Development and Distribution of Causes of Death in Provinces

The Open Data Iran database is an innovative project aimed at collecting data related to Iran in one place and presenting it in easily accessible formats. Radio Farda, in collaboration with this organization, publishes a series of articles, the first of which titled 'What Do Iranians Die From?' was released last week. The second article is as follows. What can the distribution of causes of death across provinces tell us? A look at the report from the Civil Registration Organization regarding the four main causes of death in 31 provinces of the country in 1393 (2014) shows that cardiovascular diseases are the most common cause of death, but there is significant variation among the provinces regarding the next three causes. Do unequal distribution of health and medical facilities and disparities in economic welfare play a role in these differences? The second leading cause of death in 22 provinces in 1393 was two ambiguous factors: 'unknown' and 'undefined symptoms and conditions.' As seen in the chart above, in 22 provinces of the country, 'undefined symptoms and conditions' and 'unknown' are listed as the second leading cause of death, while in Tehran province, they are not among the four causes of death at all. On the other hand, according to existing reports, it is estimated that only 40% of registered deaths in Iran occur in hospitals. If the hospital death files of the deceased are complete, they can serve as the basis for determining the main cause of death. However, the status of hospital files in different regions is not uniform, just like health and medical facilities. About 15% of the rural population is outside the coverage of health houses, and mobile groups, usually dispatched from the nearest health center or county health center, collect information. It can be imagined that in such cases, the declared cause of death may lack sufficient accuracy. In 1393, across the country, over 38,000 deaths were recorded under 'undefined symptoms and conditions,' over 28,000 under 'unknown,' and about 3,500 under 'other factors.' These three ambiguous causes together account for nearly 21% of total deaths. In other words, the cause of death for about 70,000 people in the year was ambiguous! In deprived provinces like Sistan and Baluchestan, Bushehr, Hormozgan, and Kohgiluyeh and Boyer-Ahmad, we see that the four main causes of death reported are: 'cardiovascular diseases,' 'undefined symptoms and conditions,' 'accidental events,' and 'unknown.' For example, in Hormozgan province, about 30% of death cases were reported as either unknown or under undefined symptoms and conditions, while in Isfahan province, less than 9% were unknown. The prevalence of deaths due to ambiguous causes across the country not only indicates a lack of accurate and precise information for coherent planning but also reflects the unequal distribution of medical facilities and the compounded deprivation of certain regions of the country. Does the 'infectious and parasitic diseases' that ranked fourth in causes of death in Tehran indicate a serious problem in this province, or is it also a cause of death in other provinces but unreported due to lack of health and medical facilities? This report was written using data from the Open Data Iran database.