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Iran in Transition Rouhani 9, Shirin Ahmadnia 10, Alireza Ahmadvand Iran in transition Author Danaei, Goodarz, Farzadfar, Farshad, Kelishadi, Roya, Rashidian, Arash, Rouhani, Omid M, Ahmadnia, Shirin, Ahmadvand, Alireza, Arabi, Mandana, Ardalan, Ali, Arhami, Mohammad, Azizi, Mohammad Hossein, Bahadori, Moslem, Baumgartner, Jill, Beheshtian, Arash, et al. Published 2019 Journal Title The Lancet Version Accepted Manuscript (AM) DOI https://doi.org/10.1016/S0140-6736(18)33197-0 Copyright Statement © 2019 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial- NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited. Downloaded from http://hdl.handle.net/10072/394767 Griffith Research Online https://research-repository.griffith.edu.au 1 Iran in Transition 2 3 Goodarz Danaei 1, 2, 3 †, Farshad Farzadfar 4, 5 †, Roya Kelishadi 6 †, Arash Rashidian 7, 8 † *, Omid 4 Rouhani 9, Shirin Ahmadnia 10, Alireza Ahmadvand 4, Mandana Arabi 3, 11, Ali Ardalan 12, 13, 5 Mohamad Arhami 14, Mohammad Hossein Azizi 15, Moslem Bahadori 16, Jill Baumgartner 17, Arash 6 Beheshtian 18, Shirin Djalalinia 19, 4, Leila Doshmangir 20, Ali Akbar Haghdoost 21, Rosa Haghshenas 7 4, Ahmad Reza Hosseinpoor 22 *, Farhad Islami 23, Farin Kamangar 24, 3, Davood Khalili 25, 3, Kaveh 8 Madani 26, 27, Hossein Masoumi-Asl 28, 29, Ali Mazyaki 30, 31, Ali Mirchi 32, Ehsan Moradi 33, Touraj 9 Nayernouri 34, Debbie Niemeier 35, Amir-Houshang Omidvari 36, Niloofar Peykari 37, 4, Farhad 10 Pishgar 4, Mostafa Qorbani 38, Kazem Rahimi 39, 3, Afarin Rahimi-Movaghar 40, Fahimeh Ramezani 11 Tehrani 41, Nazila Rezaei 4, Saeid Shahraz 42, 3, Amir Hossein Takian 43, Ali Tootee 44, Majid Ezzati 45 12 ‡, Hamid Reza Jamshidi 46 ‡, Bagher Larijani 47 ‡, Reza Majdzadeh 48, 12, 49 ‡, Reza Malekzadeh 50, 51 ‡ 13 14 † Authors contributed equally as first author. 15 ‡ Authors are shared corresponding authors. 16 * The authors alone are responsible for the views expressed in this publication and they do not 17 necessarily represent the views, decisions or policies of their institutions. 18 19 1 Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, 20 MA, USA 21 2 Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA 22 3 Scientific Association for Public Health in Iran, Boston, MA, USA Page 1 of 82 1 4 Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population 2 Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 3 5 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences 4 Institute, Tehran University of Medical Sciences, Tehran, Iran 5 6 Child Growth and Development Research Center, Research Institute for Primordial Prevention of 6 Non- Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran 7 7 Department of Information, Evidence and Research, Eastern Mediterranean Regional Office, 8 Word Health Organization, Cairo, Egypt 9 8 Department of Health Management and Economics, School of Public Health, Tehran University 10 of Medical Sciences, Tehran, Iran 11 9 Department of Civil Engineering and Applied Mechanics, McGill University, Montreal, Quebec, 12 Canada 13 10 Faculty of Social Sciences, Allameh Tabataba'i University, Tehran, Iran 14 11 Global Alliance for Improving Nutrition 15 12 School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 16 13 Harvard Humanitarian Initiative, Cambridge, USA 17 14 Department of Civil Engineering, Sharif University of Technology, Tehran, Iran 18 15 Academy of Medical Sciences, Tehran, Iran 19 16 Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran 20 17 Institute for Health & Social Policy, Department of Epidemiology, Biostatistics & Occupational 21 Health, McGill University, Montreal, Quebec, Canada Page 2 of 82 1 18 Cornell Program in Infrastructure Policy (CPIP), Cornell University, W. Sibley Hall, 942 University 2 Ave, Ithaca, NY 14850, USA 3 19 Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran 4 20 School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, 5 Iran 6 21 Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University 7 of Medical Sciences, Kerman, Iran 8 22 Department of Information, Evidence and Research, World Health Organization, Geneva, 9 Switzerland 10 23 Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA 11 24 Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State 12 