Trends in Incidence, Prevalence, and Mortality of Non-communicable Diseases in Iraq (2003-2021)

Trends in Incidence, Prevalence, and Mortality of Non-communicable Diseases in Iraq (2003-2021) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Trends in Incidence, Prevalence, and Mortality of Non-communicable Diseases in Iraq (2003-2021) Mohammed Merzah This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5193836/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 29 Jan, 2025 Read the published version in BMC Public Health → Version 1 posted 4 You are reading this latest preprint version Abstract Background : Non-communicable diseases (NCDs) have become a major public health concern in Iraq, playing a significant role in the country's morbidity and mortality rates. To offer a thorough overview of the patterns and the overall impact of NCDs on public health, this study aim to map the trends in the incidence, prevalence, and mortality rates of NCDs in Iraq between 2003 and 2021. Methods : Data from the Global Burden of Disease (GBD) Study 2021were utilized. The focus was on Iraq from 2003 to 2021, a period marked by significant social and political changes. Using the GBD results tool, age-standardized prevalence, incidence, and mortality rates (ASPR, ASIR, ASMR) for 12 major NCDs were extracted and expressed per 100,000 population. Descriptive statistics with 95% uncertainty intervals were calculated, and trends were analyzed. Results : The analysis revealed a nuanced trajectory of NCDs in Iraq between 2003 and 2021. The ASPR of all NCDs increased slightly (change %: 0.07, 95% UI: −0.06 to 0.14), with a notable decline in chronic respiratory diseases (change %: −14.41, 95% UI: −21.63 to −14.30) and a significant rise in neoplasms (change %: 32.66, 95% UI: 31.16 to 32.12). The ASIR of diabetes and kidney diseases showed the largest increase (change %: 42.92, 95% UI: 36.00–49.78), while chronic respiratory diseases had the greatest decline (change %: −12.09, 95% UI: −26.23–2.94). Cardiovascular diseases remained the leading cause of mortality in both sexes, with ASMRs increasing slightly for males and decreasing for females over the period. Skin and subcutaneous diseases showed the highest increase in ASMR (change %: 48.15), while digestive diseases experienced the largest decline (change %: −21.41). Conclusion : The GBD 2021 study highlights progress in reducing NCD mortality in Iraq, especially among younger people. However, older males still face high death rates from cardiovascular diseases. Rising cases of cancer, diabetes, and kidney diseases signal the need for targeted interventions. Continued focus on risk factors and healthcare access is essential. NCDs Iraq trend incidence prevalence mortality Figures Figure 1 Introduction The evolving landscape of Iraqi healthcare faces a formidable challenge with the emergence of non-communicable diseases (NCDs) 1 . While significant strides have been made in combating infectious diseases, the escalating burden of NCDs demands immediate attention. Lifestyle shifts and the adversities following prolonged conflict have propelled conditions such as cardiovascular diseases, diabetes, and cancer to the forefront of healthcare concerns 2 , 3 . The burden of these diseases poses significant socio-economic implications and strains healthcare infrastructures, necessitating a realignment of healthcare priorities and resources to address the growing incidence and impact of NCDs effectively. Implementing robust strategies emphasising prevention, early diagnosis, and effective management is crucial to mitigate the adverse effects on public health and enhance the quality of life for the Iraqi population 4 . NCDs have emerged as a significant public health challenge in Iraq, contributing substantially to morbidity and mortality. The leading NCDs—cardiovascular diseases, diabetes, cancers, and chronic respiratory conditions—are responsible for the majority of deaths in the country 5 , 6 . According to the World Health Organization (WHO), NCDs account for more than half of all fatalities in Iraq, with cardiovascular diseases alone contributing nearly 40% of these deaths 6 . Several factors contribute to the growing prevalence of NCDs in Iraq, including lifestyle changes such as increased consumption of unhealthy foods, reduced physical activity, and widespread tobacco use 7 . Prolonged conflict and instability have weakened healthcare systems, restricting access to preventive and treatment services 8 , 9 . Furthermore, the stress and trauma associated with extended conflict have indirectly fueled the rise of NCDs through increased risk behaviours, such as smoking and poor dietary habits 10 , 11 . The Iraqi healthcare system struggles to cope with the increasing burden of NCDs 12 . Ongoing economic and political instability has obstructed the creation of robust public health policies and delayed the rollout of widespread screening and prevention initiatives 12 . Consequently, many NCDs are diagnosed at advanced stages, complicating treatment and management efforts. Addressing the growing NCD crisis in Iraq requires a multifaceted approach that involves strengthening healthcare systems, implementing effective public health campaigns to raise awareness about risk factors, and promoting healthier lifestyles. Collaborative efforts among the government, international organisations, and local communities are essential to curbing the rise of NCDs and improving the overall health of the Iraqi population. This study aims to map the incidence, prevalence, and mortality rates of NCDs in Iraq from 2003 to 2021, providing a comprehensive understanding of the trends and burden of these diseases. By analysing these data, the study seeks to inform future healthcare strategies that address the urgent NCD crisis in the country. Methods Data Source Data from the Global Burden of Disease (GBD) Study 2021 was utilized for this analysis. These data provide standardized estimates of health metrics for different diseases and injuries across 204 countries and territories. The GBD study enables a detailed assessment and measurement of health loss and trends in non-communicable diseases (NCDs) over time. This study analyzed trends for 12 major NCDs, such as cardiovascular diseases and diabetes. Study Population and Time Frame Iraq faced significant social and political changes after 2003, including post-conflict scenarios, which may have had consequences on health. Due to the nature of GBD data, which includes populations of all ages and both sexes, and with the most recent available data from 2021, the period of focus for this analysis is from 2003 to 2021. Health Metrics Analyzed Using the GBD results tool, age-standardized rates (ASRs) were extracted for Iraq from the GBD 2021 database. The study focused on the following metrics: age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age-standardized mortality rate (ASMR). The ASPR represents the total number of existing cases, the ASIR refers to the number of new cases of a disease, and the ASMR represents the number of deaths due to a disease. All ASRs were expressed per 100,000 population, adjusted for age, in a specific year. Statistical Analysis Descriptive statistics of ASRs with 95% of uncertainty intervals were done for all major NCDs. Trends in rates from 2003 to 2021were calculated using Eq. 1 . All calculation was done using SPSS V. 25. \(\:Percentage\:change=\frac{\left(ASR\:in\:2021-ASR\:in\:2003\right)}{ASR\:in\:2003}\times\:100\:\:\:\:\:\) Eq. 1 Ethical Considerations Due to the nature of the publically available GBD data and the lack of direct involvement of human subjects, no ethical approval was required. Results Utilizing data from the Global Burden of Disease (GBD) study 2021 ( http://ghdx.healthdata.org/gbd-results-tool ), this analysis observed a nuanced trajectory of NCDs in Iraq from 2003 to 2021. While the age-standardized prevalence of all NCDs among both sexes exhibited a slight increase (change %: 0.07, 95% UI: −0.06 to 0.14), chronic respiratory diseases showed a marginal decline (change %: −14.41, 95% UI: −21.63 to − 14.30). Conversely, neoplasms demonstrated a worrisome escalation (change %: 32.66, 95% UI: 31.16 to 32.12) (Table 1 ). Table 1 The age-standardized prevalence rate of non-communicable diseases in Iraq 2003–2021. Non communicable diseases Gender ASPR in 2003 Rate (95% UL: LL, UL) ASPR in 2021 Rate (95% UL: LL, UL) Change (%) from 2003 to 2021 (95% UL: LL, UL) All Male 88,773.93 (87,431.66, 90,095.32) 88,935.71 (87,652.59, 90,241.90) 0.18 (0.25, 0.16) Female 94,245.03 (93,411.01, 95,029.52) 94,150.96 (93,284.37, 94,987.71) -0.10 (-0.25, -0.23) Both sexes 91,389.64 (90,323.30, 92,418.01) 91,451.26 (90,397.46, 92,473.25) 0.07 (0.14, 0.06) Cardiovascular diseases Male 11,635.38 (11,157.51, 12,085.64) 11,779.18 (11,159.85, 12,437.74) 1.24 (0.01, 2.92) Female 8,885.56 (8,488.28, 9,263.48) 9,125.62 (8,612.59, 9,658.38) 2.71 (0.70, 4.27) Both sexes 10,230.44 (9,796.16, 10,631.88) 10,418.89 (9,875.44, 11,011.53) 1.84 (0.92, 3.57) Chronic respiratory diseases Male 5,982.26 (5,380.95, 6,692.91) 5,100.23 (4,536.64, 5,800.73) -14.69 (-14.28, -23.40) Female 6,032.19 (5,486.08, 6,639.55) 5,185.17 (4,679.07, 5,798.72) -14.08 (-14.31, -21.84) Both sexes 5,985.97 (5,430.58, 6,643.71) 5,124.14 (4,592.51, 5,759.32) -14.41 (-14.30, -21.63) Diabetes and kidney diseases Male 16,833.99 (16,032.95, 17,703.71) 21,535.04 (20,415.69, 22,773.86) 28.25 (27.59, 27.48) Female 16,747.96 (15,996.11, 17,479.80) 20,889.31 (19,834.26, 22,073.08) 24.38 (23.65, 14.64) Both sexes 16,784.38 (16,040.28, 17,544.95) 21,210.88 (20,180.11, 22,305.88) 26.40 (25.91, 27.08) Digestive diseases Male 33,493.10 (31,695.03, 35,443.90) 35,808.84 (33,926.81, 37,840.90) 6.92 (6.63, 6.75) Female 35,184.29 (33,418.91, 36,962.37) 37,461.25 (35,662.76, 39,419.32) 6.46 (6.25, 3.93) Both sexes 34,310.50 (32,605.39, 36,124.33) 36,604.44 (34,815.71, 38,573.43) 6.67 (6.59, 6.85) Mental disorders Male 12,820.01 (11,745.44, 14,056.46) 13,527.69 (12,008.58, 15,240.14) 5.52 (2.23, 8.57) Female 15,350.84 (14,075.47, 16,788.91) 16,831.44 (14,558.02, 19,552.89) 9.64 (10.12, 16.45) Both sexes 14,028.09 (12,899.24, 15,347.44) 15,121.87 (13,269.26, 17,153.75) 7.77 (8.43, 11.77) Musculoskeletal disorders Male 14,720.83 (13,628.68, 15,856.95) 15,491.53 (14,296.01, 16,747.11) 5.23 (6.33, 5.58) Female 22,242.27 (20,666.94, 23,727.74) 23,180.66 (21,562.47, 24,844.56) 4.22 (4.15, 4.83) Both sexes 18,366.84 (17,083.28, 19,622.45) 19,218.78 (17,873.25, 20,560.10) 4.65 (4.64, 4.77) Neoplasms Male 603.85 (511.25, 711.81) 830.26 (676.41, 968.46) 37.45 (32.34, 36.23) Female 1,154.02 (975.18, 1,386.24) 1,504.94 (1,244.84, 1,790.50) 30.40 (29.05, 29.03) Both sexes 865.97 (737.85, 1,018.76) 1,148.63 (958.7, 1,337.50) 32.66 (32.12, 31.16) Neurological disorders Male 32,256.13 (28,971.08, 35,655.24) 32,279.24 (29,032.79, 35,641.97) 0.07 (0.01, -0.04) Female 