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      Productivity costs and years of potential life lost associated with five leading causes of death: Evidence from Iran (2006-2010)

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          Abstract

          Background: Economic burden due to premature mortalities is significant both on health system and on the society as a whole. This study aimed to determine the productivity costs and years of potential life lost associated with five leading causes of death in Iran from 2006 to 2010.

          Methods: Data on mortality by sex and age-groups due to five main leading causes of death (myocardial infarction (MI), cerebral vascular diseases (CVD), transport accidents (TA), hypertensive heart disease (HHD) and gastric cancer (GC)) were obtained from the Ministry of Health and Medical Education from 2006 to 2010 for 29 providences of Iran (data on Tehran province was not available). Three measures including years of potential life lost (YPLL), years of potential productive life lost (YPPLL) and the cost of productivity loss (CPL) due to premature mortality were used. To estimate the CPL and YPLL, the human capital approach and life expectancy method were used, respectively.

          Results: There were 518,815 deaths due to the five main leading causes of death; of which, 58% occurred in males. The estimated YPPLL resulted in 209,552,135 YPPLL from 2006 to 2011; of which, 141,966,592 (67%) were in males and 67,585,543 (33%) in females. The total cost of productivity loss caused by premature deaths due to the five leading causes of death was 7.86 billion dollars (US$) from 2006 to 2010, ranging from 1.63 billion dollars in 2006 to 1.31 billion dollars in 2010.

          Conclusion: This study revealed that the economic burden of premature mortalities due to the five main causes of death is substantial, and that these five leading causes should be considered in policy/decision making and prevention programms. The allocation of financial resources to control these causes may decrease their economic burden, resulting in higher level of health and well-being.

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          The burden of disease and injury in Iran 2003

          Background The objective of this study was to estimate the burden of disease and injury in Iran for the year 2003, using Disability-Adjusted Life Years (DALYs) at the national level and for six selected provinces. Methods Methods developed by the World Health Organization for National Burden of Disease (NBD) studies were applied to estimate disease and injury incidence for the calculation of Years of Life Lost due to premature mortality (YLL), Years Lived with Disability (YLD), and DALYs. The following adjustments of the NBD methodology were made in this study: a revised list with 213 disease and injury causes, development of new and more specific disease modeling templates for cancers and injuries, and adjustment for dependent comorbidity. We compared the results with World Health Organization (WHO) estimates for Eastern Mediterranean Region, sub-region B in 2002. Results We estimated that in the year 2003, there were 21,572 DALYs due to all diseases and injuries per 100,000 Iranian people of all ages and both sexes. From this total number of DALYs, 62% were due to disability premature deaths (YLD) and 38% were due to premature deaths (YLL); 58% were due to noncommunicable diseases, 28% – to injuries, and 14% – to communicable, maternal, perinatal, and nutritional conditions. Fifty-three percent of the total number of 14.349 million DALYs in Iran were in males, with 36.5% of the total due to intentional and unintentional injuries, 15% due to mental and behavioral disorders, and 10% due to circulatory system diseases; and 47% of DALYs were in females, with 18% of the total due to mental and behavioral disorders, 18% due to intentional and unintentional injuries, and 12% due to circulatory system diseases. The disease and injury causes leading to the highest number of DALYs in males were road traffic accidents (1.071 million), natural disasters (548 thousand), opioid use (510 thousand), and ischemic heart disease (434 thousand). The leading causes of DALYs in females were ischemic heart disease (438 thousand), major depressive disorder (420 thousand), natural disasters (419 thousand), and road traffic accidents (235 thousand). The burden of disease at the province level showed marked variability. DALY estimates by Iran's NBD study were higher than those for EMR-B by WHO. Conclusion The health and disease profile in Iran has made the transition from the dominance of communicable diseases to that of noncommunicable diseases and road traffic injuries. NBD results are to be used in health program planning, research, and resource allocation and generation policies and practices.
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            Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010.

