Daniel
D
Dicker
Institute for Health Metric and Evolution, Seattle, WA, USA.
Paria
P
Naghavi
School of Population and Public Health, University of British Columbia, BC, Canada.
Farshad
F
Pourmalek
Institute for Health Metric and Evolution, Seattle, WA, USA.
Ali
A
Mokdad
Institute for Health Metric and Evolution, Seattle, WA, USA.
Rafael
R
Lozano
Institute for Health Metric and Evolution, Seattle, WA, USA.
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
Institute for Health Metric and Evolution, Seattle, WA, USA.
Christopher J L
CJ
Murray
Institute for Health Metric and Evolution, Seattle, WA, USA.
Mohsen
M
Naghavi
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004194:Disease / Q000209:etiology; D004813:Epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007492:Iran / Q000453:epidemiology; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009026:Mortality; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D012737:Sex Factors; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult