Social Development and Revolution in Iran

According to Amartya Sen (1999, 2001), development should be assessed by how it expands peoples’ capacities and freedoms to do what they value to do. There are instrumental freedoms, then, that contribute to people’s overall freedom and capacities: “What a person has the actual capability to achieve is influenced by economic opportunities, political liberties, social facilities, and the enabling conditions of good health, basic education, and the encouragement and cultivation of initiatives” (Sen 2001:507). In this article, I focus on the enabling conditions of health and basic education, as well as on poverty and income inequality, which are obstacles to economic opportunity. I call these aspects of development “social development” to distinguish them from notions of either political or strictly economic development.

Various indicators have been used in analyses of welfare and social developments in Iran, including life expectancy, infant mortality, literacy, poverty, and income. Here, I discuss their role in the existing literature and how their trendlines compare in the periods before and after the revolution. Some, such as infant mortality and literacy, show continuity before and after the revolution, and for these I present charts that speak to the pace of change across the two periods. The data on doctors, hospital beds, and housing are presented for the first time in this article. This is of course not an exhaustive list of development indicators, but they still provide a multidimensional picture of social development in Iran before and after the revolution.

The revolution of 1977 to 1979 occurred at the end of a period of economic growth that lasted from the mid-1950s to the mid-1970s. Following the revolution, Iran entered a period of rapid economic decline. Real GDP per capita dropped to 54% of its 1976 peak. As Hadi Salehi Esfahani and M. Hashem Pesaran (2009:192–93) write: “Many factors account for this decline, particularly the high political risks for private investors after the Revolution, the exodus of large numbers of skilled professionals, adoption of adverse economic policies, falling oil revenues, and the highly destructive war with Iraq.” In an innovative recent article, Mohammad Reza Farzanegan (2020) estimates that as a result of the revolution and war, the average Iranian lost a total of USD 34,660 between 1978 and 1988. While GDP per capita is an important indicator of development, there are other non-income indicators that could be more informative about welfare and social development than income. But income is still relevant to other indicators of welfare, as it provides resources for welfare provision.

Life expectancy is another indicator of social development, and it can tell us more than GDP about the welfare consequences of the Iranian Revolution. Scholars of social development in Iran have examined life expectancy in terms of welfare provision but with contrasting conclusions. Drawing on World Bank life expectancy indicators, Harris (2017) argues for the effectiveness of social development since the revolution, while Farzanegan (2021) estimates that, in the absence of revolution and war, the average life expectancy of an Iranian between 1978 and 1988, could have been six years longer. Why do we see such a discrepancy in conclusions about post-revolution life expectancy in Iran? It seems to result from looking at different indicators of life expectancy and the period of data presentation. Harris (2017:6) only considers data on female life expectancy, and only for the period after 1980. We do observe an upward trend in female life expectancy after the revolution, but this trend began before the revolution (Figure 1). If the country was going through an inclusive social revolution after 1979, or more effective design and implementation of social policies, we would observe a discontinuity after the revolution, with larger increases in female life expectancy, but the chart shows continuity rather than rupture. On the other hand, we observe a clear decline in male and overall life expectancy during the period of revolution and war, which Harris has not presented in his analysis. Farzanegan uses total life expectancy (including both male and female) for his analysis. The charts for male and total life expectancy show a negative jump, implying destructive effects of revolution and war on the life expectancy of Iranians. The World Bank is a trusted and widely used source of data in cross-national studies on various topics, but it is possible that part of the decline in male and overall life expectancy in Iran is the result of overestimating the casualties of the Iran–Iraq War. This concern needs additional investigation.

While the decline of overall and male life expectancy after the revolution undercuts the idea of a social revolution in Iran, details of female life expectancy further complicate the argument about an inclusive social revolution in Iran after 1979. Figure 2 depicts the change in female life expectancy by subtracting the value in each year from that of the previous year. We can see that the slope is steeper before the revolution.

