Background: Following the re-imposition of US sanctions against Iran in 2018, unprecedented inflation has occurred in Iran’s food market that will undoubtedly affect the food security of the Iranian people. The present study aims to determine the effects of the sanctions on food prices and food security of Iranian households. Methods: Interrupted time series (ITS) analysis was applied to assess the effects of sanctions on the average retail price of food products in Iran. Household food security was estimated by calculating the share of household food expenditure. Costs of following a healthy diet based on the food pyramid were estimated. Results: The import dependency ratio of Iran’s food market was about 25%. After sanctions due to the limitations in international financial exchanges a significant increase in the prices of all food groups occurred in 2018, the year after the re-imposition of sanctions. The highest inflation rate was observed in vegetable, meat, and fruit groups. The percentage of urban and rural households in Iran that were prone to food insecurity increased from 8.84% and 25.17% to 11.2% and 29.2%, respectively, from 2017 to 2019. The annual average cost of a healthy diet for a sample Iranian family of 3.3, based on the current prices, is 341 866 008 IRR (US$2849) which is 3.6 times greater than the average amount Iranian families spent on food last year (94 505 000 IRR or US$788). Conclusion: After the re-imposition of US sanctions against Iran, food insecurity as a result of economic vulnerability, has increased and due to the current status of food prices and incomes, following a healthy diet has become more difficult for most Iranians. This makes the Iranian population more prone to chronic diseases in the near future and if this trend persists, it places the country in danger of food crisis and political instability.

Background: There are several conflicting conceptual models to explain social determinants of health (SDH) as responsible for most health inequalities. This study aimed to present these models in historical perspective and provide main component of SDH models as an SES indicators. Methods: This was a narrative study using international databases to retrieve literature dealing with conceptual models of SDH. All publication in English language until Mar 2015 was included. The CASP and PRISMA were used to summarize the literature. Results: Overall, 248 publications were retrieved and screened. After exclusion of irrelevant and duplicates, 94 citations were found to be relevant and 21 publications included in this review. In general, 21 models of SDH were found: some models presented before year 1995(n= 4), some models presented between 1995 and 2005 (n= 13) and some models presented after 2005 (n= 4). However, we found three categories of indicators that contribute to SDH models and that were classic factors, fixed and demographic factors and proxy factors. Conclusion: Reduction of socioeconomic inequalities in health requires understanding of mechanisms and causal pathways; therefore, every country needs to design the specific model. As the available models are for developed countries, lack of a specific model for developing ones is tangible. As there is no gold standard related to SES indicators, therefore, it is proposed to use the various indicators based on life course approach, which leads to understanding and adopting effective policy interventions.

The aim of this study was to measure the health-related quality of life (HRQoL) and to evaluate the factors affecting HRQoL in individuals with health insurance in Tehran, Iran. A cross-sectional analytical study was conducted using the 3-level EuroQol 5-dimensions (EQ-5D) questionnaire. In order to estimate the determinants of HRQoL, information about participants' demographic, socioeconomic, and health status was gathered. The cluster sampling technique was used to collect data from May to June, 2016. The chi-square test and weighted least squares method were employed for data analysis. Data were analyzed using Stata version 11.0. A total of 600 Iranians with insurance completed the study, of whom 327 (54.5%) were male and 273 (45.5%) were female. The mean age of the participants was 41.48 years (standard deviation [SD], 14.60 years). Meanwhile, the mean duration of education was 12.36 years (SD, 4.68 years). The mean EQ-5D score was 0.74 (SD, 0.16). The most common health problems in the participants were anxiety/depression (42.3%), followed by pain/discomfort (39.2%). Sex, age, years of schooling, income, chronic disease, and body mass index had a significant effect on HRQoL (p<0.05). Healthy insured individuals, on average, had a HRQoL score 0.119 higher than that of people with a chronic disease, all else being equal (p<0.001). Among all determinants of HRQoL, chronic disease was found to be the highest priority for interventions to improve the health status of Iranians with insurance. This finding can help policymakers and health insurance organizations improve their planning to promote the HRQoL of individuals with insurance and society as a whole in Iran.

The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage. A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.

Purpose: Life insurance is a kind of long-term investment; hence, the purpose of buying life insurance is to cover both current and future damages for the insured. Although insurance plays a crucial rule in fiscal and economic development, in MENA countries, insurance, especially life insurance, remains undeveloped, with a low penetration rate. Therefore, the purpose of this paper is to determine the factors that affect life insurance demand. Design/methodology/approach: To analyze the determinants of life insurance demand during 2004-2012, a panel data model was estimated with Eviews software. Data on population, gross domestic product (GDP), interest rate, inflation rate, and human development index are extracted from the World Bank, and data on life insurance premium are gathered from Sigma International reports. Findings: Results show that the price elasticity of life insurance demand is −0.77, the elasticity of life insurance subject to HDI is 1.68, the elasticity of life insurance subject to GDP is 0.92, and the elasticity of life insurance subject to interest rate is −0.33. The demand for life insurance has a positive significant relationship with population size. Research limitations/implications: The low elasticity of life insurance demand subject to GDP, interest rate, and inflation rate shows that the life insurance penetration rate in MENA countries is due to the dominance of compulsory insurance, and not due to voluntary purchasing of life insurance. The higher effect of HDI on the life insurance demand illustrates that, for developing the life insurance market, it is first necessary to improve the standard of life, education status, and the economic base. Originality/value: As in the MENA region life insurance has remained undeveloped and there are no related studies in this area, it can be hypothesized that the life insurance penetration rate in MENA is due to the dominance of compulsory insurance and not due to voluntary purchasing of life insurance. The higher effect of HDI on life insurance demand illustrates that, for developing the life insurance market, it is first necessary to improve the standard of life, education status, and economic base.

Effect of Governance Indicators on Under-Five Mortality in OECD Nations: Generalized Method of Moments