Understanding premature mortality patterns from Non–Communicable Diseases in Iran (2012-2020)
Abstract
Background: More than 85% of premature deaths from major non-communicable diseases (NCDs) occur in low- and middle-income countries.
Objectives: This study aimed to investigate trends of premature deaths (30-70 years) due to the non-communicable diseases in Iran, from 2012 to 2020.
Methods: Data on causes of death from 2012 to 2020 was extracted from the death registration system of the Ministry of Health and Medical Education.
To calculate completeness of death registration system, we used the new method presented by Adair and Lopez, which is based on the fixed effects model for predicting completeness of data from death registration system.
Results: Non-communicable diseases from 2012 to 2020 accounted for percentages of all deaths: 70.47, 69.13, 72.19, 70.55, 68.98, 69.44, 69.17, 67.94 and 54.15 percent of all deaths, respectively.
Premature deaths due to these diseases during the years of this study ranged from 50% to 71% of premature deaths.
The probability of premature deaths due to these diseases in these years was as follows: 17.35, 16.65, 16.61, 15.60, 14.95, 15.15, 15.25, 16.63 and 15.81 percent, respectively.
Conclusions: With the knowledge that the most common cause of premature death in women is non-communicable disease and the most common cause in the general population is cardiovascular disease, evidence-based planning and policy-making should be done to achieve further reductions in premature mortality, with an approach to be adopted in a unified way by focusing on modifiable risk factors in different sectors and disciplines in Iran.
References:
1) Razeghian-Jahromi I, Ghasemi Mianrood Y, Dara M, Azami P. Premature Death, Underlying Reasons, and Preventive Experiences in Iran: A Narrative Review. Arch Iran Med. July 2023;26(7):403-410.
2) Martinez R, Soliz P, Caixeta R, Ordunez P. Reflection on modern methods: years of life lost due to premature mortality-a versatile and comprehensive measure for monitoring non-communicable disease mortality. Int J Epidemiol. 2019 Aug 1;48(4):1367-1376.
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4) Bonita R, Magnusson R, Bovet P, Zhao D, Malta DC, Geneau R, et al. Country actions to meet UN commitments on non-communicable diseases: a stepwise approach. Country actions to meet UN commitments on non-communicable diseases: a stepwise approach. The Lancet. 2013 Feb 16; 381(9866):575-84.
5) Yousef M, Dastan I, Alinezhad F, Ranjbar M, Hamelmann Ch, Ostovar A, et al. Prevention and control of non-communicable diseases in Iran: the case for Investment. BMC Public Health (2022) 22:1248.
6) Malta DC, Andrade SSCA, Oliveira TP, Moura L, Prado RRD, Souza MFM. Probability of premature death for chronic non-communicable diseases, Brazil and Regions, projections to 2025. Revista Brasileira de Epidemiologia. 2019 Apr 1; 22.
7) Jagannathan R, Patel SA, Ali MK, Narayan KMV. Global updates on cardiovascular disease mortality trends and attribution of traditional risk factors. Current diabetes reports. 2019 Jul;19 (7):44.
8) Available at: World Health Organization, Non communicable diseases global monitoring framework: indicator definitions and specifications. A review of the Field. (https://www.who.int/nmh/ncdtools/indicators/GMF_Indicator_Definitions_Version_NOV2014.pdf, accessed 22 April 2020).
9) Available at: World Health Organization. Indicator metadata registry details. World Health Organization.https://www.who.int/data/gho/indicator-metadata-registry/imr- details/158. 2022.
10) NCD Countdown 2030 collaborators. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet. 2018 Sep 22;392(10152):1072-1088.
11) Kluge HHP, Wickramasinghe K, Rippin HL, Mendes R, Peters DH, Kontsevaya A, et al. Prevention and control of non-communicable diseases in the COVID-19 response. Lancet. 2020 May 30;395(10238):1678-1680.
12) akrami F, Riazi-Isfahani S, Mahdavi hezaveh A, Ghanbari Motlagh A, najmi M, afkar M, et al . Iran’s Status of NCDs Prevention and Management Services during COVID-19 Pandemic at PHC Level. SJKU 2021; 26 (5) :50-68.
13) Available at: https://www.icd10data.com/ICD10CM/Codes.
14) Population and housing censuses. Tehran: Statistical Center of Iran; 2016 (https://www.amar.org.ir/english/Population-and-Housing-Censuses, accessed 22 April 2020).
