Inequality Index Research Articles

Analysis of burden and equality of lower extremity peripheral artery disease in people aged 40 and above in the Belt and Road partner countries from 1990 to 2021.

To analyze the disease burden and inequalities of lower extremity peripheral artery disorders (LEPAD) among people aged 40 and above in the Belt and Road partner countries from 1990 to 2021. Data were retrieved from the Global Burden of Disease 2021 database. The age-standardized prevalence rates, mortality rates, and the annual rate of years lived with disability (YLDs) of LEPAD were analyzed. Trends were measured using the estimated annual percentage change (EAPC), and the slope index of inequality (SII) and concentration index were used to quantify the absolute and relative inequalities. In 2021, the age-standardized prevalence and mortality rates of LEPAD were 3168.26/105 and 3.09/105, increasing by 4.30% and 19.31% compared to 1990, and YLDs rates decreased by 4.00%. Females had higher age-standardized prevalence and YLDs rates, while males had higher mortality rates. The EAPC for prevalence rates was slightly higher in males (0.22%) than in females (0.17%); while the EAPC of age-standardized mortality rate was 2.02% for females, compared to 1.45% for males. From 1990 to 2021, the age-standardized YLDs rates decreased from 16.23/105 to 15.58/105, with a faster decline in females (－0.12%) than in males (－0.06%). LEPAD prevalence varied across countries, with higher burdens in Europe and faster growth in Gulf states. Higher socio-demographic index countries had higher prevalence. Inequity improved, with the SII at 52.90/105 and concentration index at 0.038 in 2021. Gender disparities persisted, with concentration index rising to 0.058 in females and falling to －0.026 in males. LEPAD prevalence and mortality among people aged 40 and above in the Belt and Road partner countries were risen, while YLDs rates were decreased from 1990 to 2021. Significant differences exist among peoples with different gender and countries, highlighting the need for enhanced screening, health education, and shared public health strategies across the Belt and Road partner countries.

Gender inequality and cultural values in explaining gender differences in positive and negative emotions: A comparison of 24 countries during the COVID-19 pandemic

Abstract The coronavirus pandemic posed a major challenge to mental health. Existing evidence shows that COVID-19 is related to poor emotional well-being, particularly among women. However, most work on the subject uses single-country samples, limiting the ability to generalize the disparity or explain it as a function of societal variables. The present study investigates the expression of positive and negative emotions during the pandemic as a function of gender and across 24 countries (N = 49,637). Strong gender differences emerged across countries, with women reporting more negative emotions (anxious, depressed, nervous, exhausted) and less positive emotions (calm, content, relaxed, energetic) than men. The gender gap in positive emotions was significantly wider in countries higher in individualism and narrower in countries higher in power distance. For instance, differences in emotions were larger in Western countries high in individualism, such as the USA, the UK, Italy, and France, and smaller in countries with higher collectivism and power distance, such as China, Malaysia, and South Korea, with a few exceptions like Japan and Brazil. These gender differences across countries were not explained by country-level gender inequalities indicators (GGGI and GII). Interestingly, the national severity of the pandemic, an epidemiological factor, reduced gender differences in positive emotions. These results underscore the importance of considering cultural and national factors when assessing gender differences in well-being.

Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe

We investigated the association between values and attitudes toward sexual and reproductive health and rights (SRHR) and gender equality, with reproductive agency in Ethiopia, Kenya, and Zimbabwe. Using 2020-21 World Values Survey (WVS) data (n = 3,096), we utilized the SRHR Support Index including five subindices to gauge SRHR attitudes, the WVS Equality Index for gender equality values, and the perceived level of freedom of choice and control over whether, when, and how many children to have as a proxy for reproductive agency. Descriptive statistics, bivariate, and multivariable logistic regressions were used to analyse how values and attitudes differed between respondents of high vs low reproductive agency using the median as cutoff, stratified by country and sex. Country, education, subjective social class, and religion were associated with reproductive agency. Adjusted analyses indicated associations between supportive values and attitudes towards equitable masculinity norms, SRHR interventions and gender equality, with high reproductive agency. Associations varied more between countries than by sex. Findings suggest an association between SRHR and gender equality values and attitudes and the level of reproductive agency, and underscore the importance of addressing values and attitudes in context-specific interventions. Measures of SRHR progress should be critically reviewed and complemented with self-assessed – as opposed to researcher-ascribed – items to support the successful implementation of global SRHR agendas.

