Improved Population Health in Iran from 1979 to 2019; Decreasing Mortality Rates and Increasing Life Expectancy

Background: In this study, we seek to evaluate the population health improvements during the previous four decades in Iran. We have estimated the levels and trends of child and adult mortality in addition to life expectancy from 1979 to 2019 at national and sub-national levels using all the available data. Methods: In this study, we used data from National and Sub-National Burden of Diseases study and employed Bayesian Averaging Model (BAM) to predict mortality rates and life expectancy from 1979 to 2019. By including all available data sources of death information of Iran, including national level data from the Institute for Health Metrics and Evaluation (IHME), national censuses, Demographic and Health Survey (DHS), and Death Registration System (DRS) and using Spatio-Temporal and Gaussian Process Regression (ST-GPR) models, we estimated mortality rates and life expectancy from 1990 to 2015. We also used a BAM to project our desired indices until 2019. Results: Both child and adult mortality rates decreased dramatically over the period. At the national level in Iran, in 2019, child mortality rate (deaths per 1000 livebirths), was 16.0 (95%UI: 13.0-19.6), adult mortality rates [probability of death (%)] for females and males were 6.1 (5.4-6.8) and 11.5 (10.3-12.8), respectively. Also, life expectancy values for females and males were 81.6 (80.7-82.2) and 76.1 (75.3-76.6), respectively. The results were consistent for both sexes. Despite the total narrowing gaps among provinces, a difference can still be observed particularly for the border provinces regarding child mortality rates. However, the difference in the other measures are inconsiderable. From 1979 to 2019, the overall change percent in child mortality rate, adult mortality rate for females and males and life expectancy for females and males were -86.3% (-89.0% - -83.1%), -52.5% (-60.9% - -42.9%), -48.7% (-56.9% - -39.6%), 25.3% (20.8%-31.5%), and 31.3% (25.5%-41.3%), respectively. Conclusion: This study provides an overview of the previous 40 years of mortality rates (child and adult) and life expectancy. The provided framework of national and sub-national evaluation can be used by researchers to continue the path of providing information for prioritization and evaluation of programs and also performing cost-effectiveness analysis for proposing efficient strategies to policy makers.