In all the years before and after the revolution, female life expectancy has been increasing in Iran, but before 1978, this increase was accelerating, while after 1978, it slowed. If we imagine the state as a car driving on the road to longer female life expectancy, up to 1978, the car’s speed was increasing; after 1978, it was still going forward, but with decreasing speed every year. The shah’s personalist autocratic rule and the limited nature of the political process, especially after 1963, rendered his developmental project vulnerable to upheavals such as the revolution, but the comparison of female life expectancy before and after the revolution further challenges the argument for an inclusive social revolution after 1979.

Infant mortality is another useful indicator of social development in a country. The infant mortality rate has declined continuously, before and after the revolution (Figure 3). Harris (2017:8) presented this data, but only for after 1980, to support the effectiveness of social development under the Islamic Republic. To compare pre- and post-revolutionary welfare trends, we must draw on the data from both periods. If we look at the changes in the downward trend of infant mortality, we again observe a turning point around the revolution, which points to a negative effect on the expansion of welfare provision (Figure 4). From 1978 onward, the infant mortality rate in Iran has continued to decrease, but with a decreasing speed. For both female life expectancy and infant mortality, it is natural for the pace of change to ease as a country makes progress, but it is still significant that the inflection point from acceleration to deceleration occurs over the time of the revolution.

Life expectancy and infant mortality are both related to a state’s capacity to expand health institutions and increase the number of practitioners in the country. Accordingly, we can also measure the rate of increase or decrease in the number of hospital beds and doctors in the country before and after the revolution, using data from Iran’s Statistical Yearbooks. Figure 5 presents the raw number of hospital beds at the bottom and the number per 100,000 citizens at the top. The ratio of hospital beds to population increased up to 1976, the last year before the revolution for which data are available. In this year the ratio reached 166, but in 1979, it had dropped to 149. The ratio of 1976 was not reached again until 2007, about three decades after the revolution.

Figure 6 shows a similar pattern in the number of doctors. The number of doctors peaks at 16,937 in 1979, but then starts declining, to 9,852 in 1983. In terms of doctors per 100,000, the country does not catch up with the 1979 ratio of 45 until 2006. To show the effectiveness of health provision under the Islamic Republic, Harris (2017:171) quotes a former health official who claims that, as a result of the efforts of the Ministry of Health, “The number of doctors had doubled just during the war years alone.” Per the data shown in Figure 6, this claim is false. This discrepancy between official documents and figures and statements by officials reminds us yet again that statements by officials can at best be used as supplementary rather than as substitutes for original documents.

None of the indicators we have examined thus far supports the idea of an inclusive social revolution after 1979. The period of revolution, 1977 to 1979, is a turning point in life expectancy, infant mortality, the ratio of hospital beds, and the number of doctors—that is, an inflection point from acceleration to deceleration of positive change, or a clear slowing and decline. Rather than strengthening state capacity, it is evident that the revolution and war have slowed state performance in some key areas of welfare provision.

In addition to doctors and hospitals, Harris documents other components of Iran’s health system, for example, the expansion of “health houses” (khane-ha-ye behdasht) under the Islamic Republic. These are clinics in both rural and urban areas, staffed with health practitioners, that provide lower-skill health services locally. Hoodfar (2010) argues that they have made an important contribution to population control by providing information and family planning services in rural areas. Harris presents data from Iran’s Statistical Yearbooks that show an upward trend in the expansion of health houses and the coverage of the rural population from 1983 onward. While this is an important achievement, the context is also important. The first health house in Iran was founded in 1973 in the village of Qara Chorlu. The main idea for this facility was reliance on a staff of non-doctors to provide primary healthcare. At the time, this was known as the Reza’iye plan (for the name of the area), and it was implemented in some other villages as well. According to Yazdani (2020), there were 1,422 health houses in Iran in 1977. In 1978, the Ministry of Health adopted the Reza’iye plan to expand health services throughout the country.² That is, the plan was developed and adopted before the revolution. Given what we see in other indicators such as doctors and hospitals, it is plausible that the outbreak of the revolution and war might have slowed the implementation of the Reza’iye plan.

