Surgical Workforce, Socioeconomic Status, and the Global Burden of Orofacial Clefts

Objective The purpose of this study was to investigate the association between socioeconomic status and orofacial clefts (OFC) in Scotland. Design Study of prevalence at birth over a 10-year period using an area-based measure of material deprivation. Setting Population-based study throughout Scotland. Participants Eight hundred thirty-four live births with OFC born between January 1, 1989, and December 31, 1998, ascertained from the nationwide register of the Cleft Service in Scotland, compared with the total 603,825 live births in Scotland in this period. Results There was a strong positive relationship whereby the prevalence of OFC at birth increased with increasing deprivation. This trend was statistically significant for cleft lip and/or palate (CL[P]: p = .016) but not for cleft palate (CP; p = .078). For each type of cleft, the relative risk among those resident in the most deprived areas, compared with those resident in the least deprived areas, was 2.33. Conclusions The association between OFC and socioeconomic status is consistent with a report for an earlier period in a smaller part of Scotland. Unlike the earlier study, this pattern appears to be stronger for CL(P) than for CP. These observations do not appear to be an artifact of recording. It is possible that they reflect the association between deprivation and risk factors for OFC, most likely tobacco smoking during pregnancy. Because the relationship between OFC and socioeconomic status appears to have been virtually unstudied in other populations, it would be valuable to investigate this relationship elsewhere and determine whether known risk factors account for the relationship.

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The pattern and gender disparity in global burden of age-related macular degeneration

European Journal of Ophthalmology ◽

10.1177/1120672120927256 ◽

2020 ◽

pp. 112067212092725

Author(s):

Xiling Lin ◽

Lixia Lou ◽

Qi Miao ◽

Yijie Wang ◽

Kai Jin ◽

...

Keyword(s):

Socioeconomic Status ◽

Macular Degeneration ◽

Gender Disparity ◽

Age Related Macular Degeneration ◽

Global Burden ◽

Gini Coefficients ◽

Male Ratio ◽

Age Related ◽

Life Years ◽

And Gender

Purpose: To explore the trend patterns and gender disparity in global burden of age-related macular degeneration (AMD) by year, age, and socioeconomic status using disability-adjusted life-years (DALYs) from Global Burden of Disease (GBD) study 2017. Methods: DALYs and impairment data caused by AMD were extracted from GBD Study 2017. World Bank income level (WBIL) and human development index (HDI) in 2017 were cited as indicators of socioeconomic status. The Gini coefficients and the concentration indexes were calculated to unveil trends in between-country inequality. The association between gender inequality and socioeconomic levels was analyzed by Pearson correlation. Results: Total age-standardized DALYs of AMD showed a slightly descending pattern in recent years. However, gender disparity has existed since 1990 for almost three decades, with female being more heavily impacted. This pattern became more obvious with aging and varied among different WHO and WBIL regions. Meanwhile, female subjects tended to have higher vision impairments. Gini coefficients of AMD burden increased from 0.423 to 0.448, while the ones of female-to-male ratio fluctuated around 0.11 between 1990 and 2017, with concentration indexes changing from 0.024 to −0.057 and 0.046 to 0.029 respectively. Female-minus-male difference ( r = 0.1721, p = 0.0195) and female-to-male ratio ( r = 0.2072, p = 0.0048) of age-standardized DALYs rates were positively related to HDI. Conclusions: Though global AMD health care is progressing, gender imbalance in disease burden of AMD distribution barely improved. Gender sensitive health policy should be emphasized for the increasing elder population and relieving the higher AMD burden of females.

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Global Burden of Head and Neck Cancer: Economic Consequences, Health, and the Role of Surgery

Otolaryngology ◽

10.1177/0194599819897265 ◽

2020 ◽

Vol 162 (3) ◽

pp. 296-303 ◽

Cited By ~ 5

Author(s):

Rolvix H. Patterson ◽

Victoria G. Fischman ◽

Isaac Wasserman ◽

Jennifer Siu ◽

Mark G. Shrime ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Burden Of Disease ◽

Global Burden ◽

Mortality Burden ◽

Surgical Workforce ◽

Macroeconomic Effects ◽

Disease Study

Objective We aimed to describe the mortality burden and macroeconomic effects of head and neck cancer as well as delineate the role of surgical workforce in improving head and neck cancer outcomes. Study Design Statistical and economic analysis. Setting Research group. Subjects and Methods We conducted a statistical analysis on data from the World Development Indicators and the 2016 Global Burden of Disease study to describe the relationship between surgical workforce and global head and neck cancer mortality-to-incidence ratios. A value of lost output model was used to project the global macroeconomic effects of head and neck cancer. Results Significant differences in mortality-to-incidence ratios existed between Global Burden of Disease study superregions. An increase of surgical, anesthetic, and obstetric provider density by 10% significantly correlated with a reduction of 0.76% in mortality-to-incidence ratio ( P < .0001; adjusted R2 = 0.84). There will be a projected global cumulative loss of $535 billion US dollars (USD) in economic output due to head and neck cancer between 2018 and 2030. Southeast Asia, East Asia, and Oceania will suffer the greatest gross domestic product (GDP) losses at $180 billion USD, and South Asia will lose $133 billion USD. Conclusion The mortality burden of head and neck cancer is increasing and disproportionately affects those in low- and middle-income countries and regions with limited surgical workforces. This imbalance results in large and growing economic losses in countries that already face significant resource constraints. Urgent investment in the surgical workforce is necessary to ensure access to timely surgical services and reverse these negative trends.

