Statistical Center Of Iran Research Articles

Factors Affecting Household Health Expenditures: Evidence from Iran

Abstract Background Productivity plays a crucial role in driving economic growth, and its primary determinant is human capital. Human capital, in turn, is influenced by health and education investments, leading both households and governments to allocate substantial resources toward these sectors. Understanding the factors influencing health expenses is vital for designing effective policies. Methods This study investigates the factors affecting health costs by analyzing data from various provinces in the Islamic Republic of Iran, spanning from 2006 to 2019. The data, sourced from the Statistics Center of Iran, was analyzed using the panel data approach to uncover the relationships between health expenditure and several key variables. Results The analysis revealed significant disparities in health expenditure among provinces. Sistan & Baluchestan had the lowest health expenditure per household, while Tehran reported the highest. Inflation emerged as a significant factor, having a negative impact on health expenses due to its influence on purchasing power. Conversely, the education and salary of household heads had a positive impact on health expenditure. Notably, economic growth did not exhibit a significant relationship with health expenses. Conclusions The study highlights the importance of education and income levels in shaping health expenditures, while inflation can curtail spending on health due to reduced purchasing power. Policymakers should consider these factors to ensure equitable and effective allocation of health resources. Key messages • Improving health and well-being, essential for comprehensive progress and human development, relies significantly on household health expenditure. • The efforts to enhance human capital should focus on reducing inflation.

Dietary changes during the COVID-19 lockdown in Iranian households: are we witnessing a secular trend? A narrative review.

The COVID-19 pandemic, which emerged in late 2019, influenced nearly all aspects of human life, including food choices and dietary habits. A web-based search was conducted from March to April 2024 in MEDLINE/PubMed, CINAHL, Embase, and the Cochrane Library for published reports of large-scale surveys of dietary changes during or shortly after the coronavirus pandemic lockdown in Iran. The keywords used were coronavirus OR COVID-19, diet OR nutrition, household, and Iran. Studies that focused on specific areas, subgroups (such as students), or just one city or province were not included. To monitor dietary changes from the years before the lockdown, we used and plotted data from the Household Income and Expenditure Survey (HIES), as provided by the Statistical Center of Iran. The overall results of the nationwide studies conducted during the lockdown period in Iran revealed that a significant proportion of the households reduced their consumption of milk, yogurt, cheese, red meat, white meat, eggs, and rice/bread. In approximately 47% of the households where weekly consumption of animal protein sources decreased, the consumption of rice and bread increased. Accordingly, 35 and 44% of households reported a decrease in the consumption frequency of fruits and snacks, respectively. Additionally, 21% of those who reduced their fruit consumption completely removed fruits from their food basket. Meanwhile, the use of dietary supplements, especially vitamin D, vitamin C, zinc, and multivitamins, had increased in households, particularly among those with higher incomes. Decreased income was a common reason for all of these dietary changes, which can have major health consequences in the long term. This review provides evidence that the observed changes had already begun years before the pandemic and presumably have not yet returned to the pre-pandemic situation. Finally, we suggest some strategies for policymakers to overcome the crisis and enhance community the nutrition and health of general population.

Catastrophic Health Expenditure among Iranian Households: Evidence from the COVID-19 Era.

Monitoring households' exposure to catastrophic health expenditure (CHE) based on out-of-pocket (OOP) health payments is a critical tool for evaluating the equitable financial protection status within the health system. The COVID-19 pandemic has brought unprecedented global change and potentially affected the mentioned protection indicators. This study aimed to assess the prevalence of CHE among households in Iran during the COVID-19 period. The present study employed a retrospective-descriptive design utilizing data derived from two consecutive cross-sectional Annual Household Income and Expenditure Surveys (HIES) undertaken by the Statistical Centre of Iran (SCI) in 2020 and 2021. The average annual OOP health payments and the prevalence of households facing CHE were estimated separately for rural and urban areas, as well as at the national level. Based on the standard method recommended by the World Health Organization (WHO), CHE was identified as situations in which OOP health payments surpass 40% of a household's capacity to pay (CTP). The intensity of CHE was also calculated using the overshoot measure. All statistical analyses were carried out using Excel-2016 and Stata-14 software. The average OOP health payments increased in 2021, compared to 2020, across rural and urban areas as well as at the national level. Urban residents consistently experienced higher OOP health payments than rural residents and the national level in both years. At the national level, the prevalence of CHE was 2.92% in 2020 and increased to 3.18% in 2021. In addition, rural residents faced a higher prevalence of CHE based on total health services OOP, outpatient services OOP, and inpatient services OOP compared to urban residents and the national level. Regarding the intensity of CHE using overshoot, the results for 2020 and 2021 revealed that the overshoot ranged between 0.60% and 0.65% in rural areas, between 0.30% and 0.33% in urban areas, and between 0.38% and 0.41% at the national level. A considerable percentage of households in Iran still incur CHE. This trend has increased in the second year of COVID-19 compared to the first year, as households received more healthcare services. The situation is even more severe for rural residents. There is an urgent need for targeted interventions in the health system, such as strengthening prepayment mechanisms, to reduce OOP and ensure equitable protection for healthcare recipients.

