Social determinants of health inequity in Iran: a narrative review.

Objective: COVID-19 burden the health system by influencing several aspects of social determinants of health (SDH). We review SDH inequity in Iran with notice on COVID-19 pandemic and sanctions. Method: The Databases such as MEDLINE, Scopus, and Google Scholar were searched. The SDH components were extracted regarding the effect of COVID-19 and sanctions. Global burden of disease was used to evaluate the impact of sanctions on mortality in Iran. Result: The literacy rate improved over the last decades but, there is still inequality between provinces. Age and regional inequity exists, regarding NCD mortality. Food insecurity varies in different regions between 20% and 60%.Providing care for a growing aging population, with a large burden of NCDs and disabilities will be the major issue in the next decade. The decrease slop of mortality rate due to NCDs, have become smoother since impose of sanctions, while, cancer mortality have changed upwards. COVID-19, and sanctions negatively impacts lower socioeconomically vulnerable groups due to preexisting conditions which wider the existing inequity in SDH are adding a heavy burden of inequity in Iran. Conclusion: Iran, similar to large numbers of countries, face inequity at regional level in different SDH related issues. The COVID-19 pandemic showed that economic status and health are aligned. Sanctions superimposed on the COVID-19 pandemic cause harm to millions of innocent people. One of the main goals of health authorities is to reduce SDH inequity in order to achieve the goal of "health for all". To tackle these inequities, prompt action is needed.