Health, Core of
Development
Farhad Zargari, MD
drzargari@gmail.com
MARTIN LUTHER KING :
“OF ALL THE FORMS OF
INEQUALITY,
INJUSTICE IN HEALTH
CARE IS THE MOST
SHOCKING AND
INHUMANE
(WHO)
HumanCapital
Theory
Aging
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Evidence Based
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•
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•
•
•
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•
•
 All Ages
 Both Sexes
 Comprehensive
 Integrated
Comprehension
 Social Factors
 Psychological Factors
 Spiritual Factors
 Biological Factors
Integration
 Preventive Measures
 Therapeutic Measures
 Rehabilitative Measures
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-Life Style
-Self Care
‫ك‬ ‫ي‬‫ت‬ ً‫ژ‬ ّ ‫ك‬ ‫يْلْژي‬ ‫ب‬ ‫ل‬ ‫سائ‬ ‫ه‬ ‫كي‬ ‫يزي‬ ‫ف‬ ‫يط‬‫هح‬
‫تصادي‬ ‫اق‬ ّ ‫تواعي‬ ‫اج‬ ‫يط‬‫هح‬ ‫تي‬ ‫ساله‬ ...




-

-
-




---


-
-
50 1000 2000
5400
19000
‫اّايل‬ 1800 1930 1992 2100
‫هيليْى‬ َ‫ب‬ ‫ت‬ ‫جوعي‬
1.7
0.8
2.25
0.85
2.9
0.9
3.55
0.95
4.2
1
4.9
1.2
5.75
1.25
6.2
1.3
6.65
1.35
7.3
1.4
8
1.5
1950
1970
1990
2010
2030
2050
...
3.8
2.4
2.6
2
2.9
3.6
2
‫ى‬‫ارد‬
‫ق‬‫عرا‬
‫ى‬‫ٌا‬‫ب‬‫ل‬
‫هصر‬
‫ى‬‫تا‬‫س‬‫عرب‬
‫ي‬‫سعْد‬
‫ى‬‫عوا‬
‫ى‬‫سْدا‬
1881
1891
1901
1911
1921
1926
1931
1936
1941
1946
1951
1956
1966
1976
1986
1991
1996
2000
0
1
2
3
4
5
Population Pyramid - Iran DHS2000
95+
90-94
85-89
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
...
2.71 3.2
2.46 2.3
1.75
1.41
1355 1365 1370 1372 1373 1375
23
26
18
29
48
1335-
1345
1345-
1355
1355-
1365
1365-
1370
1370-
1375
-
-
-
-

STD
-
IQ
Reproduction
IQ
IQ
IQ
-

GDP
GDP

Global Health Expenditure 1997 = US$2.6 Trillion
Africa 0.4%
Middle East and N Africa 1.5%
Europe 2.4%
Americas 3.2
Asia 3...
Out of
Pocket
GDP
4.4%
3.7%
5.2%
3.3%
4.2%
2.5%
10.5%
9.8%
9.3%
7.3%
13.7%
8.6%
10.1%
‫ى‬‫را‬‫اي‬
‫هصر‬
‫ى‬‫ارد‬
‫ت‬‫كْي‬
‫ق‬‫عرا‬
َ‫سْر...
MENAMENA ‫در‬ ‫سالهت‬ ‫ی‬ ٌَ‫ُزي‬ ًَ‫سرا‬
1,747
855
835
666
499
430
352
222
134
122
107
105
58
58
56
38
19
0 200 400 600 8...
$20
$11
$20
$42
$17
$17
$30
$1,402
$2,125
$2,365
$3,724
$1,322
$2,644
$1,757
‫ى‬‫وا‬‫ال‬
َ‫س‬ً‫را‬‫ف‬
‫يا‬‫تال‬‫اي‬
‫ي‬‫ژا...
$13
$57
$73
$33
$41
$66
$178$118
$200
$110
$2
$605
‫ى‬‫را‬‫اي‬
‫هصر‬
‫ى‬‫ارد‬
‫ت‬‫ْي‬‫ك‬
‫ق‬‫عرا‬
َ‫سْري‬
َ ً‫سرا‬
‫ن‬ ‫ي‬...
0
5,000 ,000 ,000
10 ,000 ,000 ,000
15 ,000 ,000 ,000
20 ,000 ,000 ,000
25 ,000 ,000 ,000
30 ,000 ,000 ,000
35 ,000 ,000 ,...
-
95
120 130
166
200
221 230
256
280
326
268
253 254 252 245
202
175 167 172
202
298
283
268 266
214
238
325 323
50 55 60
...
0
50
100
150
200
250
300
350
400
450
1361
1362
1363
1364
1365
1366
1367
1368
1369
1370
1371
1372
1373
1374
1375
1376
1377
...
0
100
200
300
400
500
600
700
800
1338
1340
1342
1344
1346
1348
1350
1352
1354
1356
1358
1360
1362
1364
1366
1368
1370
137...
Out of Pocket