Type-2 Backstepping T-S Fuzzy Bionic Control Based on Niche Symmetry Function

Niche can reflect the changes in the quality of the ecological environment and the balance of ecological state. The more advanced the ecosystem, the more complex and higher-order nonlinearities and uncertainties that are presented. For such an uncertain parameter system with complex nonlinearity, backstepping fuzzy control is a good control method. When the backstepping control method is introduced into the Type-2 fuzzy T-S control principle, the equality index symmetry function composed of ecological factors is used as the backstepping control consequence, and the Lyapunov function is constructed to analyze the stability and find out the adaptive law of the ecological factors in the equality index symmetry function of the control consequence. This reflects that the individual organisms always develop in their own favorable direction, highlighting the bionic intelligent control of the method. Through simulation analysis, the Type-2 Backstepping control method is effective in stability and parameter tracking, which reflects the self-development ability and self-coordination ability of individual organisms, highlighting the physical background and symmetry of the bionic intelligent control of this method.

Assessing cross-country inequalities in global burden of gastrointestinal cancers: slope and concentration index approach

PurposeNew cases and deaths of gastrointestinal cancers are predicted to increase significantly by 2040. This study aims to explore cross-country inequalities and trends in global burdens of colon and rectum cancer (CRC), esophageal cancer (EC) and gastric cancer (GC).MethodsData from the Global Burden of Diseases Study 2019 were analyzed to examine trends in disability-adjusted life-years (DALYs) for three gastrointestinal cancers with estimated annual percentage change (EAPC) and Joinpoint analysis. Inequality in their DALYs rates was assessed with the slope index of inequality and the concentration index, based on the Socio-Demographic Index (SDI).ResultsFrom 1990 to 2019, the age standardized DALYs rate of CRC decreased in these countries from high and high-middle SDI regions, with the EAPC values of − 1.018% and − 0.161%, respectively, but increased among low, low-middle and middle SDI regions (EAPC = 1.035%, 0.926% and 0.406%, respectively). The age standardized DALYs rates of EC and GC decreased in all SDI regions. Moreover, the slope index changed from 358.42 (95% confidence interval 343.28 to 370.49) to 245.13 (217.47 to 271.24) for CRC, from − 63.88 (− 87.48 to − 48.28) to − 1.36 (− 32.44 to 25.87) for EC, and from 126.37 (101.97 to 146.47) to 58.04 (20.54 to 96.12) for GC. The concentration index for CRC moved from 29.56 (28.99 to 29.84) to 23.90 (23.19 to 24.26), from − 9.47 (− 10.30 to − 9.24) to − 14.64 (− 15.35 to − 14.24) for EC, and from 8.44 (7.85 to 8.72) to − 6.42 (− 7.65 to − 6.12) for GC.ConclusionThis study suggests strong heterogeneity in global DALYs for gastrointestinal cancers across different SDI regions. Higher SDI regions faced a greater burden of CRC, while the burdens of EC and GC were more prevalent in lower SDI regions.

Spatio-temporal distribution and socioeconomic inequality of low birthweight rate in China from 1992 to 2021 and its predictions to 2030.

This paper aims to investigate the trend, spatio-temporal distribution, and socioeconomic inequality of the low birthweight rate (LBWR) in China from 1992 to 2021 and to project the LBWR to 2030. We performed a secondary analysis of data from the China Health Statistics Yearbook. LBWR refers to the ratio of the number of infants born with a birth weight less than 2,500 grams to the number of live births in a given year. We used joinpoint regression models to estimate LBWR trends from 1992 to 2021 for the whole country and from 2002 to 2021 for the three regions (eastern, central, and western regions) and each province. The slope index of inequality (SII) and relative index of inequality (RII) were calculated for each year from 2002 to 2021 based on provincial data. LBWR increased from 2.52% (1992) to 3.70% (2021), and the average annual percentage change (AAPC) (95% confidence interval [CI]) was 1.35% (0.22%, 2.49%) in China. The overall LBWR from 2002 to 2021 was greatest in the Eastern region, but LBWR had the fastest increase in the Western region, with an AAPC (95% CI) of 3.15% (2.59%, 3.12%). There were spatio-temporal differences in the LBWR and trends between provinces. The SII and RII increased linearly from -0.15 and 0.94 to 0.53 (B = 0.035%, p < 0.001) and 1.16 (B = 0.011, p < 0.01), respectively, over the past 20 years. The results of the ARIAM model showed that the National LBWR will be increasedfrom 3.70% in 2021 to 5.28% in 2030. The LBWRs in the eastern, central and western regions in 2030 will be 4.93%, 6.02% and 5.82%, respectively. National and local governments must prioritize disadvantaged groups to mitigate the rapid prevalence of LBWR, reduce regional disparities, and improve perinatal and infant health and health equity in China.