Literacy is another important indicator of social development. The charts at the top of Figure 7 present rates of literacy, based on censuses before and after the revolution. The chart at the top right breaks down the total literacy rate into urban and rural rates, as the chart at the top left does for gender. The charts at the bottom show increases in literacy rates for total, urban, rural, male, and female for every decade captured in censuses. In general, literacy has been increasing before and after the revolution. In other words, the progress since the revolution has continued a pre-revolution trend. Importantly, however, the gaps between urban and rural and between male and female have narrowed since (but not before) the revolution.

As with life expectancy and infant mortality, it is useful to consider the pace of improvement in each period. The largest increases in urban and male literacy occurred before the revolution, during the periods of 1956 to 1966 and 1966 to 1976 (bottom of Figure 8). In rural and female literacy, however, the largest increases occurred after the revolution, during the periods of 1976 to 1986 and 1986 to 1996. In terms of improvements in total literacy, the pre- and post-revolutionary regimes seem to be on par, with the largest increase (18.1%) from 1966 to 1976, and the second-largest (17.7%) from 1986 to 1996. The diminishing gaps between urban and rural and between male and female literacy rates points to more inclusive literacy campaigns after the revolution. Note that the proportion of urban to rural population has been increasing throughout the last century as Iran has become more of an urban society.

A number of conclusions can thus far be drawn about social welfare in Iran before and after the revolution. First, we should be looking at multiple indicators, as there might be discrepancies across different policy outcomes. Second, we should examine indicators before and after the revolution. Third, when we observe continuity in an indicator, such as female life expectancy or infant mortality rate, we should consider the pace of change as well. For rural and female literacy we observe larger gains after the revolution, but other indicators examined here do not point to better or more inclusive performance after the revolution in terms of welfare or development. We also know that, since the revolution, there has been considerable improvement in services, such as piped water and electricity, to rural areas (Salehi Isfahani 2019). It thus appears that since the revolution strong social development improvements have occurred in rural areas. What is ironic is that the Iranian Revolution was primarily an urban revolution.

Other relevant indicators show effective improvement in the life of Iranians after the revolution. For example, thanks to the efforts of Iranian economist Djavad Salehi Isfahani (2017), we know that since the revolution the poverty rate (the percentage of the population living on an average of USD 5 PPP per person per day or less) has fallen, and the middle class has grown. Harris (2017:178) presents Salehi Isfahani’s data on poverty rates since the revolution to show the effectiveness of the new social policies. The reduction of poverty from 1995 to 2011 is indeed a considerable policy success, but note that it occurs during a period of economic growth induced by booming oil prices. The importance of this context is downplayed in Harris’s work (2017:177): “Although oil prices are usually associated with welfare outcomes, in theory, through the spoils of rentier-state distribution, poverty trends in Iran do not neatly follow the oil markets.” Nevertheless, there is an obvious overlap between rising oil prices, rising GDP per capita, and the reduction in poverty (Figure 8). Populist government spending is plausibly an important part of this poverty reduction, but so is oil-induced economic growth. As Salehi Isfahani (2017:125) writes,

Even with reliance on petrodollars, reducing poverty is a remarkable achievement, but since this was already occurring before the revolution, one could ask how the post-revolutionary reduction in poverty (during a period of economic growth) is different. Furthermore, when we recognize the role of oil-induced growth in poverty reduction, we can ask important questions about different policy outcomes and oil-induced economic growth. For example, we observe that oil-induced growth in Iran has paralleled poverty reduction, but we do not see a similar relationship with income inequality. Again, as Salehi Isfahani notes, Iran’s policies have not been highly effective in reducing income inequality. As Lob (2018) also points out, Iran’s inequality is worse than the Middle East’s average, and similar to its neighbor Turkey, which has not gone through a revolution with social justice as its main slogan.

Figure 9 presents the trend in income inequality in Iran before and after the revolution. It should be noted that Iran does not have an effective and transparent system of taxation. As a result, we lack high-quality data on the extent of income inequality in the country; but the existing data are consistent enough to compare the pre- and post-revolution situations. The data for Iran are based on a household survey the government has been conducting since 1968 that includes extensive detail on the income and expenses of families. A shortcoming of these data is that they do not include the highest income earners, because of the sample size (Salehi Isfahani 2017). Better-quality data with which to examine income inequality would be government tax receipts (Piketty 2014, 2020).