15) Joubert J, Rao C, Bradshaw D, Vos T, Lopez AD. Evaluating the quality of national mortality statistics from civil registration in South Africa, 1997-2007. PLoS One. 2013 May 27;8(5):e64592.
16) Khosravi A, Rao C, Naghavi M, Taylor R, Jafari N, Lopez AD. Impact of misclassification on measures of cardiovascular disease mortality in the Islamic Republic of Iran: a cross-sectional study. Bulletin of the World Health Organization. 2008; 86:688-96.
17) Aghamohammadi S, Kazemi E, Khosravi A, Kazemeini H. The Trend of Ten Leading Causes of Death in the Islamic Republic of Iran, 2006- 2011. Iranian Journal of Epidemiology 2017; 12(4): 1-11.
18) Rabbani B, Khosravi A, Azimi M, Tabrizi J, Atefi A, Ataey A, et al. Provincial Differential in Premature Deaths Due to the Non-communicable Diseases in Iran, 2016-2019 Iranian Journal of Epidemiology; Winter 2023; 18 (4): 292-304.
19) WHO methods and data sources for country-level causes of death2000-2021, Department of Data and Analytics (DNA)Division of Data, Analytics and Delivery for Impact (DDI)WHO, Geneva, May 2024: available at: https://www.who.int/data/global-health-estimates
20) Adair T, Lopez AD. Estimating the completeness of death registration: an empirical method. PloS one. 2018 May 30; 13(5): e0197047.
21) Yang H, Fu Y, Hong X, Yu H, Wang W, Sun F, et al. Trend in premature mortality from four major NCDs in Nanjing, China, 2007–2018. BMC Public Health, (2021) 21:2163.
22) Yichen C, Hua C， Yi Z， Xiaobing Q， Lianghong S， Hanyi C, et al. Probability of Premature Mortality Caused by Major Non-communicable Diseases in Pudong New Area of Shanghai，2002—2020. Chinese General Medicine 2022, Vol. 25, Issue (09): 1098-1104.DOI: 10.12114/j.issn.1007-9572.2021.02.074.
23) Nojilana B, Bradshaw D, Pillay-van Wyk V, Msemburi W, Laubscher R, Somdyala NI, et al. Emerging trends in non-communicable disease mortality in South Africa, 1997-2010. South African medical journal. 2016 Jun 24;106(5):477-84.
24) World Health Organization (WHO). Global status report on noncommunicable diseases 2014. Geneva: WHO; 2014
25) Murray CJL, Lopez AD. Measuring the global burden of disease. *New England Journal of Medicine. 2013;369(5):448-457. doi:10.1056/NEJMra1201534.
26) Gakidou E, Afshin A, Abajobir AA, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. *Lancet*. 2017;390(10100):1345-1422. doi:10.1016/S0140-6736(17)32366-8.
27) Haileamlak A. The Impact of COVID-19 on Non-Communicable Diseases. Ethiop J Health Sci. 2022 Jan;32(1):1-2. doi: 10.4314/ejhs.v32i1.1. PMID: 35250211; PMCID: PMC8864391.
28) Vidal-Perez R, Brandão M, Pazdernik M, et al. Cardiovascular disease and COVID-19, a deadly combination: A review about direct and indirect impact of a pandemic. World J Clin Cases. 2022 Sep 26;10(27):9556-9572.doi: 10.12998/wjcc.v10.i27.9556. PMID: 36186196; PMCID: PMC9516905.
29) GBD 2019 Iran Collaborators. Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022 Apr 23;399(10335):1625-1645.
30) Pan American Health Organization. Monitoring the premature mortality from the four major noncommunicable diseases (cardiovascular diseases, cancer, diabetes mellitus, and chronic respiratory diseases) in the Region of the Americas, 2000-2019. Pan American Health Organization. 2021.
31) Budreviciute A, Damiati S, Sabir DK, Onder K, Schuller-Goetzburg P, Plakys G, Katileviciute A, Khoja S, Kodzius R. Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors. Front. Public Health*. 2020;8:574111. doi: 10.3389/fpubh.2020.574111.
32) Hyder AA, Rylance S, Al Saegh A, Feigin VL, Kataria I, Laatikainen T, Lee L, Mahendradhata Y, Marten R, Mikkelsen B, Miranda JJ, Nugent R, Owolabi M, Sullivan R, Virani SS, Reddy KS. Strengthening evidence to inform health systems: opportunities for the WHO and partners to accelerate progress on non-communicable diseases. BMJ Global Health. 2023;8:e013994. doi:10.1136/bmjgh-2023-013994.