Global trends and risk factors in gastric cancer: a comprehensive analysis of the Global Burden of Disease Study 2021 and multi-omics data.

Background: Gastric cancer (GC) remains a significant global health challenge. This study aimed to comprehensively analyze GC epidemiology and risk factors to inform prevention and intervention strategies. Methods: We analyzed the Global Burden of Disease Study 2021 data, conducted 16 different machine learning (ML) models of NHANES data, performed Mendelian randomization (MR) studies on disease phenotypes, dietary preferences, microbiome, blood-based markers, and integrated differential gene expression and expression quantitative trait loci (eQTL) data from multiple cohorts to identify factors associated with GC risk. Results: Global age-standardized disability-adjusted life year rates (ASDR) for GC declined from 886.24 to 358.42 per 100,000 population between 1990 and 2030, with significant regional disparities. Despite this decline, total disability-adjusted life years show a concerning upward trend from 2015, rising from approximately 22.9 million to a projected 24.3 million by 2030. The slope index of inequality shifted from 87 in 1990 to -184 in 2021, indicating a reversal in GC burden distribution, with higher ASDR now associated with lower socio-demographic index countries. The ML models analysis identified higher levels of clinical characteristics such as phosphorus, calcium, eosinophils percent, and triglycerides, as well as lower levels of iron and monocyte percent, may be associated with an increased risk of GC. MR analyses revealed causal associations between GC risk and disease phenotypes such as Helicobacter pylori infection, chronic gastritis, obesity, depression, and dietary preferences such as dairy and processed meats. Gut microbiome analysis showed associations with microbiome such as Phascolarctobacterium and Ruminococcaceae species. Blood-based markers analysis identified protective and risk effects for cortisol, glutamate, nicotinamide, Natural Killer %lymphocyte, CD4-CD8- T cell Absolute Count, Phosphatidylcholine (16:0_18:1), and Interleukin-1-alpha. Integrated genomic analysis identified 10 genes significantly associated with GC risk, with strong evidence for colocalization in genes such as CCR6 and PILRB. Conclusions: This systematic analysis reveals complex global trends in GC burden and identifies novel clinical, disease phenotypes, dietary preferences, microbial, blood-based, and genetic risk factors. These findings provide potential targets for improved risk stratification, prevention, and intervention strategies to reduce the global burden of GC.

The contribution of childhood adversity to adult socioeconomic gradients in mortality: A Swedish birth cohort analysis.

"Child maltreatment is a leading cause of health inequality" according to a leading WHO report. This statement is often assumed, yet, the size of the contribution of childhood adversity to the adult socioeconomic gradient in mortality remains unknown. Inequalities in mortality have mostly been investigated by taking adult conditions as a starting point. The objective of this study is to quantify how much of the socioeconomic gradient in adult life expectancy is associated with childhood adversity. Drawing on a 1953 birth cohort from Stockholm (n=14210), we compared inequalities in adult mortality within the full cohort to a counterfactual scenario where individuals with a history of childhood adversity (indicated by involvement with child welfare services) experienced the mortality rates of those achieving the same adult socioeconomic position, but with no history of childhood adversity. The socioeconomic gradient across education and income quintiles (attained by age 29) is measured by the slope index of inequality of temporary life expectancy (ages 29-67). The counterfactual scenario attenuated the education gradient by 40 percent for men and 54 percent for women. Similarly, inequalities by income were reduced in the counterfactual scenario by 49 percent for men and 47 percent for women. These results support that childhood adversity is an important determinant of inequalities in mortality. The size of their contribution is equivalent to established behavioural risk factors. Taking a life course approach might provide important policy entry points to mitigate health inequalities.

