Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 10 2023 09 30 2196 2206 EN Alireza Mirahmadizadeh Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Jafar Hassanzadeh Research Center for Health Sciences, Institute of Health, Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran Maryam Janfada Medical Records, Health Vice-Chancellor, Shiraz University of Medical Sciences, Shiraz, Iran Habibollah Azarbakhsh Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran 2022 05 07 2022 09 24 Background: Traditionally, mortality rates are used to estimate public health problems and determine the relative significance of different causes of mortality, but they cannot necessarily determine the burden of premature death.  We aimed to investigate the 16-year trend of burden of premature mortality in Southern Iran. Methods: In this cross-sectional study, all deaths due to various causes of death in Fars Province from the electronic population-based death registration system (EDRS) were obtained. Crude and age-standardized mortality rate, Years of Life Lost (YLL) and YLL rate data were calculated and to examine the trend, joinpoint regression was used.   Results: During the study period, 281,903 deaths occurred, of which, 59.85% (n=168,735) occurred in men. Also, 42.18% of these deaths (n=118,610) occurred due to cardiovascular diseases (CVDs). The total number of YLLs due to premature death was 4,154,828 years. Of these, 2,591,564 years (62.37%) were in men. The highest number of YLL was due to CVDs, external causes of death and cancer. Trend of YLL rate due to premature mortality was decreasing: the annual percent change (APC) was -2.1% (95% CI -2.6 to -1.6, P<0.001) for males, -0.9% (95% CI -1.4 to -0.4, P=0.002) (P=0.002) for females. Conclusion: Although the trend of premature death has been decreasing during the years of study, but the seven major causes of premature death in 2004 to 2019 were non-communicable diseases, especially ischemic heart diseases, stroke, external cause of morbidity, and cancer.  Furthermore, our findings indicate a change in the role of non-communicable diseases in premature mortality in recent years. https://ijph.tums.ac.ir/index.php/ijph/article/view/28653 https://ijph.tums.ac.ir/index.php/ijph/article/download/28653/8068