38,164.14 (34,968.15, 41,693.40) 38,174.23 (35,086.96, 41,718.59) 0.03 (0.01, 0.06) Both sexes 35,083.71 (31,999.55, 38,305.47) 35,124.88 (32,069.47, 38,353.06) 0.12 (0.12, 0.13) Other non-communicable diseases Male 65,214.12 (61,356.65, 69,416.87) 64,792.97 (60,831.38, 69,082.50) -0.65 (-0.84, -0.48) Female 86,073.83 (84,108.42, 87,850.16) 85,491.51 (83,446.04, 87,507.74) -0.68 (-0.76, -0.59) Both sexes 75,154.59 (72,400.63, 78,037.74) 74,726.54 (71,949.63, 77,909.05) -0.57 (-0.73, -0.40) Sense organ diseases Male 23,299.74 (21,779.34, 25,227.66) 23,309.40 (21,855.51, 25,162.20) 0.04 (0.00, 0.08) Female 24,152.67 (22,178.84, 26,826.44) 24,136.87 (22,158.86, 26,935.63) -0.06 (-0.12, 0.00) Both sexes 23,715.37 (22,044.94, 25,965.41) 23,704.40 (22,053.43, 25,953.02) -0.05 (-0.10, 0.00) Skin and subcutaneous diseases Male 17,200.61 (16,720.26, 17,661.62) 18,616.54 (18,122.29, 19,131.07) 8.22 (7.50, 9.00) Female 17,760.41 (17,265.13, 18,289.52) 19,168.23 (18,647.40, 19,703.41) 7.91 (7.00, 8.75) Both sexes 17,464.83 (17,013.63, 17,923.75) 18,876.21 (18,373.36, 19,380.93) 8.06 (7.25, 8.85) Substance use disorders Male 978.95 (845.79, 1,124.57) 936.97 (808.69, 1,072.83) -4.27 (-6.00, -2.50) Female 554.88 (478.23, 636.63) 529.84 (461.46, 604.5) -4.51 (-6.00, -3.00) Both sexes 777.16 (675.59, 885.47) 741.48 (645.01, 845.82) -4.59 (-6.00, -3.00) ASPR = Age-standardized prevalence rate; LL = lower limit; UL = upper limit. Bold fonts represent the highest increase or decrease in percentage changes. Regarding the age-standardized incidence rate (ASIR) for both sexes, the ASIR of all NCDs increased slightly (change %: 0.74, 95% UI: −3.06, 4.36). Diabetes and kidney diseases showed the highest increase from 2003 to 2021 (change %: 42.92, 95% UI: 36.00–49.78), while chronic respiratory diseases showed the largest decline (change %: −12.09, 95% UI: −26.23–2.94). Among males, skin and subcutaneous diseases was the highest in both years, with ASIRs of 36,588.10/100,000 (95% UI: 35,102.96–38,054.50) in 2003 and 38,270.15/100,000 (95% UI: 36,723.92–39,724.56) in 2021. Similarly, among females, skin and subcutaneous diseases also had the highest ASIR, with rates of 36,409.70/100,000 (95% UI: 35,058.75 to 37,874.24) in 2003 and 38,088.83/100,000 (95% UI: 36,701.87 to 39,616.05) in 2021. (Table 2 ). Table 2 The age-standardized incidence rate of non-communicable diseases in Iraq 2003–2021. Non-communicable diseases Gender ASIR in 2003 Rate (95% UL: LL, UL) ASIR in 2021 Rate (95% UL: LL, UL) Change (%) from 2003 to 2021 (95% UL: LL, UL) All causes Male 120,431.83 (112,626.18, 130,135.32) 120,094.75 (113,250.94, 127,925.90) -0.28 (− 5.05, 4.62) Female 160,173.94 (152,527.80, 168,362.36) 162,548.50 (154,491.91, 171,160.92) 1.48 (− 3.45, 6.80) Both sexes 139,299.31 (131,967.42, 147,524.38) 140,336.31 (132,817.79, 147,916.88) 0.74 (− 3.06, 4.36) Cardiovascular diseases Male 1,689.09 (1,509.82, 1,906.66) 1,744.40 (1,560.02, 1,964.49) 3.26 (− 18.13, 6.61) Female 1,191.51 (1,079.44, 1,323.89) 1,183.05 (1,066.07, 1,317.15) -0.39 (− 4.61, 1.75) Both sexes 1,436.72 (1,302.48, 1,608.13) 1,455.30 (1,320.00, 1,620.39) 1.80 (− 17.35, 5.75) Chronic respiratory diseases Male 780.23 (664.88, 947.40) 679.98 (578.35, 821.44) -12.85 (− 25.54, -1.08) Female 728.41 (629.62, 865.19) 646.76 (555.19, 784.89) -11.23 (− 23.88, 0.48) Both sexes 752.89 (649.26, 902.52) 661.97 (570.12, 795.00) -12.09 (− 26.23, 2.94) Diabetes and kidney diseases Male 752.43 (709.31, 799.81) 1,113.19 (1,051.38, 1,188.27) 47.94 (40.02, 55.43) Female 851.25 (804.78, 903.14) 1,180.17 (1,118.55, 1,247.16) 38.61 (32.62, 45.00) Both sexes 802.26 (760.49, 846.06) 1,146.68 (1,086.17, 1,211.80) 42.92 (36.00, 49.78) Digestive diseases Male 6,492.90 (5,968.97, 7,020.26) 6,655.40 (6,135.59, 7,181.03) 2.51 (− 12.45, 17.19) Female 7,839.39 (7,231.84, 8,470.84) 7,953.37 (7,376.37, 8,581.88) 1.45 (− 12.65, 10.79) Both sexes 7,143.64 (6,569.38, 7,698.35) 7,280.54 (6,711.11, 7,844.28) 1.91 (− 12.83, 11.33) Mental disorders Male 4,120.59 (3,742.05, 4,634.14) 5,169.08 (4,220.17, 6,385.72) 25.41 (13.83, 38.55) Female 5,979.81 (5,386.58, 6,826.82) 7,612.51 (6,050.74, 9,545.45) 27.29 (17.35, 39.05) Both sexes 5,013.80 (4,538.81, 5,675.98) 6,345.72 (5,170.50, 7,869.69) 26.47 (15.65, 38.14) Musculoskeletal disorders Male 4,042.58 (3,661.36, 4,435.26) 4,025.00 (3,628.81, 4,420.79) -0.44 (− 10.96, 10.57) Female 5,703.77 (5,126.37, 6,280.68) 5,712.74 (5,172.24, 6,322.03) 0.19 (− 10.53, 10.15) Both sexes 4,844.05 (4,390.94, 5,317.95) 4,838.77 (4,377.19, 5,322.85) -0.11 (− 10.89, 10.78) Neoplasms Male 307.22 (261.77, 356.86) 349.46 (296.50, 399.80) 13.73 (− 9.23, 44.92) Female 470.94 (390.40, 568.09) 517.20 (437.79, 619.01) 9.84 (− 6.74, 25.69) Both sexes 383.47 (324.11, 450.33) 426.34 (365.94, 500.19) 11.19 (− 3.78, 26.99) Neurological disorders Male 9,587.96 (8,435.60, 10,705.22) 9,591.82 (8,441.09, 10,718.25) 0.03 (− 3.73, 4.05) Female 10,243.43 (9,090.66, 11,278.80) 10,244.73 (9,086.59, 11,325.82) 0.01 (− 3.74, 4.06) Both sexes 9,903.75 (8,808.38, 10,948.63) 9,911.31 (8,814.46, 10,977.26) 0.04 (− 3.68, 4.06) Other non-communicable diseases Male 55,717.07 (48,037.77, 64,757.05) 52,163.75 (45,013.56, 59,886.25) -9.14 (− 16.56, -1.81) Female 90,644.89 (83,552.59, 98,800.23) 89,319.40 (81,552.61, 97,672.81) -1.46 (− 1.63, -1.29) Both sexes 72,291.29 (65,251.08, 80,359.25) 69,896.37 (63,125.13, 77,396.77) -3.30 (− 3.66, -2.94) Sense organ diseases Male 2.80 (1.27, 6.83) 2.99 (1.37, 6.98) 6.78 (− 11.31, 113.37) Female 4.27 (2.06, 9.15) 4.56 (2.18, 9.63) 6.80 (− 11.44, 121.38) Both sexes 3.51 (1.63, 8.09) 3.75 (1.76, 8.39) 6.83 (− 9.99, 130.24) Skin and subcutaneous diseases Male 36,588.10 (35,102.96, 38,054.50) 38,270.15 (36,723.92, 39,724.56) 4.63 (− 2.81, 5.44) Female 36,409.70 (35,058.75, 37,874.24) 38,088.83 (36,701.87, 39,616.05) 4.63 (− 2.81, 5.44) Both sexes 36,490.08 (35,151.65, 37,877.67) 38,157.76 (36,700.30, 39,610.58) 4.58 (− 2.89, 5.32) Substance use disorders Male 414.37 (354.11, 489.57) 401.91 (339.26, 468.14) -2.63 (− 16.58, 12.53) Female 239.15 (204.25, 282.10) 232.52 (198.25, 273.65) -2.77 (− 7.60, 19.29) Both sexes 331.10 (284.66, 386.77) 320.63 (272.06, 373.10) -3.47 (− 12.76, 14.92) ASIR = Age-standardized incidence rate; LL = lower limit; UL = upper limit. Bold fonts represent the highest increase or decrease in percentage changes. In terms of age-standardized mortality rates (ASMR) among both sexes, skin and subcutaneous diseases showed the highest increase (change %: 48.15, 95% UI: −19.44 to 81.94). However, digestive diseases showed the largest decline from 2003 to 2021 (change %: −21.41, 95% UI: −54.08 to 17.72). Among males and females separately, cardiovascular disease was the dominant cause of death in 2003, with ASMRs of 530.13/100,000 (95% UI: 421.12–664.2) for males and 414.15/100,000 (95% UI: 329.93–514.69) for females. In 2021, the ASMRs were 565.76/100,000 (95% UI: 448.82–656.26) for males and 399.63/100,000 (95% UI: 336.38–462.88) for female (Table 3 ). Table 3 The age-standardized mortality rate of non-communicable diseases in Iraq 2003–2021. Non-communicable diseases Gender ASIR in 2003 Rate (LL, UL) ASIR in 2021 Rate (LL, UL) Change (%) from 2003 to 2021 (95% UL: LL, UL) All causes Male 814.12 (649.20, 1,019.53) 875.63 (689.85, 999.50) 7.56 (− 4.82, 14.34) Female 641.77 (522.51, 794.51) 632.64 (538.39, 732.47) -1.42 (− 3.32, 0.52) Both sexes 724.78 (585.40, 901.39) 745.50 (608.77, 848.72) 2.85 (− 3.02, 6.05) Cardiovascular diseases Males 530.13 (421.12, 664.2) 565.76 (448.82, 656.26) 6.72 (− 20.22, 55.82) Females 414.15 (329.93, 514.69) 399.63 (336.38, 462.88) -3.51 (− 8.70, 8.80) Both sexes 470.72 (378.89, 588.45) 477.6 (397.13, 553.39) 1.46 (− 12.81, 34.80) Chronic respiratory diseases Males 25.57 (19.41, 33.85) 24.06 (16.97, 29.65) -5.91 (− 28.11, 21.88) Females 14.07 (10.61, 19.46) 12.44 (9.55, 16.34) -11.60 (− 31.17, 17.92) Both sexes 19.43 (15.11, 25.29) 17.62 (13.44, 21.65) -9.31 (− 27.15, 12.34) Diabetes and kidney diseases Males 76.83 (58.12, 101.1) 100.64 (69.56, 122.96) 31.01 (− 10.30, 111.49) Females 70.86 (55.68, 90.5) 84.69 (67.09, 104.97) 19.52 (− 9.61, 76.05) Both sexes 73.54 (57.07, 94.66) 91.99 (70.34, 110.47) 25.11 (− 7.94, 65.47) Digestive diseases Males 27.92 (20.85, 36.95) 23.33 (16.28, 30.51) -16.45 (− 43.52, 18.40) Females 18.28 (13.6, 24.27) 13.38 (10.24, 17.28) -26.82 (− 64.82, 23.73) Both sexes 22.97 (17.42, 29.27) 18.06 (13.43, 22.66) -21.41 (− 54.08, 17.72) Musculoskeletal disorders Males 0.22 (0.12, 0.32) 0.24 (0.12, 0.31) 9.09 (− 50.00, 158.33) Females 1.05 (0.76, 1.43) 0.89 (0.66, 1.17) -15.24 (− 27.32, 10.27) Both sexes 0.63 (0.46, 0.85) 0.57 (0.42, 0.73) -9.52 (− 32.20, 18.51) Neoplasms Males 92.05 (69.68, 116.23) 109.52 (82.68, 130.9) 18.97 (− 19.23, 63.89) Females 65.71 (51.21, 84.94) 75.3 (59.86, 92.53) 14.60 (− 16.89, 57.09) Both sexes 77.9 (60.18, 99.6) 90.54 (70.03, 109.02) 16.19 (− 18.93, 58.27) Neurological disorders Males 32.79 (14.21, 74.94) 34.73 (16.63, 72.21) 5.91 (− 49.27, 408.19) Females 32.85 (11.84, 79.48) 32.9 (12.02, 76.74) 0.15 (− 62.70, 548.48) Both sexes 32.84 (12.95, 78.41) 33.73 (14.06, 74.56) 2.71 (− 58.94, 475.88) Other non-communicable diseases Males 25.89 (20.13, 32.36) 14.39 (11.19, 18.62) -44.41 (− 83.65, -7.47) Females 23.65 (17.76, 28.57) 12.32 (9.7, 15.86) -47.93 (− 108.27, 1.10) Both sexes 24.78 (20.38, 29.31) 13.34 (10.69, 16.77) -46.16 (− 95.21, 9.52) Skin and subcutaneous diseases Males 0.28 (0.2, 0.39) 0.46 (0.32, 0.59) 64.29 (− 17.54, 179.50) Females 0.25 (0.18, 0.35) 0.35 (0.27, 0.45) 40.00 (− 22.22, 150.00) Both sexes 0.27 (0.2, 0.36) 0.4 (0.3, 0.49) 48.15 (− 19.44, 81.94) Substance use disorders Males 2.44 (1.72, 3.47) 2.51 (1.8, 3.68) 2.87 (− 26.23, 113.95) Females 0.91 (0.65, 1.22) 0.75 (0.55, 1) -17.58 (− 39.57, 35.71) Both sexes 1.65 (1.2, 2.15) 1.61 (1.18, 2.13) -2.42 (− 25.45, 45.73) ASMR = Age-standardized mortality rate; LL = lower limit; UL = upper limit. Bold fonts represent the highest increase or decrease in percentage changes. Figure 1 comparing CVD mortality rates in Iraq between 2003 and 2021 shows clear age-related trends, with mortality rates increasing steadily with age, particularly after the age of 55. Males consistently exhibit higher mortality rates compared to females across all age groups, with the gap widening significantly in older populations. From 2003 to 2021, there is a notable decline in ASMR across almost all age groups, particularly among younger individuals (20–44 years), indicating the success of preventive measures and early interventions. Discussion The findings from the GBD study 2021 offer a comprehensive overview of the shifting landscape of NCDs in Iraq from 2003 to 2021. The nuanced trajectory observed highlights progress and emerging challenges in managing the burden of NCDs over nearly two decades. These findings point to a complex public health landscape, where challenges in others offset progress in some areas, necessitating