-
-
-
-
CatastrophicNon-Catastrophic
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Catastrophic NonCatastrophic
Drug
Dental
Outpatient
Inpatient
Out of Pocket
Other
Government
Incomes
Household
Income
Public
Fund
Insurance
Fund
Health
Care
Facility
Health
Care
Provider
Resource
Ge...
Out of Pocket








35%
65%
0%
10%
20%
30%
40%
50%
60%
70%
Insured UnInsured
سلامت محور توسعه - Health, Core of Development
سلامت محور توسعه - Health, Core of Development
سلامت محور توسعه - Health, Core of Development
سلامت محور توسعه - Health, Core of Development
سلامت محور توسعه - Health, Core of Development
سلامت محور توسعه - Health, Core of Development
سلامت محور توسعه - Health, Core of Development
سلامت محور توسعه - Health, Core of Development
سلامت محور توسعه - Health, Core of Development
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سلامت محور توسعه - Health, Core of Development

  1. 1. Health, Core of Development Farhad Zargari, MD drzargari@gmail.com
  2. 2. MARTIN LUTHER KING : “OF ALL THE FORMS OF INEQUALITY, INJUSTICE IN HEALTH CARE IS THE MOST SHOCKING AND INHUMANE
  3. 3. (WHO)
  4. 4. HumanCapital Theory Aging
  5. 5. - - - -- -
  6. 6. - - - -
  7. 7. - - -
  8. 8. -
  9. 9. - - - - -
  10. 10. - - - - -
  11. 11. : . : .: .  . : 1 . 2 3 4
  12. 12. - - - - - - - - - - - - - - - - - -
  13. 13.      
  14. 14. .1 .2 .3 .4 .5 .6 .7 .8
  15. 15. package
  16. 16. -        
  17. 17. -package         
  18. 18. -    Evidence Based    
  19. 19. - • • - • • • - • •
  20. 20.  All Ages  Both Sexes  Comprehensive  Integrated
  21. 21. Comprehension  Social Factors  Psychological Factors  Spiritual Factors  Biological Factors
  22. 22. Integration  Preventive Measures  Therapeutic Measures  Rehabilitative Measures
  23. 23. - - - - - - - - - - - - - - - -Life Style -Self Care
  24. 24. ‫ك‬ ‫ي‬‫ت‬ ً‫ژ‬ ّ ‫ك‬ ‫يْلْژي‬ ‫ب‬ ‫ل‬ ‫سائ‬ ‫ه‬ ‫كي‬ ‫يزي‬ ‫ف‬ ‫يط‬‫هح‬ ‫تصادي‬ ‫اق‬ ّ ‫تواعي‬ ‫اج‬ ‫يط‬‫هح‬ ‫تي‬ ‫ساله‬ ‫ذهات‬ ‫خ‬ َ ‫ارائ‬ ‫ًظام‬
  25. 25.     - 
  26. 26. - -
  27. 27.
  28. 28.  
  29. 29.  ---
  30. 30.   - -
  31. 31. 50 1000 2000 5400 19000 ‫اّايل‬ 1800 1930 1992 2100 ‫هيليْى‬ َ‫ب‬ ‫ت‬ ‫جوعي‬