The country experienced its greatest income inequality before the revolution, during the oil boom of the 1970s (Figure 10). This is a period during which the shah had focused on economic growth, without much regard for redistribution. Nonetheless, inequality began to diminish before the revolution, and this level was never again reached under the Islamic Republic. We observe another reduction in inequality immediately following the revolution, which seems to be the result of the revolution’s negative consequences for high earners (Farzanegan and Alaedini 2018:22). As Salehi Isfahani (2017:129) notes,

Scholars have noted a second reduction in income inequality in 2011, which resulted from a cash transfer policy (discussed below). While Iran then reached its lowest income inequality, according to existing indicators, it did not endure—see Figure 9 (Karshenas and Tabatabai 2019). Overall, income has been more equal in the post-revolutionary regime, in the sense that it has not returned to the high inequality of the 1970s. Nonetheless, the trends under the Islamic Republic show continued stagnation and no improvement through redistributive policies.

There are certainly success stories since the revolution. Some are continuations of Pahlavi-era policies, as evident in infant mortality and female life expectancy, which have continued to decline, albeit at a slower pace. Some surpass Pahlavi’s successes, such as the increase in literacy in rural areas and among women since the revolution (which does not correspond with economic growth) and poverty reduction (which is related to oil-induced economic growth). Population control and lower fertility rates are among other post-revolutionary successes (Abbasi-Shavazi, McDonald, and Hosseini-Chavoshi 2009; Ladier-Fouladi 1997). The leaders of the Islamic Republic adopted this policy of population control after dismantling Iran’s new population control policy in the first years of the revolution, and then seeing a sudden increase in population growth in the country (Hoodfar 1994; Hoodfar and Assadpour 2000). At the same time, there are welfare policy failures after the revolution, such as the government’s poor performance in creating jobs (Salehi Isfahani 2019), some areas of health provision (male life expectancy, ratio of doctors to population, and ratio of hospital beds to population), and housing (see Figure 10 for the rates of homeowners and renters before and after the revolution).³ As the decline in the ratio of doctors and hospital beds to citizens shows, state provision of some health services to the population has declined since the revolution.

To reflect the complexity and heterogeneity of different policy outcomes before and after the revolution, we need to go beyond categories such as “inclusive” and “exclusive.” In her ethnographic analysis of women-only spaces in Tehran, sociologist Nazanin Shahrokni (2019) presents an alternative approach through the concept of “differential inclusion/exclusion,” arguing that policies can have both inclusionary and exclusionary outcomes simultaneously, or at different times. The mixed results of policy outcomes and the decline in some important state services reviewed here present more of a challenge to the expectations drawn from Skocpol’s theory about the social effects of revolutions and wars. Rather than expecting a full improvement or decline in all development outcomes, it might be theoretically and empirically more fruitful to examine these areas separately and then try to understand the overall transformations in social development as a result of revolutions.

Overall, it appears that the argument presented for an inclusive social revolution after 1979 (Harris 2017) is based on a glowing report of post-revolution success stories without the requisite background and context. As Iranian political economist Mohammad Maljou has suggested, such a framework introduces systematic selection bias in the argument for better social development and health provision after the revolution and war. In his response to Harris’ book, Maljou states that the argument for an inclusive social revolution after 1979 rests on underreporting welfare under Pahlavi and exaggerating welfare provision after the revolution. After one accounts for these two errors, Maljou says, “the idea of an inclusive social revolution to a large extent melts into air like smoke” (IBNA 2019). A recent review of Harris’ book by Farshid Yazdani (2020), a researcher in Iran’s social policy, points to many factual inaccuracies and errors in the argument that exaggerate development performance since the revolution and understate it before the revolution. Among other things, Harris (2017) underreports the number of individuals covered by insurance before the revolution (61) and Iran’s GNP in the 1960s, overreports average family size before the revolution (126)—which exaggerates the reduction in fertility rates after the revolution—and underreports the reduction in legal age of marriage after the revolution (133).

