M Naghavi, F Abolhassani, F Pourmalek, N Jafari, M Moradi Lakeh, B Eshrati, N Mahdavi Hezaveh, H Kazemeini, A Tehrani Banihashemi, Sh Shoaee,
Volume 4, Issue 1 (4-2008)
Abstract
Background & Objective: Disability-Adjusted Life Years (DALY) summarizes the fatal and nonfatal outcomes of diseases and injuries in one number and gives a quantitative assessment of the health of a population. Estimating the burden of diseases and injuries in Iran in terms of DALY both nationwide and in 6 provinces.
Methods: We used slightly modified versions of the methods developed by the World Health Organization for estimating the burden of premature mortality, disability, and the DALY.
Results: The DALY rate per 100,000 was 21572 and 62% of this was life lost due to premature mortality the remaining 38% was due to disability from diseases and injuries. Fifty-eight percent of the total DALYs had been lost due to non-communicable diseases, 28% due to external causes (injuries), and 14% due to communicable, maternal/ perinatal and nutritional illnesses. The group of diseases and injuries with the highest burden in males waz intentional and unintentional injuries (2.789 million DALYs), while in the female population this position was held by mental disorders with 1.191 million DALYs. The single most important cause of burden was traffic accidents in males and ischemic heart disease in females. Disease burden showed considerable variability between different provinces.
Conclusion: The profile of health and disease in Iran has generally shifted from the predominance of communicable, maternal/perinatal, and nutritional illnesses towards predominance of non-communicable diseases and injuries at the national level. These figures on disease burden at population level are the most objective evidence that can be used in policy making and management of health programs, health research, and resource development within the health sector.
Nafiseh Salehnia, Abbas Assari Arani, Hossein Sadeghi Saghdel, Alireza Olyaeemanesh,
Volume 18, Issue 4 (3-2023)
Abstract
Background and Objectives: Health promotion is a crucial task for policymakers. Therefore, this study aims to identify the key factors that determine population health in Iran and illustrate the causal relationships between these factors.
Methods: The research was conducted using a mixed-method approach in three stages. First, macro social determinants of health were identified by analyzing available resources from 2000 to 2019. Screening of factors was carried out through the fuzzy Delphi method and a survey involving 15 experts. Finally, the causal relationships between the social determinants of health were depicted using a fuzzy cognitive map.
Results: Initially, 96 health determinants were identified at the national and global levels. After the screening, 8 factors that had less significance in population health were excluded. In terms of causal relationships, the economic system emerged as the most important and influential factor, with a centrality degree of 21.06 and an out-degree of 10.91. Following that, governance and policy-making, as well as national policies, were ranked with centrality degrees of 20.25 and 20.19, respectively.
Conclusion: Irrespective of the causal relationships, the health system holds the utmost importance in population health. However, when considering the causal relationships, the economic system takes precedence as the most critical factor, while the health system does not rank among the top three factors. Therefore, the analysis of fuzzy cognitive maps assists policymakers in understanding priorities and the interconnectedness between sectors in developing and implementing health-oriented policies across all sectors, enabling the adoption of the most effective policies.