targeted interventions to address the evolving burden of NCDs in Iraq. Neoplasms underscore a growing concern in Iraq during the studied period in terms of prevalence, incidence, and mortality. A recent study reported a rise in the crude incidence rate of all types of cancer from 2012 to 2020 13 . Similarly, another study revealed that all cancers, particularly lung and gastrointestinal, steadily increased after 2007, affecting both sexes equally 3 . The burden of neoplasms is not limited to Iraq but is also a significant concern in other Arab countries. A study using GLOBOCAN data highlighted a high incidence of cancers among younger Arabs 14 . The incidence of diabetes and kidney diseases increased significantly in 2021 compared to 2003. This trend aligns with an analysis assessing the burden of chronic kidney disease among adults with type 2 diabetes, which revealed a 21.8% increase in the ASIR of diabetes and kidney diseases globally since 1990 15 . A review has also shown a rise in the prevalence and incidence of diabetes worldwide, with changes in clinical practices impacting the epidemiology of chronic kidney disease in recent years 16 . Our analysis showed a decline in the age-standardized incidence rate (ASIR) of chronic respiratory diseases from 2003 to 2021. Interestingly, a study analyzing GBD 2019 data for North Africa and the Middle East found a 10.3% rise in ASIR alongside a 32.9% reduction in the age-standardized mortality rate (ASMR) since 1990. However, this upward trend in incidence did not extend to Iraq, Iran, Bahrain, and Yemen, where a decline was observed instead 17 . Our analysis revealed that skin and subcutaneous diseases had the highest increase in cause of death in 2021, although the rate remains low compared to other diseases. Corresponding to this analysis, a study on GBD 2019 data indicated that the highest burden of skin and subcutaneous diseases was observed in lower-middle sociodemographic index countries, where Iraq is categorized 18 . A notable decline in the ASMR among almost all age group and particular among individuals aged 20 to 44 years, indicating the success of preventive measures and early interventions. However, despite this progress, mortality rates remain persistently high among the elderly, especially males over 60, suggesting the need for targeted healthcare interventions for this group. The gender disparity in mortality highlights the importance of gender-specific strategies to further reduce the CVD burden. Overall, while the improvements are encouraging, especially for younger populations, the data suggest that efforts should continue to focus on managing chronic diseases and addressing risk factors, particularly among older males. Various factors contribute to the increasing prevalence of non-communicable diseases (NCDs). The aging population, coupled with shifts in lifestyle behaviors such as diet and tobacco use, has intensified the burden of these diseases 13 . Moreover, disparities in healthcare access exacerbate the situation for at-risk populations, delaying timely interventions. These challenges have been evident in Iraq over the last decade and likely play a significant role in the growing prevalence of NCDs 12 . An analysis of ASPRs across Middle Eastern countries reveals a concerning trend of rising NCD burdens. However, in the case of Iraq, the lack of disease-specific data presents a significant challenge in drawing definitive conclusions. While this analysis offers valuable insights into existing trends, its effectiveness is limited by the absence of detailed disease information. Future research should focus on identifying risk factors and evaluating preventive strategies and treatment approaches. It is important to acknowledge certain limitations in this analysis. The GBD data for Iraq, especially during periods of conflict, may be affected by underreporting or misclassification. Furthermore, this study identifies trends but does not establish causal relationships. Additional research is needed to explore the underlying factors driving NCD trends in Iraq. Conclusion The findings from the GBD 2021 study illustrate both progress and ongoing challenges in managing NCDs in Iraq from 2003 to 2021. While significant strides have been made in reducing mortality among younger populations, particularly for chronic respiratory diseases, the persistent high mortality rates among older males, especially from cardiovascular diseases, indicate the need for more targeted interventions. The rising prevalence of neoplasms, diabetes, and kidney diseases underscores the growing burden of NCDs, exacerbated by lifestyle changes and healthcare disparities. Continued efforts to address risk factors, improve healthcare access, and focus on preventive strategies, particularly for vulnerable and older populations, are essential for further progress. Declarations Clinical trial number not applicable Funding no funding to be disclose. Author Contribution Dear Editor, The sole author of the paper titled "Trends in Incidence, Prevalence, and Mortality of Non-communicable Diseases in Iraq (2003-2021)" is Mohammed Merzah. Merzah conceived the study, designed the research, collected and analyzed the data, interpreted the results, and wrote the manuscript.Sincerely, Merzah Data Availability Utilizing data from the Global Burden of Disease (GBD) study 2021 (http://ghdx.healthdata.org/gbd-results-tool ) References Hussain AM, Lafta RK. Burden of non-communicable diseases in Iraq after the 2003 war. Saudi Med J. 2019;40:72–8. Mawaw PM, et al. Increased prevalence of obesity, diabetes mellitus and hypertension with associated risk factors in a mine-based workforce, democratic Republic of Congo. Pan Afr Med J. 2019;34:1–17. Hussain AMA, Lafta RK. Cancer trends in Iraq 2000–2016. Oman Med J. 2021;36:1–8. Bennis A, et al. Strategic Recommendations to Bridge the Gaps in Awareness, Diagnosis and Prevention of Heart Failure in the Middle East Region and Africa. J Saudi Hear Assoc. 2022;34:53–65. Pham BN, et al. Non-communicable diseases attributed mortality and associated sociodemographic factors in Papua New Guinea: Evidence from the Comprehensive Health and Epidemiological Surveillance System. PLOS Glob public Heal. 2022;2:e0000118. Noncommunicable diseases. WHO in Iraq https://www.emro.who.int/iraq/priority-areas/noncommunicable-diseases.html W H O. Chronic noncommunicable diseases risk factors survey in Iraq . Ministry of health and ministry of planning and development cooperation, in collaboration with WHO (2006). Bogale B, Scambler S, Mohd Khairuddin AN, Gallagher JE. Health system strengthening in fragile and conflict-affected states: A review of systematic reviews. PLoS ONE 19, (2024). Arage MW, et al. Exploring the health consequences of armed conflict: the perspective of Northeast Ethiopia, 2022: a qualitative study. BMC Public Health. 2023;23:1–13. Arifin H, et al. Analysis of Modifiable, Non-Modifiable, and Physiological Risk Factors of Non-Communicable Diseases in Indonesia: Evidence from the 2018 Indonesian Basic Health Research. J Multidiscip Healthc. 2022;15:2203–21. United Nations Population Fund Responding to the Challenge of Non-communicable Diseases . United Nations system agency (2019). Al Hilfi TK. Y. Toward a healthier Iraq. Yale J Biol Med. 2014;87:289–97. Al-Asadi JN, Salman JM. Cancer mortality-to-incidence ratio among Iraqi citizens: Nine-year National Estimates (2012–2020) and its relation to population growth rate and health expenditure. Qatar Med. J. 2023, 38 (2023). Al-Muftah M, Al-Ejeh F. Cancer Incidence and Mortality Estimates in Arab Countries in 2018: A GLOBOCAN Data Analysis. Cancer Epidemiol biomarkers Prev Publ Am Assoc Cancer Res cosponsored Am Soc Prev Oncol. 2023;32:1738–46. Xie D, et al. Global burden and influencing factors of chronic kidney disease due to type 2 diabetes in adults aged 20–59 years, 1990–2019. Sci Rep. 2023;13:20234. Koye DN, Magliano DJ, Nelson RG, Pavkov ME. The Global Epidemiology of Diabetes and Kidney Disease. Adv Chronic Kidney Dis. 2018;25:121–32. Fallahzadeh A, et al. The burden of chronic respiratory disease and attributable risk factors in North Africa and Middle East: findings from global burden of disease study (GBD) 2019. Respir Res. 2022;23:268. Yakupu A, et al. The burden of skin and subcutaneous diseases: findings from the global burden of disease study 2019. Front public Heal. 2023;11:1145513. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 29 Jan, 2025 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 07 Oct, 2024 Editor assigned by journal 04 Oct, 2024 Submission checks completed at journal 04 Oct, 2024 First submitted to journal 02 Oct, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5193836","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":362974136,"identity":"241cbb5e-a63a-43ae-ae76-c113beaa4f48","order_by":0,"name":"Mohammed Merzah","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/klEQVRIiWNgGAWjYLACxgYGAwYGHgaGBww2IG7jAeK1JDCkgbkkaTkMFsCrRbe99/GHnzsYjPlnnz34IaHmvN3a9sNAW2psonFpMTtz3MCw9wyDmcS5vGSJhGO3k7edSQRqOZaW24BLy400hgTeNqC3z/AYSCSw3U42OwDUwthwGLeW+88YDv4FapE/w2P8I+HfuWSz8w8JaLnBxtgMtMXM4AyPmURi2wE7sxuEbDmTxsws2yZhbHiGL80isS85wewG0JYEfH45foz549s2G8N5Z3gP3/jwzc7e7Hz6wwcfamxwaoECCTgrEawyAb9yVGBPiuJRMApGwSgYGQAA8RBj7jOBrnAAAAAASUVORK5CYII=","orcid":"","institution":"University of Debrecen","correspondingAuthor":true,"prefix":"","firstName":"Mohammed","middleName":"","lastName":"Merzah","suffix":""}],"badges":[],"createdAt":"2024-10-02 15:38:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5193836/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5193836/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-024-21080-w","type":"published","date":"2025-01-29T15:57:07+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":71478396,"identity":"a0a340f6-8824-4def-9403-68f16311cb12","added_by":"auto","created_at":"2024-12-16 05:33:08","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":142516,"visible":true,"origin":"","legend":"\u003cp\u003eTrends in the mortality rate caused by CVDs in Iraq by age and sex (2003 vs 2021)\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5193836/v1/3faf7190db2e7eb63c95a3e7.png"},{"id":75351172,"identity":"4d48b619-4481-45c6-ad17-6977ae7b9d4c","added_by":"auto","created_at":"2025-02-03 16:07:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1321761,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5193836/v1/a979391e-9d55-4801-87a4-0df2f6ae0a3f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Trends in Incidence, Prevalence, and Mortality of Non-communicable Diseases in Iraq (2003-2021)","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe evolving landscape of Iraqi healthcare faces a formidable challenge with the emergence of non-communicable diseases (NCDs) \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. While significant strides have been made in combating infectious diseases, the escalating burden of NCDs demands immediate attention. Lifestyle shifts and the adversities following prolonged conflict have propelled conditions such as cardiovascular diseases, diabetes, and cancer to the forefront of healthcare concerns \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. The burden of these diseases poses significant socio-economic implications and strains healthcare infrastructures, necessitating a realignment of healthcare priorities and resources to address the growing incidence and impact of NCDs effectively.