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Socioeconomic Status and Orofacial Clefts in Scotland, 1989 to 1998

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569(2003)040<0481:ssaoci>2.0.co;2 ◽

2003 ◽

Vol 40 (5) ◽

pp. 481-485 ◽

Cited By ~ 31

Author(s):

J. D. Clark ◽

P. A. Mossey ◽

L. Sharp ◽

J. Little

Keyword(s):

Socioeconomic Status ◽

Orofacial Clefts

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Association of Sex with the Global Burden of Age-related Macular Degeneration

10.21203/rs.3.rs-115175/v1 ◽

2020 ◽

Author(s):

Jing Wu ◽

Jiayue Zhou ◽

Xiajing Tang ◽

Xiaoning Yu ◽

Xingchao Shentu

Keyword(s):

Socioeconomic Status ◽

Linear Regression ◽

Macular Degeneration ◽

Human Development ◽

Pearson Correlation ◽

Age Related Macular Degeneration ◽

Global Burden ◽

Regression Analyses ◽

Public Attention ◽

Age Related

Abstract Background: Age-related macular degeneration (AMD) is the third leading cause of blindness and affects approximately 196 million people. This study aims to explore the association of sex with the global burden of AMD by year, age, and socioeconomic status using disability-adjusted life-years (DALYs).Methods: Global, national sex-specific DALY numbers, crude DALY rates, and age-standardized DALY rates caused by AMD, by year and age, were extracted from the Global Burden of Disease Study 2017. The human development index (HDI) in 2017 was extracted as an indicator of national socioeconomic status from the Human Development Report 2018 (HDR 2018). Pearson correlation and linear regression analyses were conducted to investigate the association between socioeconomic status and sex inequality of AMD.Results: Differences in the sex-specific global burden of AMD have persisted since 1990 to 2017. Female individuals had higher burden than male individuals of the same age in 2017, and the differences gradually increased after 55 years and maximized at 80 years or older with 105.41 DALYs rates in female vs 81.00 DALYs rates in male. The paired Wilcoxon signed rank test indicated that female had higher age-standardized DALY rates than male had (Z = -6.520, P < 0.001) and countries with lower HDI values had higher age-standardized DALY rates among both sexes. DALY rate ratio and sex differences in age-standardized DALY rates were positively associated with HDI in both Pearson correlation analyses and linear regression analyses of AMD. (P < 0.05).Conclusions: Although global blindness and vision impairment health care is progressing, sex inequality in AMD burden remained persistent since the past few decades. These findings might raise more public attention to the gender differences in global AMD burden and the association between the sex-related global burden and socioeconomic status.

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Global, regional, and national prevalence, disability adjusted life years, and time trends for refraction disorders, 1990–2019: findings from the global burden of disease study 2019

BMC Public Health ◽

10.1186/s12889-021-11648-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

He-Yan Li ◽

Yue-Ming Liu ◽

Li Dong ◽

Rui-Heng Zhang ◽

Wen-Da Zhou ◽

...

Keyword(s):

Socioeconomic Status ◽

Linear Regression ◽

World Bank ◽

Global Burden ◽

Prevalence Rates ◽

Disability Adjusted Life Years ◽

Health Burden ◽

National Characteristics ◽

Disability Adjusted Life ◽

Life Years

Abstract Background To evaluate global burden of refraction disorders by year, age, region, gender, socioeconomic status and other national characteristics in terms of disability adjusted life years (DALYs) and prevalence from Global Burden of Disease (GBD) study 2019 and World Bank Open Data 2019. Methods Global, regional, and national DALY numbers, crude DALY rates, age-standardized DALY and prevalence rates of refraction disorders were acquired from the GBD study 2019. Mobile cellular subscriptions, urban population, GDP per capita, access to electricity and total fertility rate were obtained from the World Bank to explore the factors that influenced the health burden of refraction disorders. Kruskal-Wallis test, linear regression and multiple linear regression were performed to evaluate the associations between the health burden with socioeconomic levels and other national characteristics. Wilcoxon Signed-Rank Test was used to investigate the gender disparity. Results Globally, age-standardized DALY rates of refraction disorders decreased from 88.9 (95% UI: 60.5–120.3) in 1990 to 81.5 (95% UI: 55.0–114.8) in 2019, and might fall to 73.16 (95% UI: 67.81–78.51) by 2050. Age-standardized prevalence rates would also reduce to 1830 (95% UI: 1700–1960) by 2050, from 2080 (95% UI: 1870–2310) in 1990 to 1960 (95% UI: 1750–2180) in 2019. In low SDI region, age-standardized DALY rates (equation: Y = 114.05*X + 27.88) and prevalence rates (equation: Y = 3171.1*X + 403.2) were positively correlated with SDI in linear regression respectively. East Asia had the highest blindness rate caused by refraction disorders in terms of age-standardized DALY rates (11.20, 95% UI: 7.38–16.36). Gender inequality was found among different age groups and SDI regions. Conclusion Health burden of refraction disorders decreased in recent years, and may continue to alleviate in the next three decades. Older ages, females and lower socioeconomic status were associated with higher refraction disorders health burden.

