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2 "Mohammad Aryaie"
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COVID-19: Original Article
Unemployment and COVID-19-related mortality: a historical cohort study of 50,000 COVID-19 patients in Fars, Iran
Alireza Mirahmadizadeh, Mohammad Taghi Badeleh Shamooshaki, Amineh Dadvar, Mohammad Javad Moradian, Mohammad Aryaie
Epidemiol Health. 2022;44:e2022032.   Published online March 12, 2022
  • 6,095 View
  • 390 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDF
Previous studies have estimated the risk of death associated with unemployment in the coronavirus disease 2019 (COVID-19) pandemic, but no studies have examined unemployment before COVID-19 infection as a risk factor for COVID-19-related mortality. Thus, this study aimed to investigate COVID-19 mortality among this population.
Data on 50,038 people aged 25-59 years were collected from 38 agencies in Fars Province, Iran, from February 2020 to July 2021. Follow-up lasted from participants’ diagnosis with COVID-19 based on the results of a reverse transcription-polymerase chain reaction test to participants’ death or the end of the study period. The association between unemployment and COVID-19-related mortality was estimated using the Poisson regression method, and a sensitivity analysis was conducted to calculate the E-value.
Unemployment was associated with a 2.41-fold (95% confidence interval [CI], 2.01 to 2.90) higher age-adjusted and sex-adjusted risk of COVID-19-related mortality. The adjusted Poisson regression analysis showed 8.82 (95% CI, 6.42 to 12.11), 2.84 (95% CI, 1.90 to 4.24), and 1.58 (95% CI, 1.24 to 2.01) times higher risks of COVID-19-related mortality among unemployed people aged 25-39 years, 40-49 years, and 50-59 years, respectively, than among their employed counterparts. Unemployment increased the risk of COVID-19 mortality by 3.31 (95% CI, 2.31 to 4.74) and 2.30 (95% CI, 1.86 to 2.84) times in female and male, respectively. The E-value was 3.43, reflecting the minimum strength of confounding required to shift the association between unemployment and COVID-19-related mortality toward the null.
Unemployment prior to COVID-19 infection increased the risk of COVID-19-related mortality. COVID-19-related mortality disproportionately impacted unemployed women and younger unemployed people.
Key Message
This study adds new insights to the existing body of work on the topic of unemployment and COVID-19-related mortality. Unemployment prior to COVID-19 infection was found to increase the risk of COVID-19-related mortality, which disproportionately burdened unemployed female and younger unemployed people. It seems older unemployed people and unemployed males may tend to have more financial resources and savings when they lose a job, making younger unemployed people and unemployed female more vulnerable to financial stress, which can lead to deferred care and increase their risk of COVID-19-related mortality.


Citations to this article as recorded by  
  • Is there a relationship between internet access and COVID-19 mortality? Evidence from Nigeria based on a spatial analysis
    Richard Adeleke
    Dialogues in Health.2023; 2: 100102.     CrossRef
  • Determinant Factors of Mortality in Pre-elderly and Elderly Patients With COVID-19 in Jakarta, Indonesia
    Thresya Febrianti, Ngabila Salama, Inggariwati, Dwi Oktavia
    Journal of Preventive Medicine and Public Health.2023; 56(3): 231.     CrossRef
Original Article
Predictors of Colorectal Cancer Survival in Golestan, Iran: A Population-based Study
Mohammad Aryaie, Gholamreza Roshandel, Shahryar Semnani, Mohsen Asadi-Lari, Mohsen Aarabi, Mohammad Ali Vakili, Vahideh Kazemnejhad, Seyed Mehdi Sedaghat, Masoud Solaymani-Dodaran
Epidemiol Health. 2013;35:e2013004.   Published online June 20, 2013
  • 14,341 View
  • 124 Download
  • 15 Citations
AbstractAbstract PDF

We aimed to investigate factors associated with colorectal cancer survival in Golestan, Iran.


We used a population based cancer registry to recruit study subjects. All patients registered since 2004 were contacted and data were collected using structured questionnaires and trained interviewers. All the existing evidences to determine the stage of the cancer were also collected. The time from first diagnosis to death was compared in patients according to their stage of cancer using the Kaplan-Meir method. A Cox proportional hazard model was built to examine their survival experience by taking into account other covariates.


Out of a total of 345 subjects, 227 were traced. Median age of the subjects was 54 and more than 42% were under 50 years old. We found 132 deaths among these patients, 5 of which were non-colorectal related deaths. The median survival time for the entire cohort was 3.56 years. A borderline significant difference in survival experience was detected for ethnicity (log rank test, p=0.053). Using Cox proportional hazard modeling, only cancer stage remained significantly associated with time of death in the final model.


Colorectal cancer occurs at a younger age among people living in Golestan province. A very young age at presentation and what appears to be a high proportion of patients presenting with late stage in this area suggest this population might benefit substantially from early diagnoses by introducing age adapted screening programs.