\u003c/p\u003e \u003cp\u003eImplementing robust strategies emphasising prevention, early diagnosis, and effective management is crucial to mitigate the adverse effects on public health and enhance the quality of life for the Iraqi population \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. NCDs have emerged as a significant public health challenge in Iraq, contributing substantially to morbidity and mortality. The leading NCDs\u0026mdash;cardiovascular diseases, diabetes, cancers, and chronic respiratory conditions\u0026mdash;are responsible for the majority of deaths in the country \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. According to the World Health Organization (WHO), NCDs account for more than half of all fatalities in Iraq, with cardiovascular diseases alone contributing nearly 40% of these deaths \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSeveral factors contribute to the growing prevalence of NCDs in Iraq, including lifestyle changes such as increased consumption of unhealthy foods, reduced physical activity, and widespread tobacco use \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. Prolonged conflict and instability have weakened healthcare systems, restricting access to preventive and treatment services\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Furthermore, the stress and trauma associated with extended conflict have indirectly fueled the rise of NCDs through increased risk behaviours, such as smoking and poor dietary habits\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe Iraqi healthcare system struggles to cope with the increasing burden of NCDs \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Ongoing economic and political instability has obstructed the creation of robust public health policies and delayed the rollout of widespread screening and prevention initiatives \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Consequently, many NCDs are diagnosed at advanced stages, complicating treatment and management efforts.\u003c/p\u003e \u003cp\u003eAddressing the growing NCD crisis in Iraq requires a multifaceted approach that involves strengthening healthcare systems, implementing effective public health campaigns to raise awareness about risk factors, and promoting healthier lifestyles. Collaborative efforts among the government, international organisations, and local communities are essential to curbing the rise of NCDs and improving the overall health of the Iraqi population.\u003c/p\u003e \u003cp\u003eThis study aims to map the incidence, prevalence, and mortality rates of NCDs in Iraq from 2003 to 2021, providing a comprehensive understanding of the trends and burden of these diseases. By analysing these data, the study seeks to inform future healthcare strategies that address the urgent NCD crisis in the country.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData Source\u003c/h2\u003e \u003cp\u003eData from the Global Burden of Disease (GBD) Study 2021 was utilized for this analysis. These data provide standardized estimates of health metrics for different diseases and injuries across 204 countries and territories. The GBD study enables a detailed assessment and measurement of health loss and trends in non-communicable diseases (NCDs) over time. This study analyzed trends for 12 major NCDs, such as cardiovascular diseases and diabetes.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Population and Time Frame\u003c/h3\u003e\n\u003cp\u003eIraq faced significant social and political changes after 2003, including post-conflict scenarios, which may have had consequences on health. Due to the nature of GBD data, which includes populations of all ages and both sexes, and with the most recent available data from 2021, the period of focus for this analysis is from 2003 to 2021.\u003c/p\u003e\n\u003ch3\u003eHealth Metrics Analyzed\u003c/h3\u003e\n\u003cp\u003eUsing the GBD results tool, age-standardized rates (ASRs) were extracted for Iraq from the GBD 2021 database. The study focused on the following metrics: age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age-standardized mortality rate (ASMR). The ASPR represents the total number of existing cases, the ASIR refers to the number of new cases of a disease, and the ASMR represents the number of deaths due to a disease. All ASRs were expressed per 100,000 population, adjusted for age, in a specific year.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics of ASRs with 95% of uncertainty intervals were done for all major NCDs. Trends in rates from 2003 to 2021were calculated using \u003cem\u003eEq.\u0026nbsp;1\u003c/em\u003e. All calculation was done using SPSS V. 25.\u003c/p\u003e \u003cp\u003e \u003cspan class=\"InlineEquation\"\u003e \u003cspan class=\"mathinline\"\u003e\\(\\:Percentage\\:change=\\frac{\\left(ASR\\:in\\:2021-ASR\\:in\\:2003\\right)}{ASR\\:in\\:2003}\\times\\:100\\:\\:\\:\\:\\:\\)\u003c/span\u003e \u003c/span\u003e \u003cb\u003eEq.\u0026nbsp;1\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003eDue to the nature of the publically available GBD data and the lack of direct involvement of human subjects, no ethical approval was required.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eUtilizing data from the Global Burden of Disease (GBD) study 2021 (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://ghdx.healthdata.org/gbd-results-tool\u003c/span\u003e\u003cspan address=\"http://ghdx.healthdata.org/gbd-results-tool\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e ), this analysis observed a nuanced trajectory of NCDs in Iraq from 2003 to 2021. While the age-standardized prevalence of all NCDs among both sexes exhibited a slight increase (change %: 0.07, 95% UI: \u0026minus;0.06 to 0.14), chronic respiratory diseases showed a marginal decline (change %: \u0026minus;14.41, 95% UI: \u0026minus;21.63 to \u0026minus;\u0026thinsp;14.30). Conversely, neoplasms demonstrated a worrisome escalation (change %: 32.66, 95% UI: 31.16 to 32.12) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe age-standardized prevalence rate of non-communicable diseases in Iraq 2003\u0026ndash;2021.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon communicable diseases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eASPR in 2003 \u003c/p\u003e \u003cp\u003eRate (95% UL: LL, UL)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eASPR in 2021 \u003c/p\u003e \u003cp\u003eRate (95% UL: LL, UL)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChange (%) from 2003 to 2021\u003c/p\u003e \u003cp\u003e(95% UL: LL, UL)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88,773.93 (87,431.66, 90,095.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88,935.71 (87,652.59, 90,241.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.18 (0.25, 0.16)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94,245.03 (93,411.01, 95,029.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e94,150.96 (93,284.37, 94,987.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.10 (-0.25, -0.23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91,389.64 (90,323.30, 92,418.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e91,451.26 (90,397.46, 92,473.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.07 (0.14, 0.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCardiovascular diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11,635.38 (11,157.51, 12,085.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11,779.18 (11,159.85, 12,437.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.24 (0.01, 2.92)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8,885.56 (8,488.28, 9,263.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9,125.62 (8,612.59, 9,658.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.71 (0.70, 4.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10,230.44 (9,796.16, 10,631.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10,418.89 (9,875.44, 11,011.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.84 (0.92, 3.57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eChronic respiratory diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5,982.26 (5,380.95, 6,692.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5,100.23 (4,536.64, 5,800.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-14.69 (-14.28, -23.40)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6,032.19 (5,486.08, 6,639.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5,185.17 (4,679.07, 5,798.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-14.08 (-14.31, -21.84)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5,985.97 (5,430.58, 6,643.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5,124.14 (4,592.51, 5,759.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-14.41 (-14.30, -21.63)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDiabetes and kidney diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16,833.99 (16,032.95, 17,703.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21,535.04 (20,415.69, 22,773.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28.25 (27.59, 27.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16,747.96 (15,996.11, 17,479.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20,889.31 (19,834.26, 22,073.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24.38 (23.65, 14.64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16,784.38 (16,040.28, 17,544.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21,210.88 (20,180.11, 22,305.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26.40 (25.91, 27.08)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigestive diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33,493.10 (31,695.03, 35,443.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35,808.84 (33,926.81, 37,840.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.92 (6.63, 6.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35,184.29 (33,418.91, 36,962.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37,461.25 (35,662.76, 39,419.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.46 (6.25, 3.93)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34,310.50 (32,605.39, 36,124.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36,604.44 (34,815.71, 38,573.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.67 (6.59, 6.85)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12,820.01 (11,745.44, 14,056.