Prevalence of daily fruit and vegetable intake by socio-economic characteristics, women’s empowerment, and climate zone: an ecological study in Latin American cities

Abstract This cross-sectional ecological study described fruit and vegetable (F&amp;V) intake variability across 144 cities in 8 Latin American countries and by city-level contextual variables. Data sources came from health surveys and census data (Argentina, Brazil, Chile, Colombia, El Salvador, Guatemala, Mexico, and Peru). Self-reported frequency of F&amp;V intake was harmonised across surveys. Daily F&amp;V intake was considered as consumption 7 d of the week. Using a mixed-effects model, we estimated age and sex-standardised city prevalences of daily F&amp;V intake. Through Kruskal–Wallis tests, we compared city F&amp;V daily intake prevalence by tertiles of city variables related to women’s empowerment, socio-economics, and climate zones. The median prevalence for daily F&amp;V intake was 55.7% across all cities (22.1% to 85.4%). Compared to the least favourable tertile of city conditions, F&amp;V daily intake prevalence was higher for cities within the most favourable tertile of per capita GDP (median = 65.7% vs. 53.0%), labour force participation (median = 68.7% vs. 49.4%), women achievement-labour force score (median = 63.9% vs. 45.7%), and gender inequality index (median = 58.6% vs. 48.6%). Also, prevalences were higher for temperate climate zones than arid climate zones (median = 65.9% vs. 50.6%). No patterns were found by city level of educational attainment, city size, or population density. This study provides evidence that the prevalence of daily F&amp;V intake varies across Latin American cities and may be favoured by higher socio-economic development, women’s empowerment, and temperate weather. Interventions to improve F&amp;V intake in Latin America should consider the behaviour disparities related to underlying local social, economic, and climate zone characteristics.

ANALYZING COLONIAL REMNANTS: A COMPARATIVE ANALYSIS OF INDONESIAN ECONOMIC DEVELOPMENT (1950–1980)

The Global South has always been a running contributor to the global inequality index, becoming a threat to international stability and sustainability. In most cases, it is found that colonial dependency is one major factor that causes this hindrance in development, leading to inequality. In its journey to independence, Indonesia had undergone a strict economic system under Dutch colonialism, and further transitioned to two different governing systems before its reformation, producing different outcomes of economic policy management and spread of inequality. Thus, this research wishes to understand the differences of economic system governance between the Soekarno and Soeharto era, and whether they possess any remnants of colonial dependency integrated within them. The Dependency Theory is used in this research with the concepts of postcolonialism, development, and inequality embedded into the discussions. The data of this research is gathered through academic literature, utilizing a qualitative approach, and is conducted with a descriptive and historical comparative approach. This research finds that Dutch colonialism contributed a major role in how Indonesia manages its economic strategies and how it impacts its high social and economic inequality. Further stretching to post-independence, it is found that Soekarno's decoupling of Western values translated worse into the economy, compared to Soeharto's Western-centric approaches to trade. The root causes of colonial dependencies and habits affect the outcome of economic habits, and thus contribute to the efficiencies of how Indonesia manages its economy during the period before reformation.

Business Constraints, Information Technology and Income Inequality in Sub-Saharan Africa

The objective of this study is to examine how information and communication technology can be used to moderate the unfavourable effects of doing business constraints on income inequality in 48 sub-Saharan African countries for the period from 2004 to 2019. The Gini coefficient is used as the income inequality indicator, whereas the ICT dynamics employed entail subscriptions to mobile phones and the Internet. Ten indicators of doing business constraints are also employed. From the findings, for the most part, doing business constraints increase income inequality while ICT moderates the positive effect of doing business constraints on income inequality. Thresholds of ICT at which the doing business constraints no longer increase income inequality are provided. At these established ICT penetration thresholds, ICT effectively moderates doing business constraints to reduce income inequality.

On the Margins of Emancipation: the Ambivalence of the Struggles of Evictees from the ZACA Project in Ouagadougou (Burkina Faso)

Abstract In Ouagadougou, the capital of Burkina Faso, the ZACA project, an urban renewal project, involved the destruction of inner-city neighbourhoods, and the displacement of their 12,000 inhabitants, mostly to outlying areas. Similar to other instances of forced evictions and displacements in metropolitan areas, this project has been widely used as an indicator of urban inequality, demonstrating the seizure of city centres by the upper classes and the prioritization of exchange value in neoliberal urbanism. It has also generated impulses for change through the promotion of new lifestyles, notably through the unprecedented communication campaign entrusted to the Synergie agency. In the face of this strategy, which emphasised the “modernity” of the project, tradition seemed to be an issue of struggle for the inhabitants, strongly emphasised in some speeches, and the customary authorities appeared as key actors whose support was sought by the various sides. While these injunctions may have seemed violent to a large part of the inhabitants of the zone and may partly explain the violent mobilisations that took place against the project, they may have constituted desirable horizons for others, especially the youth, making the social consequences of the ZACA project more ambivalent. By examining the testimonies of a father and his son evicted from the ZACA more than ten years after the event, and other field data, we will see that the reading of these events differs according to generation, revealing the importance of age-related inequalities in Burkinabè society. A radical change such as the expulsion from the neighbourhood of origin, if it consisted in an undeniable spatial marginalisation, could also have allowed the son to reshuffle the cards of social determinism, which he saw as a means of emancipation. In the end, this article argues for a complex reading of the accumulation of inequalities in urban societies, out of univocal logic.

