Health transition in Iran: results of the 18 Province study of mortality by cause of death

Mohsen Naghavi, Ministry of Health and Medical Education, Iran
Abolghasm Pour Reza, Regional Center for Population Reseach & Studies in Asia and the Pacific
Amir-Houshang Mehryar, Ministry of Science, Research & Technology of Iran

The past two decades have witnessed significant improvements in the living conditions and health status of Iranian people, particularly the traditionally neglected rural residents. Access to such amenities as electricity and piped water has risen above 90% and almost all children under five have been covered by vaccination. As a result, infant and under-five mortality rates have been reduced substantially, crude death rate has fallen to about 5 per 1000 and life expectancy at birth has risen to above 70 years. The morbidity and mortality pattern has changed dramatically with non-communicable diseases and accidents emerging as the main cause of death. A carefully designed mortality by cause of death project recently launched by the Ministry of Health & Medical Education in 23 of the 28 provinces of Iran has provided convincing evidence that Iran is at an advanced stage of health transition. The overwhelming majority of deaths belong to people aged 50+ years. Communicable diseases account for a minor proportion of deaths in all ages. The leading causes of death are cardiovascular diseases (45.72%), cancers (14.6%) and unintended accidents (14.85%). Among the latter, traffic accidents play a major role, accounting for over 25000 deaths per year with a much larger proportion suffering the health and economic consequences of injuries. Of the latter group the majority are aged 15-49, that is at the peak of their productive period. Men outnumber women at all age levels and all but a few disease categories.