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13,527.69 (12,008.58, 15,240.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.52 (2.23, 8.57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15,350.84 (14,075.47, 16,788.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16,831.44 (14,558.02, 19,552.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.64 (10.12, 16.45)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14,028.09 (12,899.24, 15,347.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15,121.87 (13,269.26, 17,153.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.77 (8.43, 11.77)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMusculoskeletal disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14,720.83 (13,628.68, 15,856.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15,491.53 (14,296.01, 16,747.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.23 (6.33, 5.58)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22,242.27 (20,666.94, 23,727.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23,180.66 (21,562.47, 24,844.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.22 (4.15, 4.83)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18,366.84 (17,083.28, 19,622.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19,218.78 (17,873.25, 20,560.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.65 (4.64, 4.77)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeoplasms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e603.85 (511.25, 711.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e830.26 (676.41, 968.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e37.45 (32.34, 36.23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,154.02 (975.18, 1,386.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,504.94 (1,244.84, 1,790.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30.40 (29.05, 29.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e865.97 (737.85, 1,018.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,148.63 (958.7, 1,337.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e32.66 (32.12, 31.16)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeurological disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32,256.13 (28,971.08, 35,655.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32,279.24 (29,032.79, 35,641.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.07 (0.01, -0.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38,164.14 (34,968.15, 41,693.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38,174.23 (35,086.96, 41,718.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.03 (0.01, 0.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35,083.71 (31,999.55, 38,305.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35,124.88 (32,069.47, 38,353.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.12 (0.12, 0.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eOther non-communicable diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65,214.12 (61,356.65, 69,416.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e64,792.97 (60,831.38, 69,082.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.65 (-0.84, -0.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86,073.83 (84,108.42, 87,850.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e85,491.51 (83,446.04, 87,507.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.68 (-0.76, -0.59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75,154.59 (72,400.63, 78,037.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74,726.54 (71,949.63, 77,909.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.57 (-0.73, -0.40)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSense organ diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23,299.74 (21,779.34, 25,227.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23,309.40 (21,855.51, 25,162.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.04 (0.00, 0.08)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24,152.67 (22,178.84, 26,826.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24,136.87 (22,158.86, 26,935.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.06 (-0.12, 0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23,715.37 (22,044.94, 25,965.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23,704.40 (22,053.43, 25,953.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.05 (-0.10, 0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSkin and subcutaneous diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17,200.61 (16,720.26, 17,661.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18,616.54 (18,122.29, 19,131.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8.22 (7.50, 9.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17,760.41 (17,265.13, 18,289.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19,168.23 (18,647.40, 19,703.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.91 (7.00, 8.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17,464.83 (17,013.63, 17,923.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18,876.21 (18,373.36, 19,380.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8.06 (7.25, 8.85)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubstance use disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e978.95 (845.79, 1,124.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e936.97 (808.69, 1,072.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-4.27 (-6.00, -2.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e554.88 (478.23, 636.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e529.84 (461.46, 604.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-4.51 (-6.00, -3.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e777.16 (675.59, 885.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e741.48 (645.01, 845.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-4.59 (-6.00, -3.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eASPR\u0026thinsp;=\u0026thinsp;Age-standardized prevalence rate; LL\u0026thinsp;=\u0026thinsp;lower limit; UL\u0026thinsp;=\u0026thinsp;upper limit. Bold fonts represent the highest increase or decrease in percentage changes.\u003c/p\u003e \u003cp\u003eRegarding the age-standardized incidence rate (ASIR) for both sexes, the ASIR of all NCDs increased slightly (change %: 0.74, 95% UI: \u0026minus;3.06, 4.36). Diabetes and kidney diseases showed the highest increase from 2003 to 2021 (change %: 42.92, 95% UI: 36.00\u0026ndash;49.78), while chronic respiratory diseases showed the largest decline (change %: \u0026minus;12.09, 95% UI: \u0026minus;26.23\u0026ndash;2.94). Among males, skin and subcutaneous diseases was the highest in both years, with ASIRs of 36,588.10/100,000 (95% UI: 35,102.96\u0026ndash;38,054.50) in 2003 and 38,270.15/100,000 (95% UI: 36,723.92\u0026ndash;39,724.56) in 2021. Similarly, among females, skin and subcutaneous diseases also had the highest ASIR, with rates of 36,409.70/100,000 (95% UI: 35,058.75 to 37,874.24) in 2003 and 38,088.83/100,000 (95% UI: 36,701.87 to 39,616.05) in 2021. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe age-standardized incidence rate of non-communicable diseases in Iraq 2003\u0026ndash;2021.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-communicable diseases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eASIR in 2003 \u003c/p\u003e \u003cp\u003eRate (95% UL: LL, UL)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eASIR in 2021 \u003c/p\u003e \u003cp\u003eRate (95% UL: LL, UL)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChange (%) from 2003 to 2021\u003c/p\u003e \u003cp\u003e(95% UL: LL, UL)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll causes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120,431.83 (112,626.18, 130,135.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e120,094.75 (113,250.94, 127,925.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.28 (\u0026minus;\u0026thinsp;5.05, 4.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e160,173.94 (152,527.80, 168,362.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e162,548.50 (154,491.91, 171,160.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.48 (\u0026minus;\u0026thinsp;3.45, 6.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e139,299.31 (131,967.42, 147,524.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e140,336.31 (132,817.79, 147,916.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.74 (\u0026minus;\u0026thinsp;3.06, 4.36)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCardiovascular diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,689.09 (1,509.82, 1,906.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,744.40 (1,560.02, 1,964.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.26 (\u0026minus;\u0026thinsp;18.13, 6.61)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,191.51 (1,079.44, 1,323.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,183.05 (1,066.07, 1,317.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.39 (\u0026minus;\u0026thinsp;4.61, 1.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,436.72 (1,302.48, 1,608.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,455.30 (1,320.00, 1,620.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.80 (\u0026minus;\u0026thinsp;17.35, 5.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eChronic respiratory diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e780.23 (664.88, 947.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e679.98 (578.35, 821.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-12.85 (\u0026minus;\u0026thinsp;25.54, -1.08)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e728.41 (629.62, 865.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e646.76 (555.19, 784.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-11.23 (\u0026minus;\u0026thinsp;23.88, 0.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e752.89 (649.26, 902.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e661.97 (570.12, 795.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-12.09 (\u0026minus;\u0026thinsp;26.23, 2.94)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDiabetes and kidney diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e752.43 (709.31, 799.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,113.19 (1,051.38, 1,188.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.94 (40.02, 55.43)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e851.25 (804.78, 903.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,180.17 (1,118.55, 1,247.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38.61 (32.62, 45.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e802.26 (760.49, 846.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,146.68 (1,086.17, 1,211.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e42.92 (36.00, 49.78)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigestive diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6,492.90 (5,968.97, 7,020.