Impacts of economic sanctions on population health and health system: a study at national and sub-national levels from 2000 to 2020 in Iran

Table 4 Results of mediation analysis; the relationship between healthcare and health indicators and economic sanctions

Numb	Indicators	Multiplicative direct effect¹	p-value²
1	Household health expenditure (%)	0.89	0.15
2	Out of Pocket (%) (OOP)	1.15	0.001
3	The share of household expenditure on food (%)	1.06	0.01
4	Total hospital beds	1.00	0.001
5	Neonatal mortality rate (NMR)	0.92	0.001
6	Under-five mortality rate (per 1000 live births)	0.92	0.001
7	Maternal mortality ratio MMR)	0.87	0.001
8	Cardiovascular disease mortality rate	0.95	0.92
9	Hypertension mortality rate	1.01	0/001
10	Myocardial infarction mortality rate	0.96	0.06
11	COPD mortality rate	1.05	0.41
12	Diabetes mortality rate	0.87	0.001
13	Multiple sclerosis mortality rate	0.83	0.02
14	Thalassemia mortality rate	1.02	0.01
15	Stroke mortality rate	0/91	0.06
16	Brain tumor mortality rate	0.86	0.001
17	Leukemia mortality rate	0.89	0.38
18	Lung cancer mortality rate	0.93	0.14
19	Colorectal cancer mortality rate	0.74	0.001
20	Gastric cancer mortality rate	0.90	0.58
21	Prostate cancer mortality rate	0.94	0.01
22	Breast cancer mortality rate	0.92	0.001
23	Total cancer mortality rate	0.88	0.01

1.“Multiplicative direct effect” show the direct impact of sanctions (by considering the mediator variables). It reflects the percentage change in each indicator during the sanction period. The difference of the reported statistic with 1 indicates the percentage of changes. For example, the average of “household health expenditure (%)” in years with sanctions is 11% less than the years without
2. The “p-value” serves as a crucial metric in determining the significance of the impact of sanctions on the studied indicators, providing insight into whether the observed effects on the index are statistically significant

ISSN: 1744-8603