Cost Estimating of Providing Desired Food Basket for the Iranian Society and Its Situation in the Last 3 Years

Background: Food security has always been emphasized as a primary goal of sustainable development policies. Events, such as the COVID-19 outbreak, climate change, wars, and unjust (cruel) sanctions against countries threaten global food security. Therefore, considering the importance of nutrition and food consumption in budget planning and household shopping, we indirectly examined the cost of providing an optimal food basket for the Iranian community, in total and by separating its components based on the average price of selected food items in urban areas from year 1399-1401 in the Solar Hijri calendar (2020 to 2022). Methods: In this cross-sectional costing study, the country’s desired food basket was used as a reference for cost measurement of an acceptable food basket, and information on food prices and household expenses was obtained from the Statistical Center of Iran and the Central Bank. The cost of providing an optimal food basket for the Iranian community, in total and for each component, was calculated for an individual and a family of four. After extracting the cost information of providing an optimal food basket in these three years, the data were compared and analyzed to study the trend. Results: Based on the costs of providing an optimal household basket, the average food cost for a family of four in 1399 (2020- 2021) was about 3.2 million Tomans, which increased by 27% to 4.365 million Tomans in 1400 (2021-2022), and in 1401 (October 2022), it reached 6.785 million Tomans, a 35% increase compared to 1400 (2021-2022). Conclusion: It is suggested to support vulnerable groups and target subsidies according to different income levels. The salaries and wages should be revised in line with inflation food prices and household expenses, and also policymakers and planners are suggested to monitor the prices.

Incidence of Cancer from 2015 to 2019 in Northwestern of Iran: A Population-Based on Cancer Registry Profile of Maragheh County

Background: Cancer is a leading cause of death globally and poses a significant obstacle to increasing life expectancy in every country, including Iran, where it is a major health threat. Objectives: This study aimed to assess the cancer situation in Maragheh County, Iran, from 2015 to 2019. Methods: Data from Maragheh County for the years 2015 - 2019 were obtained from the Iranian National Population-Based Cancer Registry and the Statistical Center of Iran. The age-standardized rate (ASR) was calculated using the population model suggested by the WHO, with STATA software for data analysis. Results: During the study period, Maragheh recorded a total of 1,700 cancer cases, with males accounting for 970 (54%) of these cases. The average age of cancer patients was 62.4 ± 22.2 years. The ASR for cancer in females ranged from 101.5 to 165.5 per 100,000 people, and for males, it ranged from 128.3 to 150.3 per 100,000 people. Conclusions: The incidence rate of cancer in Maragheh was slightly different from that in Iran and East Azerbaijan province but remained below the global average. The most common cancers in men were stomach, lung, bladder, colorectal, and prostate cancer, while in women, they were breast, colorectal, stomach, leukemia, and thyroid cancer.

Exploring the County Level Mortality Pattern Variations in Rural Areas of Iran (2006-2016).