University, Baltimore, MD, USA 13 25 Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, 14 Shahid Beheshti University of Medical Sciences, Tehran, Iran 15 26 Department of Physical Geography, Stockholm University, Stockholm, Sweden 16 27 Centre for Environmental Policy, Imperial College London, London, UK 17 28 Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, 18 Iran 19 29 Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious 20 diseases, Iran University of Medical Sciences, Tehran, Iran 21 30 Department of Economics, Allameh Tabataba'i University, Tehran, Iran 22 31 Institute for Management and Planning Studies (IMPS), Tehran, Iran Page 3 of 82 1 32 Department of Biosystems and Agricultural Engineering, Oklahoma State University, 111 2 Agriculture Hall, Stillwater, OK 74078, USA 3 33 Department of Civil Engineering and Applied Mechanics, McGill University, Montreal, Quebec, 4 Canada 5 34 Department of Neuroscience, School of Advanced Medical Technologies, Tehran University of 6 Medical Sciences, Tehran, Iran 7 35 Department of Civil and Environmental Engineering, One Shields Avenue, University of 8 California, Davis, California, USA 9 36 School of Public Health, Imperial College London, London, UK 10 37 Ministry of Health and Medical Education, Tehran, Iran 11 38 Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran 12 39 The George Institute for Global Health, University of Oxford, Oxford, UK 13 40 Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, 14 Tehran, Iran 15 41 Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid 16 Beheshti University of Medical Sciences, Tehran, Iran 17 42 Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA 18 43 Department of Health Management and Economics, School of Public Health, Tehran University 19 of Medical Sciences, Tehran, Iran 20 44 Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran 21 University of Medical Sciences, Tehran, Iran Page 4 of 82 1 45 School of Public Health, MRC-PHE Centre for Environment and Health, Imperial College London, 2 London, UK 3 46 School of Medicine, Department of Pharmacology, Shahid Beheshti University of Medical 4 Sciences, Tehran, Iran 5 47 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical 6 Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 7 48 Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran 8 49 Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, 9 Iran 10 50 Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, 11 Tehran University of Medical Science, Tehran, Iran 12 51 Non-Communicable Disease Research Center, Shiraz University of Medical Science, Shiraz, Iran 13 14 ‡ Corresponding authors 15 Majid Ezzati 16 School of Public Health, Chair in Global Environmental Health, Imperial College London, London 17 SW7 2AZ, UK, Email: [email protected], Phone: +44 (0)20 7594 0767 18 19 Hamid Reza Jamshidi 20 School of Medicine, Department of Pharmacology, Shahid Beheshti University of Medical Sciences, 21 Tehran, Iran, Email: [email protected], Phone: +98 (0)21 8848 0152 22 Page 5 of 82 1 Bagher Larijani 2 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences 3 Institute, Tehran University of Medical Sciences, Tehran, Iran, Email: [email protected], Phone: 4 +98 (0)21 8822 0094 5 6 Reza Majdzadeh 7 Community Based Participatory Research Center, Knowledge Utilization Research Center and 8 School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, E-mail: 9 [email protected] 10 11 Reza Malekzadeh 12 Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran 13 University of Medical Science, Tehran and Non-Communicable Disease Research Center, Shiraz 14 University of Medical Science, Shiraz, Iran, Email: [email protected], Phone: +98 (0)21 8241 5104 15 16 Word count: 13, 299 Page 6 of 82 1 Summary 2 Being the second-largest country in the Middle East, Iran has a long history of civilization during 3 which it has witnessed the overthrowing and establishment of several dynasties and 4 reorganization of health-related structures. It has witnessed replacement of traditional practices 5 with modern medical treatments, emergence of multiple pioneer scientists and physicians with 6 great contributions to the advancement of science, environmental and ecological changes in 7 addition to large-scale natural disasters,
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