Thus far, I have argued that existing evidence does not support an overall improvement in social development and state capacity in Iran after the revolution, contrary to the expectations of theories about the positive effect of social revolutions on states’ developmental capacity (Skocpol 1979, 1995). Nonetheless, it is still worthwhile to consider how post-revolutionary politics have affected social development and the state in Iran. Even though repression, exclusion, and authoritarianism remained as predominant features after the revolution, the configuration of Iranian politics underwent drastic changes.

First, elite competition and factionalism drastically increased compared with 1963 to 1977. The factional feature of Iranian politics is a widely recognized dynamic in post-1979 Iran and has been the subject of scholarly analysis and investigation (Ayatollahi Tabaar 2018; Keshavarzian 2005; Moslem 2002). Second, popular mobilization has increased since 1977. This has manifested itself both in anti-government mobilization using armed and unarmed methods, and in mobilization by and within the state. In the 1980s, war mobilization by the state and insurgent mobilization against the state were the main forms of popular mobilization. Since the 1990s, electoral mobilization has also become an important dynamic. Scholars of Iranian politics have examined the dynamics of different episodes of contention and the interaction of popular mobilization and elite politics through different post-revolutionary periods (Alemzadeh 2018; Kadivar 2013; Kadivar and Abedini 2020; Mashayekhi 2001; Moghadam and Gheytanchi 2010; Rivetti 2020). Third, since 1979 Iran’s foreign policy has become more confrontational, and Iran has been part of more regional and international conflicts. Scholars have disagreed on the cause, but this greater level of conflict is a fact recognized by scholars of Iran’s foreign policy and international relations (Byman et al. 2001; Ramazani 2013; Walt 1997).

While these changes are widely known among scholars of Iranian politics, the manner in which they have affected policy outcomes is the subject of debate and disagreement. Furthermore, since post-revolutionary social development outcomes vary in terms of improvement or decline, it is analytically necessary to consider how each of these mechanisms has served or undermined social development since the revolution.

Regarding factionalism, one approach contends that the increased elite competition since the revolution has contributed to further expansion of the welfare state and more inclusive social development. An important mechanism (in this approach) is the emergence of parallel welfare institutions due to factional competition (Harris 2017). Plausibly, to gain popular support, some factions have sought to expand welfare provision as part of their competition with other factions, although this hypothesis requires further specification and empirical evidence. But it is also plausible that factions block each other’s programs, for similar reasons. Furthermore, factions are likely to pack state bureaucracies with their cronies to expand their access to the spoils of the office. This is likely to undermine bureaucratic performance and increase corruption. For example, we know from the work of political economists that factionalism may harm economic growth (Kjetil, Farzanegan, and Friedrich 2013). Or, as Nazanin Shahrokni (2019) shows in her sophisticated and informative study of women’s demand to access sports stadiums in Iran, factional politics becomes detrimental to the cause, because each faction does not want another faction to take credit for giving women access to sports stadiums.

The example of cash transfers is telling here as well. In 2011, under President Ahmadinejad, Iran started a direct cash transfer program, which notably reduced income inequality in the country (Salehi Isfahani 2017). The program was related to reforms in energy subsidies, a policy that was discussed in Iran some years earlier. The Khatami administration (before Ahmadinejad) tried to start the subsidy reforms, but the process stalled due to resistance from the conservative parliament at the end of Khatami’s administration. There were debates in the country as to whether to adopt a targeted cash transfer or a universal cash transfer after the subsidy reforms. In 2005, Mehdi Karrubi, a reformist candidate, proposed in his electoral campaign a universal cash payment to each Iranian citizen. But he did not win that election, and his electoral promise was not fulfilled. Karrubi objected to voting irregularities, but his complaints fell on deaf ears, and Ahmadinejad won. In 2011, finally, both subsidy reforms and cash payments were implemented, and under Ahmadinejad’s presidency, the government also decided to conduct a universal cash transfer.