Mortality rate in rural areas is a useful measure of the health of the population and the function of the health system, which varies over space and time. The objective of this research is to explore the spatial and temporal variations in the rural mortality rate in Iran at the county level in 2006, 2011, and 2016. data were gathered from the rural population and mortality statistics published by the Statistical Centre of Iran (SCI) and the National Organization for Civil Registration (NOCR). Global spatial patterns were assessed using the global Moran's I and local clusters through the local Moran's I. Spatial distribution of rural mortality rate shows that during the years under study the number of counties with a lower rate has increased. The counties with rate of less form continuous areas in the southwest, central and east regions. The excess risk map reveals significant variations in both value and extent. Also, the values of Moran's index increased from 0.1848 in 2006 to 0.4041 in 2016, which indicates the strengthening of the cluster spatial pattern of the overall rural mortality rate. Local patterns have undergone substantial changes over space and time. The findings indicate significant spatial and temporal variations in rural mortality rates in Iran. Policy-makers can use this information to plan and enhance healthcare infrastructure in specific counties. The findings serve for evaluating the effectiveness of health policies, enabling policy-makers to make informed decisions, allocate resources efficiently and design targeted interventions for improved public health outcomes.

Assessing the impacts of climate change on water resource management and crop patterns in Eastern Iran

Rapid population growth and climate change are poised to significantly impact water resources and agriculture. Consequently, it becomes imperative to delve into the repercussions of climate change on agriculture and natural resources in developing nations. In this research, an economic–hydrological model was employed to assess the influence of climate change on water management and cropping patterns in the Eastern border catchment of Iran. The climatic data used in this study, spanning the years 1997–2022, encompassed daily rainfall and temperature records from the Khorasan and Sistan & Balouchestan meteorological organization, as well as the Iranian Statistical Center. Monthly water discharge data were obtained from the Khorasan and Sistan & Balouchestan regional water authority, while information on crop levels and agricultural inputs was collected from the Khorasan and Sistan & Balouchestan agricultural jihad organization. The findings reveal that areas dedicated to cultivating high-yield crops experienced a decrease when associated with high water consumption, whereas the cultivation areas of high-yield crops expanded when water consumption was reduced. The implementation of modern irrigation methods, such as pressurized irrigation, not only conserves valuable water resources but also enhances efficiency, ultimately resulting in decreased water consumption and increased production. Consequently, the provision of enhanced training programs aimed at educating farmers about these practices and facilitating their adoption can play a pivotal role in adapting to and mitigating the challenges posed by climate change.

Stratification of Urban Health Centers of Khorramabad Based on Socioeconomic Status of Households Using Factor Analysis and Cluster Analysis

Background: In numerous studies in the field of medical sciences, researchers use health centers as a frame for stratified sampling. Since socioeconomic variables play a major role in health outcomes, the present study aimed to classify urban health centers of Khorramabad in terms of the socioeconomic status of households using factor and cluster analysis. Materials and Methods: In this cross-sectional study, the statistical population included all urban areas of Khorramabad based on the population and housing census conducted by the Statistical Center of Iran. Firstly, the scatter maps of urban areas and health centers were adopted together. Thereafter, socioeconomic indexes of urban areas were calculated in seven fields, and exploratory factor analysis was used to reduce dimensions. Finally, the similar health centers in terms of factor scores were allocated to the same clusters by k-means cluster analysis using SPSS software (version 26) and were displayed on city maps using Arc GIS software. Results: Three factors identified in factor analysis explained about 73.3% of the total variance of socioeconomic indexes. Based on cluster analysis, 11 health centers were located in cluster 1 (related to lower educational attainment, poorer housing amenities, and higher rate of homelessness and divorce), 16 centers were located in cluster 2 (related to higher studying persons rate, lower marriage rate in women, lower unemployment rate, and higher residence in apartment flats) and 10 health centers were located in cluster 3 (related to higher academic graduates, more profitable jobs, and better housing amenities). Conclusion: The results of this research can be used in health studies in urban areas of Khorramabad as a basis for performing stratified sampling. Furthermore, it is recommended that authorities adopt more effective planning to improve deprived areas in cluster one.

The 15-year national trends of urinary cancers incidence among Iranian men and women; 2005–2020