Citations to this article as recorded by  
  • Prognostic Factors of Rectal Cancer in Southern Iran
    Seyed Vahid Hosseini, Abbas Rezaianzadeh, Salar Rahimikazerooni, Alimohammad Bananzadeh, Afrouz Farghadin, Mohammad Zare Band Amiry, Ahmad Izadpanah, Mohammad Mohammadianpanah, Sohrab Iranpour
    Journal of Gastrointestinal Cancer.2022; 53(1): 113.     CrossRef
  • Colorectal cancer incidence and mortality trends by sex and population group in South Africa: 2002–2014
    Lactatia Motsuku, Wenlong Carl Chen, Mazvita Molleen Muchengeti, Megan Naidoo, Tamlyn Mac Quene, Patricia Kellett, Matshediso Ivy Mohlala, Kathryn M. Chu, Elvira Singh
    BMC Cancer.2021;[Epub]     CrossRef
  • Detection Rate of Colorectal Polyps in Symptomatic Candidates of Colonoscopy: When Should We Do a Total Colonoscopy?
    Alireza Norouzi, Sima Besharat, Fazel Isapanah Amlashi, Maryam Nasrabadi, Isan Gharanjik, Ali Ashkbari, Zoha Riahi, Sajjad Kaabe, Iman Shahabi Nasab, Gholamreza Roshandel, Ahmad Sohrabi, Taghi Amiriani, Shahryar Semnani
    Middle East Journal of Digestive Diseases.2021; 13(4): 314.     CrossRef
  • Associated Factors of Survival Rate and Screening for Colorectal Cancer in Iran: a Systematic Review
    Hossein Mozafar Saadati, Farzad Khodamoradi, Hamid Salehiniya
    Journal of Gastrointestinal Cancer.2020; 51(2): 401.     CrossRef
  • Survival Status and Predictors of Mortality Among Colorectal Cancer Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Follow-up Study
    Bantalem Tilaye Atinafu, Fekadu Aga Bulti, Tefera Mulugeta Demelew
    Journal of Cancer Prevention.2020; 25(1): 38.     CrossRef
  • Survival Rate of Colorectal Cancer in Eastern Mediterranean Region Countries: A Systematic Review and Meta-Analysis
    Hossein-Ali Nikbakht, Soheil Hassanipour, Layla Shojaie, Mohebat Vali, Saber Ghaffari-fam, Mousa Ghelichi-ghojogh, Zahra Maleki, Morteza Arab-Zozani, Elham Abdzadeh, Hamed Delam, Hamid Salehiniya, Maryam Shafiee, Salman Mohammadi
    Cancer Control.2020; 27(1): 107327482096414.     CrossRef
  • Temporal and geographical variations in colorectal cancer incidence in Northern Iran 2004–2013
    Susan Hasanpour-Heidari, Abdolreza Fazel, Shahryar Semnani, Seyyed-Reza Khandoozi, Taghi Amiriani, SeyedMehdi Sedaghat, Reza Hosseinpoor, Ramin Azarhoush, Mohammad Poorabbasi, Mohammad Naeimi-Tabiei, Gholamreza Roshandel, Freddie Bray, Elisabete Weiderpas
    Cancer Epidemiology.2019; 59: 143.     CrossRef
  • Clinicopathological features and survival of colorectal cancer patients younger than 50 years: a retrospective comparative study
    Robabeh Ghodssi-Ghassemabadi, Ebrahim Hajizadeh, Shaghayegh Kamian, Mahmood Mahmoudi
    Journal of the Egyptian National Cancer Institute.2019;[Epub]     CrossRef
  • Building cancer registries in a lower resource setting: The 10-year experience of Golestan, Northern Iran
    Gholamreza Roshandel, Shahryar Semnani, Abdolreza Fazel, Mohammadreza Honarvar, MohammadHossein Taziki, SeyedMehdi Sedaghat, Nafiseh Abdolahi, Mohammad Ashaari, Mohammad Poorabbasi, Susan Hasanpour, SeyedAhmad Hosseini, SeyedMohsen Mansuri, Ataollah Jahan
    Cancer Epidemiology.2018; 52: 128.     CrossRef
  • Preferences for Colorectal Cancer Screening Tests: Differences Between Insured and Uninsured Beneficiaries of Iranian Health Transformation Plan
    Vajiheh Ramezani Doroh, Alireza Delavari, Mehdi Yaseri, Sara Emamgholipour Sefiddashti, Ali Akbari Sari
    Health Scope.2018;[Epub]     CrossRef
  • Prognostic factors and survival of colorectal cancer in Kurdistan province, Iran
    Mohammad Aziz Rasouli, Ghobad Moradi, Daem Roshani, Bahram Nikkhoo, Ebrahim Ghaderi, Bahman Ghaytasi
    Medicine.2017; 96(6): e5941.     CrossRef
  • Colorectal Cancer in Iran: Molecular Epidemiology and Screening Strategies
    Roya Dolatkhah, Mohammad Hossein Somi, Mortaza Jabbarpour Bonyadi, Iraj Asvadi Kermani, Faris Farassati, Saeed Dastgiri
    Journal of Cancer Epidemiology.2015; 2015: 1.     CrossRef
  • Recurrence and Five Year Survival in Colorectal Cancer Patients After Surgery
    Seyed Reza Fatemi, Mohamad Amin Pourhoseingholi, Farshad Asadi, Mohsen Vahedi, Sara Pasha, Leila Alizadeh, Mohammad Reza Zali
    Iranian Journal of Cancer Prevention.2015;[Epub]     CrossRef
  • An Overview of Clinical and Pathological Characteristics and Survival Rate of Colorectal Cancer in Iran
    Sareh Hoseini, Leila Moaddabshoar, Simin Hemati, Mohammad Mohammadianpanah
    Annals of Colorectal Research.2014;[Epub]     CrossRef
  • Overview of Cancer Registration Research in the Asian Pacific from 2008-2013
    Malcolm A. Moore
    Asian Pacific Journal of Cancer Prevention.2013; 14(8): 4461.     CrossRef

Epidemiol Health : Epidemiology and Health