Maziar Moradi-Lakeh1, Sadaf G Sepanlou2, Seyed M Karimi3, Narjes Khalili1, Shirin Djalalinia4, Chante Karimkhani5, Kristopher Krohn6, Ashkan Afshin6, Farshad Farzadfar7, Aliasghar Ahmad Kiadaliri8, Mohsen Asadi-Lari9, Hamid Asayesh10, Ali Reza Esteghamati11, Maryam S Farvid12, Seyed-Mohammad Fereshtehnejad13, Pouria Heydarpour14, Ardeshir Khosravi15, Jagdish Khubchandani16, Amir Kasaeian17, Saleem M Rana18, Mahdi Mahdavi19, Habib Masoudifarid20, Alireza Mohammadi21, Farshad Pourmalek22, Mostafa Qorbani23, Amir Radfar24, Kazem Rahimi25, Vafa Rahimi-Movaghar26, Gholamreza Roshandel27, Sare Safi28, Payman Salamati26, Arash Tehrani-Banihashemi1, Shahrzad Bazargan-Hejazi29, Theo Vos6, Reza Malekzadeh2, Ali H Mokdad6, Christopher J L Murray6, Mohsen Naghavi6. 1. Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran. 2. Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 3. University of Washington, Tacoma, USA. 4. Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran, Non-communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 5. Department of Dermatology, University of Colorado, Aurora, Colorado, USA. 6. Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA. 7. Non-communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 8. Lund University, Lund, Sweden. 9. Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran, Cancer Pathology Research Center, Iran University of Medical Sciences, Tehran, Iran. 10. Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran. 11. Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. 12. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 13. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden. 14. Sina MS Research Center, Tehran University of Medical Sciences, Tehran, Iran. 15. Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran. 16. Department of Nutrition and Health Science, Ball State University, Muncie, USA. 17. Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. 18. Contech School of Public Health, Lahore, Pakistan. 19. National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran. 20. State Welfare Organisation, Tehran, Iran. 21. Neuroscience Research Center, Baqiyatallah University of Medical Science, Tehran, Iran. 22. Department of Urology, School of Population and Public Health, University of British Columbia, Vancouver, Canada. 23. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. 24. A T Still University, Kirksville, USA. 25. The George Institute for Global Health, University of Oxford, Oxford, UK. 26. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. 27. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. 28. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 29. Charles R. Drew University of Medicine and Science, Los Angeles, California, USA, David Geffen School of Medicine, University of California, Los Angeles (UCLA), California, USA.
Abstract
BACKGROUND: The Global burden of disease and injuries study (GBD 2015) reports expected measures for years of life lost (YLL) based on socio-demographic index (SDI) of countries, as well as the observed measures. In this extended GBD 2015 report, we reviewed total and cause-specific deaths and YLL for Iran and all its neighboring countries between 1990 and 2015. METHODS: We extracted data from the GBD 2015 database. Observed YLL measures were calculated by multiplying the number of deaths by standard life expectancy at each age. SDI was a composite index, calculated based on income per capita, average years of schooling, and total fertility rate. The GBD world population was used for age standardization. RESULTS: All-ages crude death rate in Iran reduced from 665.6 per 100,000 population (95% uncertainty interval: 599.3-731.6) in 1990 to 487.2 (414.9-566.1) in 2015. The ratio of observed to expected YLL (O/E ratio) for all-causes ranged between 0.54 (Turkey) and 1.95 (Russia) in 2015. For Iran, the all-causes O/E ratio was less than 1 in all years (1990-2015), except 2003. However, cause-specific O/E ratio was more than 1 for some causes, including the top leading causes of YLL (ischemic heart disease, road injuries, and cerebrovascular disorders). Ischemic heart disease was the first or second cause of YLL in all comparator countries except Afghanistan. CONCLUSION: The leading YLL causes with high O/E ratios should be prioritized in public health efforts. In addition to research evidence, countries with low O/E ratios should be scrutinized to find feasible innovative interventions.
BACKGROUND: The Global burden of disease and injuries study (GBD 2015) reports expected measures for years of life lost (YLL) based on socio-demographic index (SDI) of countries, as well as the observed measures. In this extended GBD 2015 report, we reviewed total and cause-specific deaths and YLL for Iran and all its neighboring countries between 1990 and 2015. METHODS: We extracted data from the GBD 2015 database. Observed YLL measures were calculated by multiplying the number of deaths by standard life expectancy at each age. SDI was a composite index, calculated based on income per capita, average years of schooling, and total fertility rate. The GBD world population was used for age standardization. RESULTS: All-ages crude death rate in Iran reduced from 665.6 per 100,000 population (95% uncertainty interval: 599.3-731.6) in 1990 to 487.2 (414.9-566.1) in 2015. The ratio of observed to expected YLL (O/E ratio) for all-causes ranged between 0.54 (Turkey) and 1.95 (Russia) in 2015. For Iran, the all-causes O/E ratio was less than 1 in all years (1990-2015), except 2003. However, cause-specific O/E ratio was more than 1 for some causes, including the top leading causes of YLL (ischemic heart disease, road injuries, and cerebrovascular disorders). Ischemic heart disease was the first or second cause of YLL in all comparator countries except Afghanistan. CONCLUSION: The leading YLL causes with high O/E ratios should be prioritized in public health efforts. In addition to research evidence, countries with low O/E ratios should be scrutinized to find feasible innovative interventions.