Robust inference on income inequality: t-statistic based approach

. Empirical analyses of income and wealth inequality often face the difficulty that the observations are heterogeneous, heavy-tailed, or correlated in some unknown fashion. This article focuses on applications of the recently developed computationally simple t-statistic based robust inference approach to the analysis of inequality. Two regions can be compared in terms of inequality as follows: the data in the samples relating to the two regions are partitioned into small numbers of groups, and the chosen inequality index/measure is estimated for each group. Inference is then based on standard t-tests with the resulting group estimators. The t-statistic based approach results in valid inference, as long as the group estimators of the inequality index are asymptotically independent, unbiased, and Gaussian, possibly with different variances. These conditions are typically satisfied in empirical applications. The presented method complements and compares favorably with other approaches to inference on inequality. We apply this approach to examine income inequality across Russian regions. Our analysis reveals that income distribution in Russia is notably heavy-tailed, with most regions exhibiting higher levels of inequality compared to Moscow. Robust comparisons of this type offer a good foundation for evaluating and shaping regional policies aimed at addressing income disparities.

Poverty, inequality, and growth dynamics in Indian states: pre-COVID, COVID, and post-COVID insights from Consumer Pyramids Household Survey

This study analyses poverty rates and inequality indices in Indian states from 2016 to 2022, examining different methodologies to provide a comprehensive view of poverty and inequality. It finds that there are drastic regional disparities in poverty rates, where Bihar, Jharkhand, Odisha and Uttar Pradesh all have uniformly heightened levels. The impact of the COVID-19 pandemic is evident, with significant increases in poverty rates across all states in 2020, exacerbating income inequality. Growth incident curves and kernel density plots present the faster income and expenditure contraction in the first period and partial recovery in favor of more middle-income groups, yet less beneficial compared with the lower-income segments. Although this recovery was widespread, it did not favor impoverished groups, highlighting the necessity for focused initiatives aimed at promoting inclusive growth and sustainable development among at-risk populations.

Disease burden and health inequality of older adults with edentulism and the projected trend until 2040: based on the global burden of disease study 2021.

To comprehensively analyze the current situation and the trends over the next 21 years, focusing on health inequalities related to edentulism among the elderly across global regions. Data on edentulism in older adults were collected from the 2021 global burden of disease (GBD) study. Disease burden trends were analyzed using a joinpoint model. We used the Slope Index of Inequality (SII) and the Concentration Index (CI) to assess health inequalities. A Bayesian age-period-cohort (BAPC) model was used to analyze the projected trend of prevalence up to 2040. The number of incident, prevalent, and years lived with disability (YLD) cases of edentulism in older adults is increasing globally, while the rate is declining. According to the analysis of health inequality, the burden of edentulism among older adults was gradually concentrated in countries with lowerSociodemographic Index(SDI). Significant downward trends were expected in the global age-standardized prevalence rate (ASPR) of edentulism for both genders from 2020 to 2040; however, the number is increasing. Taken together, the burden of edentulism in older people remains high and generally shifts from higher-SDI countries to lower-SDI countries. There are great differences between countries, and effective measures should be taken in countries with poorer economies. The disease burden of edentulism in older adults is gradually shifting towards lower SDI countries. It is crucial to optimize the utilization and allocation of healthcare resources to reduce health inequities in edentulism in older adults.

On the issue of a working model for modernizing the Unified State Exam to overcome inequality of access to higher education