BackgroundUrinary tract cancers including bladder, kidney, ureter, and pelvis are a common malignancy worldwide with high mortality ratio. Aimed to investigate the prevalence of these cancers, we conducted this study.MethodsIn this study, all the information related to ICD10 codes, gender, age and province of residence of individuals were obtained from the data of Iran’s cancer registry by the Ministry of Health, Medicine and Medical Education and demographic evidence for each sub-country from the reports of Statistics Center of Iran (SCI). Also, the data of two Iranian national survey studies CASPIAN-III, IV, and V (information related to the care and prevention of non-communicable diseases (NCD) in childhood and adolescence) and STEPs (including information on NCD in adults over 18 years old) were used. The data was analyzed using Poisson regression with mixed effects to estimate the incidence of cancers.ResultsBladder and kidney neoplasm are the most common cancers of the urinary system in Iran. The prevalence of bladder cancer has increased from 5.82 to 11.50 per 100,000 individuals. The increasing trend is growing faster in men compared with women. The incidence of kidney neoplasm has increased over the years (2.03 in 2005 vs. 7.02 in 2020 per 100,000). Having a higher incidence ratio compared with bladder cancer, kidney cancer is responsible for 35.06% of all urinary cancers in 2020 compared with 23.71% in 2005. Both neoplasms of the ureter and renal pelvis were recorded rarely and with lower incidence in both sexes during this period.ConclusionConsidering the increasing trend in the incidence of urinary neoplasms in Iran during these years, the advantage of focusing on the risk of urinary cancers is highlighted. Therefore, investigating the prevalence and incidence of urinary cancers to plan and manage these cancers will result in prevention and reduction of the disease burden on the Iranian society. Future studies in this field can help in the prevention and well-timed diagnosis of these cancers.

Descriptive Epidemiology of Early-Onset Gastrointestinal Cancers in Iran, 2014-2018.

We aim to present incidence rates and geographical distribution of most common early-onset gastrointestinal cancers (EOGICs), including early-onset esophageal cancer (EOEC), gastric cancer (EOGC) and colorectal cancer (EOCRC) in Iran, 2014-2018. Data on new cases of EOEC, EOGC and EOCRC were obtained from publicly available annual reports of the Iranian National Population-based Cancer Registry (INPCR). Incidence rates were calculated using the population data available from the Statistical center of Iran. We considered the World standard population for calculation of age-standardized incidence rates (ASR). We also calculated 95% confidence intervals (CIs) for ASR. All rates are presented per 100000 person-years. Overall, 19,679 new cases of EOGIC were registered by the INPCR between 2014 and 2018. The ASRs (95% CI) of EOEC, EOGC and EOCRC were 0.49 (95% CI: 0.47-0.51), 1.67 (1.63-1.71), and 3.07 (3.01-3.13) per 100,000 person-years, respectively. Our findings indicate decreasing and constant trends in the ASR of EOEC and EOGC during the study period, 2014-2018. There was an increasing trend in the ASR of EOCRC. We also found geographical disparities in the incidence rates of EOGICs across provinces of Iran, suggesting the highest ASRs of EOEC in Golestan (1.3), EOGC in Ilam (2.99) and EOCRC in Ilam (4.49). Our findings suggested that the incidence rate of EOCRC is consistently increasing. We also found variations in the incidence of EOGICs among different provinces. Further investigations are recommended to clarify the time trends and risk factors of EOGICs in Iran.

Estimation of health-related and economic impacts of PM2.5 in Arak, Iran, using BenMAP-CE.

Ambient air quality is one of the most critical threats to human health. In this study, the health and economic benefits of reducing PM2.5 were estimated in the city of Arak during the period of 2017-2019. The concentration data were obtained from the Environmental Protection Organization of Central Province, while the demographic data were obtained from the website of the Iran Statistics Center. The number of premature deaths from all causes, ischemic heart disease, chronic obstructive pulmonary disease, and lung cancer, attributable to PM2.5 pollution was estimated using the Environmental Benefits Mapping and Analysis Program-Comprehensive Version (BenMAP_CE) to limit the guidelines of the World Health Organization. The results showed that improving air quality in 2017, 2018, and 2019 in Arak could prevent the deaths of 729, 654, and 460 people, respectively. The number of years of life lost (YLL) in 2017, 2018, and 2019 was 11383, 10362, and 7260 years, respectively. The total annual economic benefits of reducing the PM2.5 concentration in Arak under the proposed scenarios in 2017, 2018, and 2019 were estimated to be 309,225,507, 262,868,727, and 182,224,053 USD, respectively, using the statistical life method (VSL). Based on the results of this study, there are significant health and economic benefits to reducing PM2.5 concentrations in Arak City. Therefore, planning and adopting control policies to reduce air pollution in this city are necessary.