            we aimed to recap and highlight the major results of the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 by mortality and morbidity to clarify the current health priorities and challenges in Iran. We estimated Iran's mortality and burden of 289 diseases with 67 risk factors and 1160 sequelae, which were used to clinically present each disease and its disability or cause of death. We produced several measures to report health loss and status: all-cause mortality, cause-specific mortality, years of life lost due to death (YLL), healthy years of life lost due to disability (YLD), disability-adjusted life years (DALYs), life expectancy, and healthy life expectancy, for three time periods: 1990, 2005, and 2010. We found out that life expectancy at birth was 71.6 years in men and 77.8 years in women. Almost 350 thousand deaths occurred in both sexes and all age groups in 2010. In both males and females and all age groups, ischemic heart disease was the main cause of death, claiming about 90 thousand lives. The main contributors to DALYs were: ischemic heart disease (9.1%), low back pain (9.0%), road injuries (7.3%), and unipolar depressive disorders (6.3%). The main causes of death under 5 years of age included: congenital anomalies (22.4%), preterm birth complications (18.3%), and other neonatal disorders (13.5%). The main causes of death among 15 - 49 year olds in both sexes included: injuries (23.6%) and ischemic heart disease (12.7%) The highest rates of YLDs were observed among 70+ year olds for both sexes (27,365 per 100,000), mainly due to low back pain, osteoarthritis, diabetes, falls, and major depressive disorder. The main risk factors to which deaths were attributable among children under 5 years included: suboptimal breast feeding, ambient PM pollution, tobacco smoking, and underweight. The most important risk factors among 15 to 49 year olds were: dietary risks, high blood pressure, high body mass index, physical inactivity, smoking, and ambient PM pollution. The pattern was similar among 50+ year olds. Although non-communicable diseases had the greatest burden in 2010, the challenge of communicable and maternal diseases for health system is not over yet. Diet and physiological risk factors appear to be the most important targets for public health policy in Iran. Moreover, Iranians would greatly benefit from effective strategies to prevent injury and musculoskeletal disorders and expand mental care. Persistent improvement is possible by strengthening the health information system to monitor the population health and evaluate current programs.
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              Productivity costs of cancer mortality in the United States: 2000-2020.

              A model that predicts the economic benefit of reduced cancer mortality provides critical information for allocating scarce resources to the interventions with the greatest benefits. We developed models using the human capital approach, which relies on earnings as a measure of productivity, to estimate the value of productivity lost as a result of cancer mortality. The base model aggregated age- and sex-specific data from four primary sources: 1) the US Bureau of the Census, 2) US death certificate data for 1999-2003, 3) cohort life tables from the Berkeley Mortality Database for 1900-2000, and 4) the Bureau of Labor Statistics Current Population Survey. In a model that included costs of caregiving and household work, data from the National Human Activity Pattern Survey and the Caregiving in the U.S. study were used. Sensitivity analyses were performed using six types of cancer assuming a 1% decline in cancer mortality rates. The values of forgone earnings for employed individuals and imputed forgone earnings for informal caregiving were then estimated for the years 2000-2020. The annual productivity cost from cancer mortality in the base model was approximately $115.8 billion in 2000; the projected value was $147.6 billion for 2020. Death from lung cancer accounted for more than 27% of productivity costs. A 1% annual reduction in lung, colorectal, breast, leukemia, pancreatic, and brain cancer mortality lowered productivity costs by $814 million per year. Including imputed earnings lost due to caregiving and household activity increased the base model total productivity cost to $232.4 billion in 2000 and to $308 billion in 2020. Investments in programs that target the cancers with high incidence and/or cancers that occur in younger, working-age individuals are likely to yield the greatest reductions in productivity losses to society.
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                Author and article information

                Journal
                Med J Islam Repub Iran
                Med J Islam Repub Iran
                MJIRI
                Med J Islam Repub Iran
                Medical Journal of the Islamic Republic of Iran
                Iran University of Medical Sciences
                1016-1430
                2251-6840
                2016
                07 September 2016
                : 30
                : 412
                Affiliations
                1 Professor of Epidemiology, Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. farid_n32@ 123456yahoo.com
                2 Associate Professor of Health Management, Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. bkm_1344@ 123456yahoo.com
                3 PhD Student in Health Economics, Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. satarrezaei@ 123456gmail.com
                4 PhD, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran, & Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. ardeshir1344@ 123456yahoo.com
                5 PhD Student in Health Economics, Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. moslemsoofi@ 123456yahoo.com
                Author notes
                (Corresponding author) PhD Student in Health Economics, Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. moslemsoofi@ 123456yahoo.com
                Article
                10.1136/bmjopen-2014-005386
                5307621
                28210577
                d5c2f002-0041-42d4-bd3a-e5c3a9eca971
                © 2016 Iran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 17 January 2016
                : 04 May 2016
                Page count
                Tables: 5, Equations: 2, References: 32, Pages: 8
                Categories
                Original Article

                economic burden,premature mortality,lost productivity,iran

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