How the policies were developed, blocked, and postponed in the context of elite competition is noteworthy. Furthermore, the reforms in energy subsidies finally occurred when the state had become more unified, after 2005, as conservatives dominated both the executive and the legislature. In other words, at this time, factionalism had diminished, as reformists lost control of the legislature and executive in 2004 and 2005. The conservatives then implemented policies that reformists had developed and promoted earlier.⁴

It has been claimed that revolutionary and post-revolutionary popular mobilizations have contributed to the expansion of welfare in Iran—for example, that the universal cash transfers of 2011 were the result of the 2009 Green Movement protests, although this claim lacks empirical support (Harris 2017). A more developed and specified version of this argument is presented by Lob (2020), regarding Reconstruction Jihad (RJ) and its health and literacy campaigns in rural areas. RJ was a revolutionary organization, formed in 1979 after the fall of the monarchy, that allied with Islamists and focused on rural development. Lob’s argument about the developmental campaign of RJ in rural areas relates to the post-revolutionary expansion of literacy in rural areas presented in Figure 8. Lob argues that, in addition to health and development provisions, RJ also attempted to drive leftist organizations from rural areas. At the same time, Lob pays attention to the exclusionary efforts of an organization, such as RJ, in tandem with their developmental efforts to include the rural population in its access to different developmental services. Accordingly, one can also investigate other detrimental effects of the intense mobilizations of the 1980s.

In another important analysis of mobilization and social policy, Hoodfar (2010) documents how the mobilization of about a hundred thousand voluntary female health workers was integral to Iran’s success in implementing the population control policy. These volunteers also contributed to improving the provision of other health services in their communities. Some volunteers expressed interest in expanding their activities and in maintaining their volunteer network for future projects, but state officials dismissed such initiatives and did not facilitate the formation of an independent social organization out of this vast network of volunteers.

In addition to the positive effects, a comprehensive account of mobilization and social development would also consider how mobilization has contributed to loss of life in Iran, particularly for young men in the 1980s, a decade of intense political violence. From 1977 to 1979, the monarchy killed about 2,000 people, mostly men, during street protests. In the Iran–Iraq War, about 180,000 people were killed. Many members of insurgent groups such as Mojahedin-e Khalq and Kurdish fighters were killed in armed clashes with government forces. The government also executed thousands of opposition members, from leaders to the rank and file, along with royalists, leftists, and ethnic and religious minorities such as the Baha’i. It is thus reasonable to consider all the lives that were lost during the mobilizations from 1977 to 1988.⁵ At the same time that serious efforts were being undertaken to improve the life of rural Iranians through education and service provision, lives were being lost to mobilization. The level of popular mobilization in Iran has increased since 1977, but so has the level of repression and political violence.

In addition to the physical harms and resentments caused by popular mobilizations in 1977 to 1988 (Ehsani 2016), the psychological consequences of the trauma experienced during post-revolutionary mobilization and violence are also valid topics for investigation. In her ethnographic study of the psychiatric discourse within Iranian institutions, Orkideh Behrouzan (2016) documents how in the 1990s, after the end of the war, a psychiatric discourse emerged in Iran around rising psychological problems, such as heightened levels of depression, among the urban population. Data from Iran’s Statistical Yearbooks on the rate of suicide in the country from 1968 to 2015 are consistent with Behrouzan’s argument (Figure 11). Following the end of the Iran–Iraq war, the annual suicide rate increased from about one per hundred thousand to over four per hundred thousand. This is consistent with prior literature on the effect of war on suicide rates (Marshall 1981). For example, an analysis of suicide in Northern Ireland found that the cohort of children and young people that grew up during the period of most intense violence have higher levels of suicide and more rapidly rising suicide rates, compared to earlier and later cohorts (Tomlinson 2012). The relationship of war and suicide in Iran thus also deserves further attention and investigation.