Effects of Sanctions on Food Intake of Urban Households in Razavi Khorasan Province, Iran (2017-2019)

Background: Sanctions are a type of forfeit aimed at forcing the subject to obey the desired political will. Since sanctions affect various components of the economic sectors. The purpose of this study is to investigate the effect of sanctions on food intake of households living in Khorasan Razavi province, Iran. Methods: To investigate the effect of sanctions on food intake of households living in Khorasan Razavi province, the survey data of the National Statistics Center of Iran (NSCI) on cost and income was used. 2129 households (number of households in 2017: 702, 2018: 726 and 2019: 701) were studied. In the N4 program, macronutrients and micronutrients were calculated. The studied variables were analyzed based on four income categories. In the SPSS software, quantitative variables of 2017 to 2019 were reviewed by ANOVA test and variables in pairs of the same period were reviewed by post hoc Tukey test. Results: The analysis showed that by intensifying sanctions, the cost of food has increased more than the average of income, and prices of all food groups spesifically healthy food groups have increased. The diet quality index has decreased significantly. The lower-income classes had the most insufficient dietary intake of micronutrients and the gap between dietary intake of different income classes increased during the study. Conclusion: Sanctions have affected the dietary intake due to the rise in the price of food expenditure and as a result people tend to consume cheaper and lower quality food.

Association between Socioeconomic Factors and the Risk of Gastric Cancer Incidence: Results from an Ecological Study.

Gastric cancer (GC), one of the most common cancer worldwide, remains the third leading cause of cancer-related mortality. The etiology of GC may arise from genetic and environmental factors. This study aimed to determine the association between GC incidence and socioeconomic status in Iran. An ecological study was designed to investigate the relationship between socioeconomic factors and the risk of GC incidence. The data of socioeconomic variables such as income changes, unemployment rate, urbanization ratio, inflation rate, and air pollution changes in 31 provinces were collected from the Statistical Center of Iran, and the data of GC of 31 provinces were provided from the Iranian National Population-based Cancer Registry (INPCR). Data from 2014 to 2017 was analyzed using panel data analysis, the fixed effects model by EViews software. Panel data model was suitable for the present study. Results showed that there was a positive and significant relationship between GC incidence and socioeconomic factors including income changes (P≤ 0.001), unemployment rate (P≤0.01), inflation rate (P≤ 0.05), and air pollution changes (P≤ 0.001). The urbanization ratio showed a negative relationship and was not statistically associated with GC incidence (P> 0.05). Our findings suggest a positive and significant association between socioeconomic status and GC incidence, proposing a GC risk factor. The key public health policies and welfare policies' priority should therefore be to schedule for the GC management.

Comparing food consumption during the COVID-19 pandemic: analysis of household income and expenditure survey data in Iran

BackgroundOn March 11, 2020, the WHO declared the outbreak of the infectious disease COVID-19 as a pandemic. The health strategies of nations lead to possible changes in lifestyle and increase poor eating habits. Hence, the purpose of this study is to compare food consumption during COVID-19 pandemic in Iran.MethodsThis cross-sectional study used secondary data from the Households Income and Expenditure Survey (HIES) conducted annually by the Statistical Centre of Iran. Food cost data of HIES included the amount of all food items in household food baskets during the last month. Then, they were classified into six food groups to evaluate their energy intake. The consequence of food consumption was analyzed as a function of socioeconomic status (SES) variables and residence pre- and post-COVID-19 pandemic.ResultsIn total, 75,885 households (83.5% male) were included in the study. Among the population of urban and rural areas as well as in different SES categories, people tended to increase the consumption of meat (P < 0.05) and fresh foods, especially vegetable groups (P < 0.001) and decrease the consumption of fruit (P < 0.001), fat and sweets groups (P < 0.05) and also in energy intake (P < 0.05). Macronutrient changes were different in the category of SES, urban and rural.ConclusionOur study indicated that the COVID-19 pandemic had different effects on food groups, energy and macronutrients consumption, which could be due to possible changes in food patterns as a result of the pandemic.