  32. 32. 1.7 0.8 2.25 0.85 2.9 0.9 3.55 0.95 4.2 1 4.9 1.2 5.75 1.25 6.2 1.3 6.65 1.35 7.3 1.4 8 1.5 1950 1970 1990 2010 2030 2050 َ‫يافت‬ َ‫تْسع‬ ‫كوتر‬ ‫كشْرُاي‬ َ‫يافت‬ َ‫تْسع‬ ‫بيشتر‬ ‫كشْرُاي‬
  33. 33. 3.8 2.4 2.6 2 2.9 3.6 2 ‫ى‬‫ارد‬ ‫ق‬‫عرا‬ ‫ى‬‫ٌا‬‫ب‬‫ل‬ ‫هصر‬ ‫ى‬‫تا‬‫س‬‫عرب‬ ‫ي‬‫سعْد‬ ‫ى‬‫عوا‬ ‫ى‬‫سْدا‬
  34. 34. 1881 1891 1901 1911 1921 1926 1931 1936 1941 1946 1951 1956 1966 1976 1986 1991 1996 2000 0 1 2 3 4 5
  35. 35. Population Pyramid - Iran DHS2000 95+ 90-94 85-89 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-09 0-04 0.02.04.06.08.0 0.0 2.0 4.0 6.0 8.0 Female Male
  36. 36. 2.71 3.2 2.46 2.3 1.75 1.41 1355 1365 1370 1372 1373 1375
  37. 37. 23 26 18 29 48 1335- 1345 1345- 1355 1355- 1365 1365- 1370 1370- 1375
  38. 38. - - - -  STD -
  39. 39. IQ Reproduction IQ IQ IQ
  40. 40. -
  41. 41.
  42. 42. GDP GDP 
  43. 43. Global Health Expenditure 1997 = US$2.6 Trillion Africa 0.4% Middle East and N Africa 1.5% Europe 2.4% Americas 3.2 Asia 3.5% Developed Countries 88.9%
  44. 44. Out of Pocket
  45. 45. GDP 4.4% 3.7% 5.2% 3.3% 4.2% 2.5% 10.5% 9.8% 9.3% 7.3% 13.7% 8.6% 10.1% ‫ى‬‫را‬‫اي‬ ‫هصر‬ ‫ى‬‫ارد‬ ‫ت‬‫كْي‬ ‫ق‬‫عرا‬ َ‫سْري‬ ‫ى‬‫وا‬‫ال‬ َ‫س‬ً‫را‬‫ف‬ ‫يا‬‫تال‬‫اي‬ ‫ي‬‫ژاپ‬ ‫كا‬‫ري‬‫اه‬ ‫ا‬‫كاًاد‬ ‫س‬‫ي‬‫سْئ‬
  46. 46. MENAMENA ‫در‬ ‫سالهت‬ ‫ی‬ ٌَ‫ُزي‬ ًَ‫سرا‬ 1,747 855 835 666 499 430 352 222 134 122 107 105 58 58 56 38 19 0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000 OECD ‫اهارات‬ ‫قطر‬ ‫کْيت‬ ‫لبٌاى‬ ‫بحريي‬ ‫عربستاى‬ ‫عواى‬ ‫اردى‬ ‫فلسطيي‬ ‫ايراى‬ ‫تًْس‬ ٍ‫لجزير‬ ‫ا‬ ْ‫هْراک‬ ‫دجيبْتی‬ ‫هصر‬ ‫يوي‬ ‫آهريکا‬ ‫دالر‬ َ‫ب‬ ‫سالهت‬ ٌَ‫ُزي‬ ًَ ‫سرا‬
  47. 47. $20 $11 $20 $42 $17 $17 $30 $1,402 $2,125 $2,365 $3,724 $1,322 $2,644 $1,757 ‫ى‬‫وا‬‫ال‬ َ‫س‬ً‫را‬‫ف‬ ‫يا‬‫تال‬‫اي‬ ‫ي‬‫ژاپ‬ ‫كا‬‫ري‬‫اه‬ ‫ا‬‫كاًاد‬ ‫س‬‫ي‬‫سْئ‬ َ ً‫سرا‬ ‫ن‬ ‫ي‬‫ق‬‫ت‬‫س‬ ‫ه‬ ‫ن‬ ِ‫س‬
  48. 48. $13 $57 $73 $33 $41 $66 $178$118 $200 $110 $2 $605 ‫ى‬‫را‬‫اي‬ ‫هصر‬ ‫ى‬‫ارد‬ ‫ت‬‫ْي‬‫ك‬ ‫ق‬‫عرا‬ َ‫سْري‬ َ ً‫سرا‬ ‫ن‬ ‫ي‬‫ق‬‫ت‬‫س‬ ‫ه‬ ‫ن‬ ِ‫س‬
