Sex disparity in non-communicable disease burden in Iran from 1990 to 2021 based on the global burden of disease study

Non-communicable diseases (NCDs) pose a major health challenge worldwide, especially in low- and middle-income countries like Iran. Understanding sex disparities in NCDs is crucial for tailoring public health strategies to address unique risks and outcomes for different sexes. This study focused on 11 major NCD categories, estimating incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Age-standardized rates were calculated, values were presented with 95% uncertainty intervals (95% UI). Decomposition analysis assessed the impact of population growth, age structure, and incidence rates on incidence and death rates. In 2021, Iran had 80.2 million prevalent NCD cases, with slightly higher age-standardized prevalence in females. The age-standardized incidence rate was higher in females across all age groups, reaching 181,264.4 (95% UI: 165,696.5 to 200,091.3) in females and 131,900.5 (95% UI: 120,657.2 to 145,496.4) in males. Although the age-standardized death rate decreased more in males, it remained higher in males (477.6 (456.7 to 497.2)) than females (438.1 (420.3 to 455.5)). DALYs were moderately higher in females (19,983.4 (16,884.3 to 23,410.1)). In all provinces, YLLs were higher than YLDs for females, while the reverse was true for males in most provinces. These findings underscore the need for targeted public health interventions to address NCDs in females and males. While in males deaths are higher, in females DALYs are slightly higher which calls for tailored intervention to prevent death and disability.