Finally, in terms of the effect of foreign policy on social development, one approach contends that the anti-systemic tendencies of the Islamic Republic’s international politics have provided strong motivations for the country’s leadership to pursue developmental policies (Harris 2017). Movahed (2020), for example, documents how Iran developed and expanded a dynamic auto industry under sanctions. Similarly, part of the Islamic Republic’s leadership has maintained on occasion that superpowers can do no damage to the country, and that sanctions cannot harm Iran’s economy. For example, Iran’s leader, Ali Khamene’i, has claimed that “sanctions cannot harm us…. Under some conditions, sanctions can even benefit us; because it increases our efforts and activities” (BBC Persian 2016). However, scholars of political economy, and critics within Iran of Iran’s foreign policy, have highlighted the high economic cost of international confrontations, especially in the form of sanctions on Iran’s oil and banking sectors. This approach documents the negative effect of sanctions on economic growth in the formal and informal sectors, and the cost in household welfare among different income groups (Farzanegan and Hayo 2019; Farzanegan, Khabbazan, and Sadeghi 2016; Shahrokni 2021). Both before and since the revolution, Iran has pursued developmental projects, but post-revolutionary, confrontational foreign policy has limited these efforts in important ways. Sanctions, of course, reflect an unequal world system, in which superpowers impose sanctions on less powerful countries, but it is also undeniable that a faction within the Islamic Republic has sought confrontation and escalation with the United States to promote its own factional interests (Ayatollahi Tabaar 2018).⁶

How have developmental trends changed in Iran after the revolution of 1979? Different indicators examined in this article present a mixed picture of post-revolutionary developmental trends. Regarding male life expectancy, we observe a decline after the revolution until the end of the war. Female life expectancy has continued to increase similar to the pre-revolutionary upward trend, but the pace of progress has slowed down after the revolution. Infant mortality has decreased after the revolution, as it had been also decreasing before the revolution. Similar to female life expectancy, the pace of progress on this indicator has slowed down after the revolution. The ratio of hospital beds to population has decreased after the revolution. The number of doctors and doctor to population ratio also have decreased in the post-revolutionary period. Literacy has continued to increase after the revolution similar to the pre-revolutionary period, but with more expansion in rural areas and among women. Absolute poverty has decreased in periods before and after the revolution, and the changes in oil prices seem to be a common factor contributing in reduction of poverty before and after the revolution. Income inequality has decreased after the revolution and then the level of income inequality has stagnated after the initial decrease. Finally, while the percentage of home-owner households had been increasing before the revolution, this percentage has decreased in the post-revolutionary period. These results together depict a mixed picture of the post-revolutionary developmental trends. Among these outcomes, we observe improvement for example in terms of rural and female education. We also observe continuation of progress in areas such as female life expectancy and infant mortality, while the progress before the revolution has been accelerating and then then the progress has been decelerating since the revolution. In other words, progress in female life expectancy and infant mortality has slowed down after the revolution. We also observe decline in developmental trends in areas such as male life expectancy, ratio of hospital beds, ratio of doctors, and housing. How do these results matter for studies of revolution and war?

The effects of revolutions and war-making on state-building projects have been an important area of inquiry within comparative historical analysis. For example, as Charles Tilly (1975:42) famously said, “war made the state, and state made war” (see also Tilly 1992). Similarly, in her influential book on social revolutions, Skocpol (1979) contended that social revolutions in France, Russia, and China strengthened centralization and state capacity in the respective countries. And in her analysis of welfare in the United States, Skocpol (1995) documented how providing for the soldiers of the American Civil War and their families became an important source of social policy. One can think of extending such arguments to the case of Iran to claim that the 1979 revolution and the Iran–Iraq War culminated in a social revolution, imagined to give rise to broad and inclusive social development and welfare. But, as the evidence reviewed in this essay shows, the consequences of the revolution and war for social development do not fit the theoretical expectations driven by these studies. There is evidence that state capacity and performance in some areas of social development have slowed since the revolution. Instead of trying to fit the case of Iran to the theoretical expectations of these studies, it would be theoretically more fruitful to use the case of Iran to correct and revise these classic studies of the social consequences of revolutions and wars. More specifically, we can ask in what areas the revolution and war strengthened state capacity, versus undermining them. Then we can enquire through which simultaneous mechanisms and processes revolution and war undermine, strengthen, or reshape state-building projects. Of course the dimensions of social development examined in this article are not exhaustive. Future research could look into other indicators not examined here, such as social spending versus military spending, addiction and narcotics consumption, and informal housing, among others.