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6,655.40 (6,135.59, 7,181.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.51 (\u0026minus;\u0026thinsp;12.45, 17.19)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7,839.39 (7,231.84, 8,470.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7,953.37 (7,376.37, 8,581.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.45 (\u0026minus;\u0026thinsp;12.65, 10.79)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7,143.64 (6,569.38, 7,698.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7,280.54 (6,711.11, 7,844.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.91 (\u0026minus;\u0026thinsp;12.83, 11.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4,120.59 (3,742.05, 4,634.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5,169.08 (4,220.17, 6,385.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.41 (13.83, 38.55)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5,979.81 (5,386.58, 6,826.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7,612.51 (6,050.74, 9,545.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.29 (17.35, 39.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5,013.80 (4,538.81, 5,675.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6,345.72 (5,170.50, 7,869.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.47 (15.65, 38.14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMusculoskeletal disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4,042.58 (3,661.36, 4,435.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4,025.00 (3,628.81, 4,420.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.44 (\u0026minus;\u0026thinsp;10.96, 10.57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5,703.77 (5,126.37, 6,280.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5,712.74 (5,172.24, 6,322.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.19 (\u0026minus;\u0026thinsp;10.53, 10.15)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4,844.05 (4,390.94, 5,317.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4,838.77 (4,377.19, 5,322.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.11 (\u0026minus;\u0026thinsp;10.89, 10.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeoplasms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e307.22 (261.77, 356.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e349.46 (296.50, 399.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.73 (\u0026minus;\u0026thinsp;9.23, 44.92)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e470.94 (390.40, 568.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e517.20 (437.79, 619.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.84 (\u0026minus;\u0026thinsp;6.74, 25.69)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e383.47 (324.11, 450.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e426.34 (365.94, 500.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.19 (\u0026minus;\u0026thinsp;3.78, 26.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNeurological disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9,587.96 (8,435.60, 10,705.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9,591.82 (8,441.09, 10,718.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.03 (\u0026minus;\u0026thinsp;3.73, 4.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10,243.43 (9,090.66, 11,278.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10,244.73 (9,086.59, 11,325.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.01 (\u0026minus;\u0026thinsp;3.74, 4.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9,903.75 (8,808.38, 10,948.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9,911.31 (8,814.46, 10,977.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.04 (\u0026minus;\u0026thinsp;3.68, 4.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eOther non-communicable diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55,717.07 (48,037.77, 64,757.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52,163.75 (45,013.56, 59,886.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-9.14 (\u0026minus;\u0026thinsp;16.56, -1.81)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e90,644.89 (83,552.59, 98,800.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89,319.40 (81,552.61, 97,672.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.46 (\u0026minus;\u0026thinsp;1.63, -1.29)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72,291.29 (65,251.08, 80,359.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69,896.37 (63,125.13, 77,396.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-3.30 (\u0026minus;\u0026thinsp;3.66, -2.94)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSense organ diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.80 (1.27, 6.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.99 (1.37, 6.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.78 (\u0026minus;\u0026thinsp;11.31, 113.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.27 (2.06, 9.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.56 (2.18, 9.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.80 (\u0026minus;\u0026thinsp;11.44, 121.38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.51 (1.63, 8.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.75 (1.76, 8.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.83 (\u0026minus;\u0026thinsp;9.99, 130.24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSkin and subcutaneous diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36,588.10 (35,102.96, 38,054.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38,270.15 (36,723.92, 39,724.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.63 (\u0026minus;\u0026thinsp;2.81, 5.44)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36,409.70 (35,058.75, 37,874.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38,088.83 (36,701.87, 39,616.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.63 (\u0026minus;\u0026thinsp;2.81, 5.44)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36,490.08 (35,151.65, 37,877.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38,157.76 (36,700.30, 39,610.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.58 (\u0026minus;\u0026thinsp;2.89, 5.32)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSubstance use disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e414.37 (354.11, 489.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e401.91 (339.26, 468.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.63 (\u0026minus;\u0026thinsp;16.58, 12.53)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e239.15 (204.25, 282.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e232.52 (198.25, 273.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.77 (\u0026minus;\u0026thinsp;7.60, 19.29)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e331.10 (284.66, 386.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e320.63 (272.06, 373.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-3.47 (\u0026minus;\u0026thinsp;12.76, 14.92)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eASIR\u0026thinsp;=\u0026thinsp;Age-standardized incidence rate; LL\u0026thinsp;=\u0026thinsp;lower limit; UL\u0026thinsp;=\u0026thinsp;upper limit. Bold fonts represent the highest increase or decrease in percentage changes.\u003c/p\u003e \u003cp\u003eIn terms of age-standardized mortality rates (ASMR) among both sexes, skin and subcutaneous diseases showed the highest increase (change %: 48.15, 95% UI: \u0026minus;19.44 to 81.94). However, digestive diseases showed the largest decline from 2003 to 2021 (change %: \u0026minus;21.41, 95% UI: \u0026minus;54.08 to 17.72). Among males and females separately, cardiovascular disease was the dominant cause of death in 2003, with ASMRs of 530.13/100,000 (95% UI: 421.12\u0026ndash;664.2) for males and 414.15/100,000 (95% UI: 329.93\u0026ndash;514.69) for females. In 2021, the ASMRs were 565.76/100,000 (95% UI: 448.82\u0026ndash;656.26) for males and 399.63/100,000 (95% UI: 336.38\u0026ndash;462.88) for female (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e ).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe age-standardized mortality rate of non-communicable diseases in Iraq 2003\u0026ndash;2021.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-communicable diseases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eASIR in 2003 \u003c/p\u003e \u003cp\u003eRate (LL, UL)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eASIR in 2021 \u003c/p\u003e \u003cp\u003eRate (LL, UL)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChange (%) from\u003c/p\u003e \u003cp\u003e2003 to 2021\u003c/p\u003e \u003cp\u003e(95% UL: LL, UL)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll causes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e814.12 (649.20, 1,019.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e875.63 (689.85, 999.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e7.56 (\u0026minus;\u0026thinsp;4.82, 14.34)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e641.77 (522.51, 794.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e632.64 (538.39, 732.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-1.42 (\u0026minus;\u0026thinsp;3.32, 0.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e724.78 (585.40, 901.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e745.50 (608.77, 848.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e2.85 (\u0026minus;\u0026thinsp;3.02, 6.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCardiovascular diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e530.13 (421.12, 664.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e565.76 (448.82, 656.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e6.72 (\u0026minus;\u0026thinsp;20.22, 55.82)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e414.15 (329.93, 514.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e399.63 (336.38, 462.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-3.51 (\u0026minus;\u0026thinsp;8.70, 8.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e470.72 (378.89, 588.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e477.6 (397.13, 553.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e1.46 (\u0026minus;\u0026thinsp;12.81, 34.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eChronic respiratory diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.57 (19.41, 33.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.06 (16.97, 29.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-5.91 (\u0026minus;\u0026thinsp;28.11, 21.88)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.07 (10.61, 19.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.44 (9.55, 16.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-11.60 (\u0026minus;\u0026thinsp;31.17, 17.92)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.43 (15.11, 25.