Trend of Conflict Rate in Iran from 2014 to 2020: An Ecological Study.

Abstract

Detecting the correlation of conflict rate within provinces over time provides a better understanding for health policymakers in identifying potential causes. The purpose of this study was to assess the trend of conflict rate in 31 provinces of Iran using the growth mixture model (GMM). This ecologic study was conducted based on the data obtained from the Iranian Legal Medicine Organization (ILMO) by gender and provinces between March 21, 2014 and March 21, 2020. First, the 7-year cumulative incidence rates were described; second, the trend of conflict rate was modeled by a linear mixed-effects model according to gender and overall; finally, distinct classes of provinces with similar conflict trends in seven years were identified using the GMM. The significance level was considered less than 0.05. Among provinces, Ardebil and Sistan Baluchistan had the highest and the lowest 7-year conflict incidence rates (95% CI) with 66.6 (52.38, 84.67) and 20.79 (13.53, 31.95) per 100000, respectively. The results of the linear mixed-effects model showed that the annual rate of conflict in Iran decreased by 0.37% from 2014 to 2017 and then slightly increased by 0.07% after 2017. In addition, the GMM results indicated that the trends for Iranian provinces can be clustered into four distinct classes. Our study showed the increasing growth of conflict in the last years in most provinces of Iran. Necessary interventions are important to prevent the rising conflict rate due to the various effects of conflict on psychological, social, and health factors.