The 15-year national trends of endocrine cancers incidence among Iranian men and women; 2005–2020

Cancer is one of the important health problems in Iran, which is considered as the third cause of death. Endocrine cancers are rare but mostly curable. Thyroid cancer, the most common endocrine tumors, includes about one percent of malignant cancer. In this study, we examined the 15-year national trend of endocrine cancer incidence in Iranian men and women. The data in each province were evaluated based on age, gender, and cancer type according to International Classification of Disease Codes version 10 (ICD-10) from 2005 to 2020 in Iran. All data were obtained from the reports of the Statistics Center of Iran (SCI), 6 phases of the step-by-step approach to monitoring the risk factors of chronic diseases over 18 years old (STEPs), and 3 periods of the CASPIAN study (survey of non-communicable diseases in childhood and adolescence). Statistical analyzes and graph generation were done using R statistical software. Poisson regression with mixed effects was used for data modeling and incidence rate estimation. The incidence of thyroid gland malignancy is higher in women than in men. On the other hand, the incidence of adrenal gland cancer is slightly higher in men than in women. The same pattern is observed for other endocrine neoplasms and related structures. The incidence rate of these types of cancers has generally increased from 2005 to 2020 in Iran. This increase is more in women than in men. In addition, in the middle of the country, there is a strong region in terms of the occurrence of these types of cancers. The incidence rate in these provinces is relatively higher for both sexes and all studied periods. We conducted a study to observe the changing trends for various types of endocrine cancers over 15 years in men and women. Considering the increasing trend of thyroid cancers in Iran, therefore, creating essential policies for the management of these types of cancers for prevention, rapid diagnosis, and, timely treatment is particularly important.

The 15-year national trends of genital cancer incidence among Iranian men and women; 2005–2020

BackgroundCancer is a major health problem and cause of mortality worldwide. Despite the prevalence of other cancers in males and females, genital cancers are especially important because of their psychological effects on individuals. Currently, cervical cancer, corpus uteri neoplasm, and ovarian cancer are the most common gynecological cancers in Iran. Prostate cancer has increased in Iranian men in the last decade. Therefore, this study aimed to investigate the 15-year national trend in the incidence of genital cancers in the Iranian population.MethodsIn this study, we used Iranian cancer registration data collected by the Ministry of Health and Medical Education, demographic information from the reports of the Statistics Center of Iran, STEPs (STEPwise approach to non-communicable diseases risk factor surveillance), and Caspian (childhood and adolescence surveillance and prevention of adult non-communicable disease). A list of potential auxiliary variables and secondary variables at all levels of the province-age-sex were evaluated during the years. We used mixed-effects Poisson regression to model the data and calculate the incidence of each cancer.ResultsOur results show an enhancement in the outbreak of all types of male cancers, but the most important are prostate (11.46 in 2005 to 25.67 in 2020 per 100,000 males) and testicular cancers (2.39 in 2005 to 5.05 per 100,000 males). As for female cancers, there has been an increase in ovarian and corpus uteri neoplasm incidence with 6.69 and 4.14 incidences per 100,000 females in 2020, making them the most occurring female genital neoplasms. While the occurrence of cervical cancer has decreased over the years (4.65 in 2005 to 3.24 in 2020). In general, the incidence of genital cancers in men and women has amplified in the last 15 years.ConclusionsOur study examined the trend of change for each malignant genital neoplasm for 15 years in Iranian men and women in each province. Considering the growing trend of the elderly population in Iran, patient awareness and early screening are essential in reducing mortality and costs imposed on patients and the health care system.

Prevalence and intensity of cigarette smoking in Iranian households: measurement of socioeconomic inequality

ABSTRACT Background Cigarette smoking is one of the most important behavioral risk factors for chronic diseases. This study aimed to investigate socioeconomic inequalities in cigarette smoking (CS) among Iranian households. Methods Concentration index (C) was calculated to measure socioeconomic inequality in smoking and number of smoked cigarettes per month among households using data from the income-expenditure survey of the statistical center of Iran (SCI) in 2017. To identify the contribution of socioeconomic and demographic variables to the measured socioeconomic inequality, the C index was decomposed using Wagstaff method. Results The results indicated that 19.89% (N = 7547) of the households were smoking cigarettes with an average number of 87.91 (SD = 235.22) per month. The C index was −0.009 for smoking households (95% CI = −0.023, 0.006) and 0.004 (95% CI = −0.011, 0.019) for the number of cigarettes smoked per month and were not statistically significant. Most of provinces had pro-rich inequality in prevalence and intensity of CS. The province of residence had the highest contribution to inequality in smoking (66.82%) followed by SES and age of the household head. Conclusions The study concluded that the prevalence and intensity of cigarette smoking were more concentrated among low-SES groups. The strategies to control CS should be modified based on the province of residence, and socioeconomic inequalities in CS among households.