33) Doshmangir, L., Moshiri, E., Mostafavi, H., Alipouri Sakha, M., & Assan, A. (2019). Policy analysis of the Iranian Health Transformation Plan in primary healthcare. BMC Health Services Research, 19, 670.
1) Razeghian-Jahromi I, Ghasemi Mianrood Y, Dara M, Azami P. Premature Death, Underlying Reasons, and Preventive Experiences in Iran: A Narrative Review. Arch Iran Med. July 2023;26(7):403-410.
2) Martinez R, Soliz P, Caixeta R, Ordunez P. Reflection on modern methods: years of life lost due to premature mortality-a versatile and comprehensive measure for monitoring non-communicable disease mortality. Int J Epidemiol. 2019 Aug 1;48(4):1367-1376.
3) Available at: World Health Organization. Non-communicable diseases country profiles 2018. https://www.who.int/nmh/publications/ncd-profiles-2018/en/. Accessed 24 Sep 2018.
4) Bonita R, Magnusson R, Bovet P, Zhao D, Malta DC, Geneau R, et al. Country actions to meet UN commitments on non-communicable diseases: a stepwise approach. Country actions to meet UN commitments on non-communicable diseases: a stepwise approach. The Lancet. 2013 Feb 16; 381(9866):575-84.
5) Yousef M, Dastan I, Alinezhad F, Ranjbar M, Hamelmann Ch, Ostovar A, et al. Prevention and control of non-communicable diseases in Iran: the case for Investment. BMC Public Health (2022) 22:1248.
6) Malta DC, Andrade SSCA, Oliveira TP, Moura L, Prado RRD, Souza MFM. Probability of premature death for chronic non-communicable diseases, Brazil and Regions, projections to 2025. Revista Brasileira de Epidemiologia. 2019 Apr 1; 22.
7) Jagannathan R, Patel SA, Ali MK, Narayan KMV. Global updates on cardiovascular disease mortality trends and attribution of traditional risk factors. Current diabetes reports. 2019 Jul;19 (7):44.
8) Available at: World Health Organization, Non communicable diseases global monitoring framework: indicator definitions and specifications. A review of the Field. (https://www.who.int/nmh/ncdtools/indicators/GMF_Indicator_Definitions_Version_NOV2014.pdf, accessed 22 April 2020).
9) Available at: World Health Organization. Indicator metadata registry details. World Health Organization.https://www.who.int/data/gho/indicator-metadata-registry/imr- details/158. 2022.
10) NCD Countdown 2030 collaborators. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet. 2018 Sep 22;392(10152):1072-1088.
11) Kluge HHP, Wickramasinghe K, Rippin HL, Mendes R, Peters DH, Kontsevaya A, et al. Prevention and control of non-communicable diseases in the COVID-19 response. Lancet. 2020 May 30;395(10238):1678-1680.
12) akrami F, Riazi-Isfahani S, Mahdavi hezaveh A, Ghanbari Motlagh A, najmi M, afkar M, et al . Iran’s Status of NCDs Prevention and Management Services during COVID-19 Pandemic at PHC Level. SJKU 2021; 26 (5) :50-68.
13) Available at: https://www.icd10data.com/ICD10CM/Codes.
14) Population and housing censuses. Tehran: Statistical Center of Iran; 2016 (https://www.amar.org.ir/english/Population-and-Housing-Censuses, accessed 22 April 2020).
15) Joubert J, Rao C, Bradshaw D, Vos T, Lopez AD. Evaluating the quality of national mortality statistics from civil registration in South Africa, 1997-2007. PLoS One. 2013 May 27;8(5):e64592.
16) Khosravi A, Rao C, Naghavi M, Taylor R, Jafari N, Lopez AD. Impact of misclassification on measures of cardiovascular disease mortality in the Islamic Republic of Iran: a cross-sectional study. Bulletin of the World Health Organization. 2008; 86:688-96.
17) Aghamohammadi S, Kazemi E, Khosravi A, Kazemeini H. The Trend of Ten Leading Causes of Death in the Islamic Republic of Iran, 2006- 2011. Iranian Journal of Epidemiology 2017; 12(4): 1-11.