Among the different development indicators reviewed in this article, the ratios of doctors and hospital beds to the population are directly related to the COVID-19 epidemic the world and Iran have been suffering since 2020. These indicators show a decline in the post-revolution years. Previous cross-national research indicates a significant negative correlation between cumulative death rate due to COVID-19 and the number of hospital beds (Su et al. 2020). Based on these findings, one can make a case that the post-revolutionary decline in some areas of health provision has contributed to the high number of deaths due to COVID-19 in Iran.

As of this writing (September 2021), the official number of such deaths has surpassed 110,000 (Farsnews 2021). But according to officials in the Ministry of Health, the real number is about twice that (BBC Persian 2021), which means more than 220,000 deaths in a year and a half. This is more than the number of Iranians that were killed during the eight years of the Iran–Iraq War (about 180,000).

The government’s program for vaccination has been slow. As of early September 2021 Iran had vaccinated about 22% of the population, compared to 58% in neighboring Turkey. The failure of the vaccination program is also relevant to discussion of the performance of parallel institutions and development outcomes. Initially, government institutions announced the development and domestic production of five different vaccines within Iran, or in collaboration with Cuba and Russia. One was supposed to be developed by the Executive Headquarters for the Imam’s Decree (EHID), one of the parallel institutions under the authority of Iran’s leader. Given this institution’s connection with the leader’s office and other centers of power, other vaccines faced hurdles and impediments. A plan to import vaccines was also postponed, to support the future mass production of this vaccine for the domestic market (Roozarooz 2021). Reflecting the Islamic Republic’s confrontational foreign policy, Ali Khamenei also announced that he did not trust the American or British vaccines, and banned their importing. Mohammad Mokhber, the head of the EHID, promised on multiple occasions to produce and distribute millions of doses of Iran’s vaccine in the country, but this did not happen (Rouydad24 2021). And though the performance of Mokhber and his organization in vaccine production was an utter failure, in the summer of 2021, Mokhber was appointed vice president (to the new president, Ebrahim Raisi), and the government announced a new policy prioritizing vaccine imports, contrary to the earlier promises by Mokhber and others. With deaths and hospitalizations mounting with the advent of the Delta variant, many Iranians who lost loved ones have expressed frustration with the government’s failed vaccination policy. Public criticism has been so strong that Iran’s Ministry of Education has revised textbooks that earlier praised Iran’s effective containment of COVID-19 (ISNA 2021). This failure then serves as another important example of how parallel institutions and factionalism have hindered effective policy making and government action.

The approach presented here to assess the outcomes of the Iranian Revolution could be adopted to other revolutions as well, for example the classic cases of China, Russia, and France, or later revolutions of the twentieth century, such as Nicaragua, Algeria, and Mozambique. New data and research show that it is more accurate to consider the heterogeneity of outcomes in the classic cases examined by Skocpol, rather than assuming consistent improvement or decline across all indicators. For example, it seems that the French Revolution strengthened state bureaucracy but left major patterns of income inequality intact (Piketty 2020). China’s Cultural Revolution (1966 to 1976) resulted in a state with impressive developmental performance, but there is also evidence of detrimental effects on health and educational outcomes (Fan 2016, 2017). Future research can provide case studies of revolutionary outcomes based on various indicators and discussions of mechanisms linking revolutionary processes and developmental outcomes. Based on such case studies, then, scholars of revolutions and their outcomes could present comparisons between cases and make more general statements regarding the commonalities and differences in outcomes and mechanisms.

I thank Charles Kurzman, Houchang Chehabi, Benjamin Bradlow, Maryam Alemzadeh, Eskandar Sadeghi-Boroujerdi, Xiaohong Xu, and Neil Ketchley for their comments on the earlier drafts of this article. I also thank the editors and the two anonymous reviewers for their constructive feedback.