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.62 (13.44, 21.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-9.31 (\u0026minus;\u0026thinsp;27.15, 12.34)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDiabetes and kidney diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76.83 (58.12, 101.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.64 (69.56, 122.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e31.01 (\u0026minus;\u0026thinsp;10.30, 111.49)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70.86 (55.68, 90.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e84.69 (67.09, 104.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e19.52 (\u0026minus;\u0026thinsp;9.61, 76.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73.54 (57.07, 94.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e91.99 (70.34, 110.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e25.11 (\u0026minus;\u0026thinsp;7.94, 65.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigestive diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.92 (20.85, 36.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.33 (16.28, 30.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-16.45 (\u0026minus;\u0026thinsp;43.52, 18.40)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.28 (13.6, 24.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.38 (10.24, 17.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-26.82 (\u0026minus;\u0026thinsp;64.82, 23.73)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.97 (17.42, 29.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.06 (13.43, 22.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-21.41 (\u0026minus;\u0026thinsp;54.08, 17.72)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMusculoskeletal disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.22 (0.12, 0.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.24 (0.12, 0.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e9.09 (\u0026minus;\u0026thinsp;50.00, 158.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.05 (0.76, 1.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.89 (0.66, 1.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-15.24 (\u0026minus;\u0026thinsp;27.32, 10.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.63 (0.46, 0.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.57 (0.42, 0.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-9.52 (\u0026minus;\u0026thinsp;32.20, 18.51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeoplasms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92.05 (69.68, 116.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e109.52 (82.68, 130.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e18.97 (\u0026minus;\u0026thinsp;19.23, 63.89)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65.71 (51.21, 84.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e75.3 (59.86, 92.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e14.60 (\u0026minus;\u0026thinsp;16.89, 57.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77.9 (60.18, 99.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e90.54 (70.03, 109.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e16.19 (\u0026minus;\u0026thinsp;18.93, 58.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeurological disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32.79 (14.21, 74.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.73 (16.63, 72.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e5.91 (\u0026minus;\u0026thinsp;49.27, 408.19)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32.85 (11.84, 79.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.9 (12.02, 76.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e0.15 (\u0026minus;\u0026thinsp;62.70, 548.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32.84 (12.95, 78.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.73 (14.06, 74.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e2.71 (\u0026minus;\u0026thinsp;58.94, 475.88)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eOther non-communicable diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.89 (20.13, 32.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.39 (11.19, 18.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-44.41 (\u0026minus;\u0026thinsp;83.65, -7.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.65 (17.76, 28.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.32 (9.7, 15.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-47.93 (\u0026minus;\u0026thinsp;108.27, 1.10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.78 (20.38, 29.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.34 (10.69, 16.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-46.16 (\u0026minus;\u0026thinsp;95.21, 9.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSkin and subcutaneous diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.28 (0.2, 0.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.46 (0.32, 0.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e64.29 (\u0026minus;\u0026thinsp;17.54, 179.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.25 (0.18, 0.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.35 (0.27, 0.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e40.00 (\u0026minus;\u0026thinsp;22.22, 150.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.27 (0.2, 0.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.4 (0.3, 0.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e48.15 (\u0026minus;\u0026thinsp;19.44, 81.94)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubstance use disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.44 (1.72, 3.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.51 (1.8, 3.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e2.87 (\u0026minus;\u0026thinsp;26.23, 113.95)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.91 (0.65, 1.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.75 (0.55, 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-17.58 (\u0026minus;\u0026thinsp;39.57, 35.71)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth sexes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.65 (1.2, 2.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.61 (1.18, 2.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c5\"\u003e \u003cp\u003e-2.42 (\u0026minus;\u0026thinsp;25.45, 45.73)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eASMR\u0026thinsp;=\u0026thinsp;Age-standardized mortality rate; LL\u0026thinsp;=\u0026thinsp;lower limit; UL\u0026thinsp;=\u0026thinsp;upper limit. Bold fonts represent the highest increase or decrease in percentage changes.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e comparing CVD mortality rates in Iraq between 2003 and 2021 shows clear age-related trends, with mortality rates increasing steadily with age, particularly after the age of 55. Males consistently exhibit higher mortality rates compared to females across all age groups, with the gap widening significantly in older populations. From 2003 to 2021, there is a notable decline in ASMR across almost all age groups, particularly among younger individuals (20\u0026ndash;44 years), indicating the success of preventive measures and early interventions.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings from the GBD study 2021 offer a comprehensive overview of the shifting landscape of NCDs in Iraq from 2003 to 2021. The nuanced trajectory observed highlights progress and emerging challenges in managing the burden of NCDs over nearly two decades. These findings point to a complex public health landscape, where challenges in others offset progress in some areas, necessitating targeted interventions to address the evolving burden of NCDs in Iraq.\u003c/p\u003e \u003cp\u003eNeoplasms underscore a growing concern in Iraq during the studied period in terms of prevalence, incidence, and mortality. A recent study reported a rise in the crude incidence rate of all types of cancer from 2012 to 2020 \u003csup\u003e13\u003c/sup\u003e. Similarly, another study revealed that all cancers, particularly lung and gastrointestinal, steadily increased after 2007, affecting both sexes equally \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. The burden of neoplasms is not limited to Iraq but is also a significant concern in other Arab countries. A study using GLOBOCAN data highlighted a high incidence of cancers among younger Arabs \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe incidence of diabetes and kidney diseases increased significantly in 2021 compared to 2003. This trend aligns with an analysis assessing the burden of chronic kidney disease among adults with type 2 diabetes, which revealed a 21.8% increase in the ASIR of diabetes and kidney diseases globally since 1990 \u003csup\u003e15\u003c/sup\u003e. A review has also shown a rise in the prevalence and incidence of diabetes worldwide, with changes in clinical practices impacting the epidemiology of chronic kidney disease in recent years \u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOur analysis showed a decline in the age-standardized incidence rate (ASIR) of chronic respiratory diseases from 2003 to 2021. Interestingly, a study analyzing GBD 2019 data for North Africa and the Middle East found a 10.3% rise in ASIR alongside a 32.9% reduction in the age-standardized mortality rate (ASMR) since 1990. However, this upward trend in incidence did not extend to Iraq, Iran, Bahrain, and Yemen, where a decline was observed instead\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOur analysis revealed that skin and subcutaneous diseases had the highest increase in cause of death in 2021, although the rate remains low compared to other diseases. Corresponding to this analysis, a study on GBD 2019 data indicated that the highest burden of skin and subcutaneous diseases was observed in lower-middle sociodemographic index countries, where Iraq is categorized \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eA notable decline in the ASMR among almost all age group and particular among individuals aged 20 to 44 years, indicating the success of preventive measures and early interventions. However, despite this progress, mortality rates remain persistently high among the elderly, especially males over 60, suggesting the need for targeted healthcare interventions for this group. The gender disparity in mortality highlights the importance of gender-specific strategies to further reduce the CVD burden. Overall, while the improvements are encouraging, especially for younger populations, the data suggest that efforts should continue to focus on managing chronic diseases and addressing risk factors, particularly among older males.