18) Rabbani B, Khosravi A, Azimi M, Tabrizi J, Atefi A, Ataey A, et al. Provincial Differential in Premature Deaths Due to the Non-communicable Diseases in Iran, 2016-2019 Iranian Journal of Epidemiology; Winter 2023; 18 (4): 292-304.
19) WHO methods and data sources for country-level causes of death2000-2021, Department of Data and Analytics (DNA)Division of Data, Analytics and Delivery for Impact (DDI)WHO, Geneva, May 2024: available at: https://www.who.int/data/global-health-estimates
20) Adair T, Lopez AD. Estimating the completeness of death registration: an empirical method. PloS one. 2018 May 30; 13(5): e0197047.
21) Yang H, Fu Y, Hong X, Yu H, Wang W, Sun F, et al. Trend in premature mortality from four major NCDs in Nanjing, China, 2007–2018. BMC Public Health, (2021) 21:2163.
22) Yichen C, Hua C， Yi Z， Xiaobing Q， Lianghong S， Hanyi C, et al. Probability of Premature Mortality Caused by Major Non-communicable Diseases in Pudong New Area of Shanghai，2002—2020. Chinese General Medicine 2022, Vol. 25, Issue (09): 1098-1104.DOI: 10.12114/j.issn.1007-9572.2021.02.074.
23) Nojilana B, Bradshaw D, Pillay-van Wyk V, Msemburi W, Laubscher R, Somdyala NI, et al. Emerging trends in non-communicable disease mortality in South Africa, 1997-2010. South African medical journal. 2016 Jun 24;106(5):477-84.
24) World Health Organization (WHO). Global status report on noncommunicable diseases 2014. Geneva: WHO; 2014
25) Murray CJL, Lopez AD. Measuring the global burden of disease. *New England Journal of Medicine. 2013;369(5):448-457. doi:10.1056/NEJMra1201534.
26) Gakidou E, Afshin A, Abajobir AA, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. *Lancet*. 2017;390(10100):1345-1422. doi:10.1016/S0140-6736(17)32366-8.
27) Haileamlak A. The Impact of COVID-19 on Non-Communicable Diseases. Ethiop J Health Sci. 2022 Jan;32(1):1-2. doi: 10.4314/ejhs.v32i1.1. PMID: 35250211; PMCID: PMC8864391.
28) Vidal-Perez R, Brandão M, Pazdernik M, et al. Cardiovascular disease and COVID-19, a deadly combination: A review about direct and indirect impact of a pandemic. World J Clin Cases. 2022 Sep 26;10(27):9556-9572.doi: 10.12998/wjcc.v10.i27.9556. PMID: 36186196; PMCID: PMC9516905.
29) GBD 2019 Iran Collaborators. Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022 Apr 23;399(10335):1625-1645.
30) Pan American Health Organization. Monitoring the premature mortality from the four major noncommunicable diseases (cardiovascular diseases, cancer, diabetes mellitus, and chronic respiratory diseases) in the Region of the Americas, 2000-2019. Pan American Health Organization. 2021.
31) Budreviciute A, Damiati S, Sabir DK, Onder K, Schuller-Goetzburg P, Plakys G, Katileviciute A, Khoja S, Kodzius R. Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors. Front. Public Health*. 2020;8:574111. doi: 10.3389/fpubh.2020.574111.
32) Hyder AA, Rylance S, Al Saegh A, Feigin VL, Kataria I, Laatikainen T, Lee L, Mahendradhata Y, Marten R, Mikkelsen B, Miranda JJ, Nugent R, Owolabi M, Sullivan R, Virani SS, Reddy KS. Strengthening evidence to inform health systems: opportunities for the WHO and partners to accelerate progress on non-communicable diseases. BMJ Global Health. 2023;8:e013994. doi:10.1136/bmjgh-2023-013994.
33) Doshmangir, L., Moshiri, E., Mostafavi, H., Alipouri Sakha, M., & Assan, A. (2019). Policy analysis of the Iranian Health Transformation Plan in primary healthcare. BMC Health Services Research, 19, 670.
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| Issue | Vol 11 No 1 (2025): . | |
| Section | Articles | |
| Keywords | ||
| Mortality, Non-communicable diseases, Premature death, Mixed effect model, Iran. | ||
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How to Cite
1.
Rabbani B. Understanding premature mortality patterns from Non–Communicable Diseases in Iran (2012-2020). JBE. 2025;11(1):50-62.