Weather or not? The role of international sanctions and climate on food prices in Iran

IntroductionThe scarcity of resources have affected food production, which has challenged the ability of Iran to provide adequate food for the population. Iterative and mounting sanctions on Iran by the international community have seriously eroded Iran's access to agricultural technology and resources to support a growing population. Limited moisture availability also affects Iran's agricultural production. The aim of this study was to analyze the influence of inflation, international sanctions, weather disturbances, and domestic crop production on the price of rice, wheat and lentils from 2010 to 2021 in Iran.MethodData were obtained from the statistical yearbooks of the Ministry of Agriculture in Iran, Statistical Center of Iran, and the Central Bank of Iran. We analyzed econometric measures of food prices, including CPI, food inflation, subsidy reform plan and sanctions to estimate economic relationships. After deflating the food prices through CPI and detrending the time series to resolve the non-linear issue, we used monthly Climate Hazards group Infrared Precipitation with Stations (CHIRPS) precipitation data to analyze the influence of weather disturbances on food prices.Results and discussionThe price of goods not only provides an important indicator of the balance between agricultural production and market demand, but also has strong impacts on food affordability and food security. This novel study used a combination of economic and climate factors to analyze the food prices in Iran. Our statistical modeling framework found that the monthly precipitation on domestic food prices, and ultimately food access, in the country is much less important than the international sanctions, lowering Iran's productive capability and negatively impacting its food security.

Direct and indirect medical costs of bladder cancer in Iran

BackgroundBladder cancer is one of the most prevalent and costly cancers in the world. Estimating the economic burden of bladder cancer is essential for allocating resources to different sectors of health systems and determining the appropriate payment mechanisms. The present study aimed at estimating the economic burden of bladder cancer in Iran.MethodsIn this study, we used a prevalence-based approach for estimating the economic burden of bladder cancer. Direct and indirect costs of bladder cancer were calculated using the cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including Iran bladder cancer clinical practice guideline, the Statistical Center of Iran, Iran’s Ministry of Cooperatives, Labor, and Social Welfare, Relative Value of Health Services (RVHS) book and Iranian Food and Drug Administration organization.The analyses were done by Microsoft Excel 2013 and Stata 13.ResultsThe number of the cases of 5-year prevalence of bladder cancer in Iran was estimated as 21,807 people in 2018. The economic burden of bladder cancer in Iran was estimated at US$ 86,695,474. Indirect medical costs constituted about two-third of the economic burden of bladder cancer, and mostly related to productivity loss due to mortality. Most of the direct medical costs (29.7%) were related to the stage T2–T3 and transurethral resection of bladder (31.01%) and radical cystectomy (19.99%) procedures.ConclusionOur results showed that the costs of bladder cancer, imposed on the healthcare system, were significant and mostly related to lost production costs. The implementation of screening and diagnostic programs can improve the survival rate and quality of life of patients and reduce the cost of lost productivity due to mortality in these patients.

Role of Health Insurance in Facing Health Expenditures Among Urban Female-headed Households in Iran

Background: Health insurance is one of the important parts of financing in the health system to reduce inequality in household health expenditures. Objectives: This study aimed to investigate the role of health insurance in facing health expenditures among urban female-headed households in Iran. Methods: This descriptive-analytical applied study was performed cross-sectionally using the double-sample selection econometrics method in Stata software (version 16) in 2021. The sample included 2645 female-headed households, and the data were prepared by the Statistics Center of Iran using a questionnaire. Results: The results showed that social security insurance, private insurance, and insurance of special organizations led to an increase in the health expenditures of female-headed households by 159896, 334137, and 18332 Rials, respectively. Increasing household size, having children, having an elderly person, increasing per capita income, and per capita tobacco expenditures led to an increase in the health expenditures of female-headed households by 875260, 1545153, 2441094, 0.32, and 1.65 Rials, respectively. Conclusions: Private insurance, social security insurance, and insurance of special organizations had the greatest impact on increasing the health expenditures of female-headed households, respectively. Therefore, it is necessary to create an integrated health insurance system that reduces insurance organizations and funds and provides the same level of coverage for health goods and services. It is also suggested to adopt policies to increase the educational level of female-headed households to reduce health expenditures.