\u003c/p\u003e \u003cp\u003eVarious factors contribute to the increasing prevalence of non-communicable diseases (NCDs). The aging population, coupled with shifts in lifestyle behaviors such as diet and tobacco use, has intensified the burden of these diseases \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Moreover, disparities in healthcare access exacerbate the situation for at-risk populations, delaying timely interventions. These challenges have been evident in Iraq over the last decade and likely play a significant role in the growing prevalence of NCDs \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAn analysis of ASPRs across Middle Eastern countries reveals a concerning trend of rising NCD burdens. However, in the case of Iraq, the lack of disease-specific data presents a significant challenge in drawing definitive conclusions. While this analysis offers valuable insights into existing trends, its effectiveness is limited by the absence of detailed disease information. Future research should focus on identifying risk factors and evaluating preventive strategies and treatment approaches.\u003c/p\u003e \u003cp\u003eIt is important to acknowledge certain limitations in this analysis. The GBD data for Iraq, especially during periods of conflict, may be affected by underreporting or misclassification. Furthermore, this study identifies trends but does not establish causal relationships. Additional research is needed to explore the underlying factors driving NCD trends in Iraq.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings from the GBD 2021 study illustrate both progress and ongoing challenges in managing NCDs in Iraq from 2003 to 2021. While significant strides have been made in reducing mortality among younger populations, particularly for chronic respiratory diseases, the persistent high mortality rates among older males, especially from cardiovascular diseases, indicate the need for more targeted interventions. The rising prevalence of neoplasms, diabetes, and kidney diseases underscores the growing burden of NCDs, exacerbated by lifestyle changes and healthcare disparities. Continued efforts to address risk factors, improve healthcare access, and focus on preventive strategies, particularly for vulnerable and older populations, are essential for further progress.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eClinical trial number\u003c/strong\u003e \u003cp\u003enot applicable\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eno funding to be disclose.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eDear Editor, The sole author of the paper titled \"Trends in Incidence, Prevalence, and Mortality of Non-communicable Diseases in Iraq (2003-2021)\" is Mohammed Merzah. Merzah conceived the study, designed the research, collected and analyzed the data, interpreted the results, and wrote the manuscript.Sincerely, Merzah\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eUtilizing data from the Global Burden of Disease (GBD) study 2021 (http://ghdx.healthdata.org/gbd-results-tool )\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHussain AM, Lafta RK. Burden of non-communicable diseases in Iraq after the 2003 war. Saudi Med J. 2019;40:72\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMawaw PM, et al. Increased prevalence of obesity, diabetes mellitus and hypertension with associated risk factors in a mine-based workforce, democratic Republic of Congo. Pan Afr Med J. 2019;34:1\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHussain AMA, Lafta RK. Cancer trends in Iraq 2000\u0026ndash;2016. Oman Med J. 2021;36:1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBennis A, et al. Strategic Recommendations to Bridge the Gaps in Awareness, Diagnosis and Prevention of Heart Failure in the Middle East Region and Africa. J Saudi Hear Assoc. 2022;34:53\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePham BN, et al. Non-communicable diseases attributed mortality and associated sociodemographic factors in Papua New Guinea: Evidence from the Comprehensive Health and Epidemiological Surveillance System. PLOS Glob public Heal. 2022;2:e0000118.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNoncommunicable diseases. \u003cem\u003eWHO in Iraq\u003c/em\u003e \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.emro.who.int/iraq/priority-areas/noncommunicable-diseases.html\u003c/span\u003e\u003cspan address=\"https://www.emro.who.int/iraq/priority-areas/noncommunicable-diseases.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eW H O. \u003cem\u003eChronic noncommunicable diseases risk factors survey in Iraq\u003c/em\u003e. \u003cem\u003eMinistry of health and ministry of planning and development cooperation, in collaboration with WHO\u003c/em\u003e (2006).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBogale B, Scambler S, Mohd Khairuddin AN, Gallagher JE. Health system strengthening in fragile and conflict-affected states: A review of systematic reviews. PLoS ONE 19, (2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArage MW, et al. Exploring the health consequences of armed conflict: the perspective of Northeast Ethiopia, 2022: a qualitative study. BMC Public Health. 2023;23:1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArifin H, et al. Analysis of Modifiable, Non-Modifiable, and Physiological Risk Factors of Non-Communicable Diseases in Indonesia: Evidence from the 2018 Indonesian Basic Health Research. J Multidiscip Healthc. 2022;15:2203\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u003cem\u003eUnited Nations Population Fund Responding to the Challenge of Non-communicable Diseases\u003c/em\u003e. \u003cem\u003eUnited Nations system agency\u003c/em\u003e (2019).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl Hilfi TK. Y. Toward a healthier Iraq. Yale J Biol Med. 2014;87:289\u0026ndash;97.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Asadi JN, Salman JM. Cancer mortality-to-incidence ratio among Iraqi citizens: Nine-year National Estimates (2012\u0026ndash;2020) and its relation to population growth rate and health expenditure. \u003cem\u003eQatar Med. J.\u003c/em\u003e 2023, 38 (2023).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Muftah M, Al-Ejeh F. Cancer Incidence and Mortality Estimates in Arab Countries in 2018: A GLOBOCAN Data Analysis. Cancer Epidemiol biomarkers Prev Publ Am Assoc Cancer Res cosponsored Am Soc Prev Oncol. 2023;32:1738\u0026ndash;46.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXie D, et al. Global burden and influencing factors of chronic kidney disease due to type 2 diabetes in adults aged 20\u0026ndash;59 years, 1990\u0026ndash;2019. Sci Rep. 2023;13:20234.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKoye DN, Magliano DJ, Nelson RG, Pavkov ME. The Global Epidemiology of Diabetes and Kidney Disease. Adv Chronic Kidney Dis. 2018;25:121\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFallahzadeh A, et al. The burden of chronic respiratory disease and attributable risk factors in North Africa and Middle East: findings from global burden of disease study (GBD) 2019. Respir Res. 2022;23:268.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYakupu A, et al. The burden of skin and subcutaneous diseases: findings from the global burden of disease study 2019. Front public Heal. 2023;11:1145513.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"NCDs, Iraq, trend, incidence, prevalence, mortality","lastPublishedDoi":"10.21203/rs.3.rs-5193836/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5193836/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Non-communicable diseases (NCDs) have become a major public health concern in Iraq, playing a significant role in the country's morbidity and mortality rates. To offer a thorough overview of the patterns and the overall impact of NCDs on public health, this study aim to map the trends in the incidence, prevalence, and mortality rates of NCDs in Iraq between 2003 and 2021.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: Data from the Global Burden of Disease (GBD) Study 2021were utilized. The focus was on Iraq from 2003 to 2021, a period marked by significant social and political changes. Using the GBD results tool, age-standardized prevalence, incidence, and mortality rates (ASPR, ASIR, ASMR) for 12 major NCDs were extracted and expressed per 100,000 population. Descriptive statistics with 95% uncertainty intervals were calculated, and trends were analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The analysis revealed a nuanced trajectory of NCDs in Iraq between 2003 and 2021. The ASPR of all NCDs increased slightly (change %: 0.07, 95% UI: −0.06 to 0.14), with a notable decline in chronic respiratory diseases (change %: −14.41, 95% UI: −21.63 to −14.30) and a significant rise in neoplasms (change %: 32.66, 95% UI: 31.16 to 32.12). The ASIR of diabetes and kidney diseases showed the largest increase (change %: 42.92, 95% UI: 36.00–49.78), while chronic respiratory diseases had the greatest decline (change %: −12.09, 95% UI: −26.23–2.94). Cardiovascular diseases remained the leading cause of mortality in both sexes, with ASMRs increasing slightly for males and decreasing for females over the period. Skin and subcutaneous diseases showed the highest increase in ASMR (change %: 48.15), while digestive diseases experienced the largest decline (change %: −21.41).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The GBD 2021 study highlights progress in reducing NCD mortality in Iraq, especially among younger people. However, older males still face high death rates from cardiovascular diseases. Rising cases of cancer, diabetes, and kidney diseases signal the need for targeted interventions. Continued focus on risk factors and healthcare access is essential.\u003c/p\u003e","manuscriptTitle":"Trends in Incidence, Prevalence, and Mortality of Non-communicable Diseases in Iraq (2003-2021)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-16 05:33:03","doi":"10.21203/rs.3.rs-5193836/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-10-07T07:23:43+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-10-04T07:03:12+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-10-04T07:03:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2024-10-02T15:23:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b156c8c0-7201-4212-9d04-ab02ddefd284","owner":[],"postedDate":"December 16th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-03T15:59:56+00:00","versionOfRecord":{"articleIdentity":"rs-5193836","link":"https://doi.org/10.1186/s12889-024-21080-w","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2025-01-29 15:57:07","publishedOnDateReadable":"January 29th, 2025"},"versionCreatedAt":"2024-12-16 05:33:03","video":"","vorDoi":"10.1186/s12889-024-21080-w","vorDoiUrl":"https://doi.org/10.1186/s12889-024-21080-w","workflowStages":[]},"version":"v1","identity":"rs-5193836","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5193836","identity":"rs-5193836","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}