  49. 49. 0 5,000 ,000 ,000 10 ,000 ,000 ,000 15 ,000 ,000 ,000 20 ,000 ,000 ,000 25 ,000 ,000 ,000 30 ,000 ,000 ,000 35 ,000 ,000 ,000 40 ,000 ,000 ,000 45 ,000 ,000 ,000 50 ,000 ,000 ,000 1360 1361 1362 1363 1364 1365 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 1376 1377 1378 1379 1380 íÑÇÌ íÚÇãÊÌÇÑæãÇ íäÇÑãÚíÚÇãÊÌÇÑæãÇ íÑÇÌåí ÐÛÊ æäÇãÑÏ ¡ÊÔÇÏåÈáÕÝ íä ÇÑãÚ åí ÐÛÊæäÇãÑÏ¡ÊÔÇÏåÈ áÕÝ
  50. 50. - 95 120 130 166 200 221 230 256 280 326 268 253 254 252 245 202 175 167 172 202 298 283 268 266 214 238 325 323 50 55 60 96 95 93 100 117 135 158 195 236 300 351 337 278 320 383 354 406 459 442 335 368 396 358 354 354 140 180 210 262 300 315 345 373 400 484 463 489 560 603 582 480 515 550 526 608 757 725 603 634 610 596 679 677 0 100 200 300 400 500 600 700 800 1350 1351 1352 1353 1354 1355 1356 1357 1358 1359 1360 1361 1362 1363 1364 165 1366 1367 1368 1369 1370 171 1372 1373 1374 1375 1376 1377 ‫ت‬ ‫دّل‬ ‫ش‬ ‫خ‬‫ب‬ ‫اى‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ ‫ل‬ ‫ك‬ ‫ي‬‫خصْص‬ ‫ش‬ ‫خ‬‫ب‬ ‫اى‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ ‫ل‬ ‫ك‬ ‫ى‬‫ا‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ ‫ل‬ ‫ك‬
  51. 51. 0 50 100 150 200 250 300 350 400 450 1361 1362 1363 1364 1365 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 1376 1377 1378 ‫ي‬‫ٌگ‬ ‫ذي‬ ‫ق‬ ً G.D.P ‫اري‬‫ج‬ ‫ت‬ ‫دّل‬ ‫ـ‬ ‫اى‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اري‬‫ج‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ ‫شْر‬ ‫ك‬ ‫ـ‬ ‫اى‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ
  52. 52. 0 100 200 300 400 500 600 700 800 1338 1340 1342 1344 1346 1348 1350 1352 1354 1356 1358 1360 1362 1364 1366 1368 1370 1372 1374 ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫در‬ ‫ْرم‬‫ت‬ ‫ل‬ ‫ك‬ ‫شاخص‬
  53. 53. Out of Pocket  - - - - CatastrophicNon-Catastrophic
  54. 54. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Catastrophic NonCatastrophic Drug Dental Outpatient Inpatient Out of Pocket
  55. 55. Other Government Incomes Household Income Public Fund Insurance Fund Health Care Facility Health Care Provider Resource Generators Client Foreign Resources Tax Premium Out of Pocket Charities
  56. 56. Out of Pocket        
  57. 57. 35% 65% 0% 10% 20% 30% 40% 50% 60% 70% Insured UnInsured

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