A global health expert's research revealed unexpected similarities between Iran and the United States—comparable life expectancy, higher literacy rates, and superior childhood immunization coverage—before U.S. and Israeli strikes began destroying hospitals, killing 160 schoolgirls, and creating food shortages. The data suggests Iranians lived lives not so different from Americans just weeks ago.
My work in global health always nudges me to learn about places and people I read about in the news. Right now: Iran, of course. Though I’ve never been there, I knew it was an incredibly old civilization, dating back several millennia with a vibrant culture and elegant, stunning architecture from the past. In recent decades it’s been led by a dictatorial, hard-line Muslim, the Supreme Leader. I investigated a few facts about the country because understanding how the health of people in other settings compares with ours is often enlightening. Iran is poorer economically than the U.S., so the population probably would have lower living standards, life expectancy, and literacy rates than we do. I’ve worked in public health in a number of low-income countries, so I also expected that use of important services like immunizations for children and family planning for women would be limited. A quick web search revealed that, indeed, our population is much wealthier than Iran’s. That country has a median income of $4300, compared to the U.S. with around $19,300. But the other assumptions didn’t fit what I expected. A surprising 100% of the population has access to electricity. Much lower life expectancy? No, they are not dying at young ages: the average Iranian man in 2024 would live to be 76 years old, not far behind the American man at 77 years. I also didn’t expect that most of the main causes of death were the same as ours – heart disease, stroke, hypertension and injuries. Adult literacy, an important social determinant of health, was even more perplexing: only 11% of Iranians were nonliterate in 2023, compared to 21% of Americans around that time. Maternal and child health practices are important monitors of a population’s well-being. So, another surprise: over 99% of Iranian children have the full set of immunizations by age five--while in the U.S. that rate is only 94% and said to be dropping. For women, childbearing patterns hint at their roles in family decision-making. How does that work in this solidly Muslim country? Another puzzler: at today’s birth rates, both Iranian and American women will have, on average, fewer than two children over their lifetimes. Pondering these numbers, I couldn’t escape the feeling that Iranians were, put simply, very much like us. They have strong families, send their children off to school every day, have basic conveniences and an efficient public health system. Or at least they did, until the current military onslaught by the U.S. and Israel began. Since then, the devastation of the country has been relentless: bombing of military targets with unknown numbers of civilian deaths— including the well-documented strike that killed some 160 schoolgirls. Over a dozen hospitals have been bombed, a pall of toxic “black rain” has fallen on Tehran as a result of the destruction of oil facilities, and food shortages in the cities are under way. It appears, however, that to date the death, destruction and massive displacement inflicted on their country has only strengthened the determination of the Iranian leadership, and also perhaps its people, to endure. At some point this war will end. Until then the people of Iran, whose everyday lives had not been so very different from ours just a few weeks ago, will continue to go to bed every night wondering what hell the Americans and Israelis will inflict their country the next day.
About the author ~
Dr. Mary Anne Mercer is a University of Washington public health faculty member and author whose four-decade career has focused on maternal and child health in developing nations. Beginning with her transformative year providing immunizations in rural Nepal in 1978, she has developed health projects in 14 countries and authored books including Beyond the Next Village (2022) and Sickness and Wealth: The Corporate Assault on Global Health. Her recent work strengthening midwifery care through mobile technology in Timor-Leste has been adopted as a national program.
Dr. Mary Anne Mercer is a University of Washington public health faculty member and author whose four-decade career has focused on maternal and child health in developing nations. Beginning with her transformative year providing immunizations in rural Nepal in 1978, she has developed health projects in 14 countries and authored books including Beyond the Next Village (2022) and Sickness and Wealth: The Corporate Assault on Global Health. Her recent work strengthening midwifery care through mobile technology in Timor-Leste has been adopted as a national program.
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