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Epidemiological Variations in the Global Burden of Psoriasis, an Analysis With Trends From 1990 to 2017

Frontiers in Medicine ◽

10.3389/fmed.2021.585634 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chen Peng ◽

Xin Xu ◽

Wenjuan Chen ◽

Xingzi Li ◽

Xuemei Yi ◽

...

Keyword(s):

Socioeconomic Status ◽

Global Health ◽

Geographical Location ◽

Epidemiological Studies ◽

Global Scale ◽

Global Burden ◽

Years Of Life Lost ◽

The Past ◽

Health Burden ◽

Life Years

Background: Although there have been many epidemiological studies, research focusing on psoriasis' health burden on a global scale is still lacking. Trends and variations in the global health burden of psoriasis are evaluated by time, age, gender, geographical location, and socioeconomic status, using disability-adjusted life years (DALYs) from the Global Burden of Disease Study.Methods: The health burden of psoriasis was evaluated by DALYs, which combined years lost to disability (a morbidity component) with years of life lost (a mortality component). The global and national DALYs number, crude DALYs rate, and age-standardized DALYs rate were obtained from the GBD 2017 study database. The corresponding human development index (HDI) was collected from the United Nations Development Programme.Results: From 1990 to 2017, the DALYs number and crude DALYs rate due to psoriasis increased by 73 and 22%, respectively. In comparison, the age-standardized DALYs rate showed a slight increase. Patients in the age range of 65–69 years bear a more significant psoriasis burden. Both males and females showed an increasing trend in burden caused by psoriasis over the past 27 years, with females bearing a more significant psoriasis burden than males. The health burden of psoriasis was substantially unequal in geography with a Gini coefficient of 0.27. The concentration indexes indicated a socioeconomic associated inequality in psoriasis burden with values of 0.22, accounting for 48.64% variance across countries (R2 = 0.4864, p < 0.001). Between-nation inequality in the distribution of psoriasis burden continued to decline throughout the past 27 years. Gini coefficients of psoriasis burden decreased from 0.280 in 1990 to 0.265 in 2017. The concentration indexes indicated the same trend with 0.236 in the 1990s and 0.223 in 2017.Conclusions: Global health progress in psoriasis together with inequality in the past few decades. Although the inequality of psoriasis burden has shown some improvement during the past 27 years, disparities still exist in age, gender, geographical location, as well as socioeconomic status. The findings of this study highlight the global importance of psoriasis and is important in policy planning for psoriasis services on a global scale.

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An Update on the Global Burden and Socioeconomics of Scabies

SKIN The Journal of Cutaneous Medicine ◽

10.25251/skin.4.6.5 ◽

2020 ◽

Vol 4 (6) ◽

pp. 534-542

Author(s):

Katelyn Urban ◽

Rachel Lynn Giesey ◽

Maria Delost ◽

Gregory Raymond Delost

Keyword(s):

Socioeconomic Status ◽

Rheumatic Fever ◽

Low Income ◽

Solomon Islands ◽

Skewed Distribution ◽

Low Income Countries ◽

Global Burden ◽

Life Years ◽

The Individual ◽

Disease Study

Introduction: Scabies represents a significant burden worldwide, but epidemiologically, how it relates to socioeconomic status, and impact of recent global interventions remains largely unknown.Methods: We analyzed global scabies trends from 2015 to 2017 in 195 countries worldwide through the Global Burden of Disease Study (GBD) database, including age-standardized prevalence rates, relationship to comorbidities, and age and sex patterns. We also compared scabies burden to a country’s socioeconomic status by using disability-adjusted life years and socio-demographic index, respectively. Results: The age-specific prevalence rate in 2017 demonstrated a right skewed distribution with a peak between 15 and 20 years of age, and a roughly equal male:female ratio across all ages. Scabies burden was higher in resource-poor countries. The world regions of Oceania, Southeast Asia, East Asia, and tropical Latin America had the greatest prevalence of scabies. The individual countries with highest scabies burden were Papua New Guinea (age-standardized DALYs 148.2), Solomon Islands (140.5), Kiribati (139.9), Timor-Leste (138.2) and the Maldives (134.9). A positive linear relationship exists between scabies burden and burden of rheumatic fever and bacterial skin disease.Conclusion: The burden of scabies is highest in children, adolescents, tropical climates, and low income countries. Rheumatic fever and bacterial skin disease burden is higher in areas where scabies burden is also higher. These global data may potentially serve as a purposeful measure for directing resources to improve the global burden of scabies.

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