Health impacts of US international economic sanctions: a scoping review

Abstract

Abstract Objectives There is growing concern about potential deleterious health impacts from international economic sanctions imposed by the USA. We summarised the existing research on the health impacts of US-imposed international economic sanctions. Design Scoping review. Data sources PubMed, Embase, PsycINFO, EconLit and ProQuest Dissertations and Theses were searched through 30 November 2023 and Google Scholar through 22 December 2023, with an updated search of all databases through 26 January 2026. Eligibility criteria We included primary quantitative or qualitative English-language research documenting health impacts of economic sanctions in the domains of access to basic needs, access to medical services and supplies, and clinical outcomes. Data extraction and synthesis Two independent reviewers performed title, abstract and full-text reviews and extracted data from each paper using a standard data review form. We collected information on country/countries, domain(s), study design, population, data source(s), age, gender, sample size (n), results, including impact of sanctions on health-related measures and important emergent themes (for qualitative studies). Results We identified 2484 papers and included 43 in the review. Most studies (63%) were based in Iran. Access to drugs or medical equipment was evaluated in 25 studies (58%); 17 (40%) examined varied clinical outcomes and 8 (19%) focused on access to basic needs like clean water and food. The literature was of variable quality and some studies included incomplete methodological information. 42 of the 43 studies documented health-related harms associated with sanctions, including higher mortality rates, reduced access to essential medications, increased food insecurity and higher infectious disease rates. Conclusions This scoping review documents diverse health-related harms from international economic sanctions. The available literature consistently describes sanctions-associated health impacts. Uniformity of outcomes and methods would facilitate better quantification of health-related harms to inform physician involvement. Trial registration number OSF (https://doi.org/10.17605/OSF.IO/AKSDW).