The study formulates approaches to determining inequality of access to higher education through regionally determined choice of subjects and Unified State Exam results. The dependence of the choice and results of the Unified State Exam on the quality of education and innovative development of regions is presented. Indicators of inequality are the distribution of students according to “success cohorts” when passing the Unified State Exam and the choice of subject by students to take, and the average score in the region. Quantitative characteristics of the choice of basic and specialized mathematics and other academic subjects by students in the regions are presented. The calculations used data from the entire population of applicants in 2019 and 2020; accordingly, the conclusions of the article relate to the period until 2021. The problem of increasing the efficiency of the Unified State Examination is objective and has matured before the political events associated with the departure from the Bologna system in 2022. It is noted that Olympiads and additional internal university tests are not an alternative to the Unified State Exam. Based on the goals of leveling regional inequality, a variant of the model for modernizing the Unified State Examination with an objective assessment procedure is proposed– a remote creative exam using the existing infrastructure of examination points and video communication. Due to the random assignment of tasks and assessing experts from different regions, universities, organizations, remote creative exam retains the advantages of the Unified State Exam, comparability of results is achieved, corruption and the possibility of “training” for certain types of answers are eliminated. A person assesses the exam results: a teacher at a general education organization or university, the head of a government agency or enterprise. The examination model includes the advantages of Olympiads and internal university examinations without their corruption-prone components. The article notes that any innovation in the field of final/entrance examinations must necessarily go through testing and experimentation with a gradual increase in coverage and adjustment of the applied methods and procedures based on the results of professional discussion.

Structural Transformation and Inequality in India: A Decomposition Analysis of Trends in Regional Inequality in Post-reform Period

India has undergone a rapid sectoral shift from an agrarian to a predominantly service economy in the post-reform period. The objective of this article is to understand and assess the impact of this shift on the inter-state income distribution during the period from 1993–94 to 2019–20. We have shown how inequality decomposition by income source can be used to disaggregate the inequality trend into its various contributory influences. Our results assist in understanding the role of sectors and sub-sectors in terms of their contribution to inter-state inequality. Our results show that the tertiary and secondary sectors are largely responsible for the growth in inequality, which was partially offset by the primary sector. The evidence at the sub-sectoral level is along the same lines, with manufacturing and an overwhelming number of tertiary sub-sectors contributing to the growth in inequality, while agriculture and allied activities playing a role in keeping a check on it.

Analisis Faktor-faktor Yang Mempengaruhi Tingkat Pertumbuhan Ekonomi di Provinsi Banten

The aim of this research is to evaluate the variables that have an influence on the level of economic growth in Banten province in 2022. Employment level, human development index, unemployment rate, poverty level and level of income inequality are some of the variables studied. Using descriptive methodology, secondary data using the SPSS multiple linear regression application method from BPS Banten province is used to describe economic phenomena realistically. It is hoped that the results of the study will broaden insight into various factors that influence economic growth in Banten province. Findings-according to this research, only the labor force participation rate has a meaningful influence on economic development, while the human resource development index, the level of welfare deprivation, the level of lack of employment opportunities, and the level of income inequality are statistically insignificant. Engagement-This research can provide valuable knowledge about the elements that influence economic growth, which can be used to make decisions in the future.

Global, regional and national temporal trends in Parkinson's disease incidence, disability-adjusted life year rates in middle-aged and older adults: a cross-national inequality analysis and Bayesian age-period-cohort analysis based on the global burden of disease 2021.

Parkinson's disease (PD) ranks as the second most prevalent neurodegenerative disorder; however, its epidemiological characteristics among middle-aged and older adults at global, regional, and national levels remain inadequately documented. This study assessed temporal trends in PD among middle-aged and older adults by extracting incidence rates, disability-adjusted life year (DALY) rates, and corresponding age-specific rates (ASRs) from the Global Burden of Disease (GBD) database spanning 1990 to 2021. Estimated annual percentage change (EAPC) was employed to analyze trends over the past 30 years. The slope index of inequality (SII) and concentration index (CI) were utilized to evaluate disparities in the burden of PD across various countries. Additionally, Bayesian age-period-cohort (BAPC) modeling was applied to project DALY figures for the next 15 years. In 2021, the global incidence and DALY rates for middle-aged and older adults with PD stood at 79.68 and 477.50 cases per 100,000 population, respectively. Both incidence and DALY rates have exhibited an upward trajectory over the past 32 years, with EAPCs of 1.2 (95% UI: 1.1-1.3) and 0.6 (95% UI: 0.5-0.7), respectively. Among the five sociodemographic index (SDI) regions, the high-middle SDI region reported the highest incidence and DALY rates for PD in 2021, at 93.93 and 512.29 cases per 100,000 population, respectively. A positive correlation was observed between the SDI and age-specific incidence rate (ASIR) as well as age-specific DALY rate (ASDR). Disparities in the burden of PD among middle-aged and older adults, associated with SDI, are on the rise and are primarily concentrated in high SDI countries. It is projected that the global incidence and DALY rates for middle-aged and older adults with PD will experience significant increases over the next 15 years. The global burden of PD among middle-aged and older adults has markedly escalated over the past 32 years, particularly in high-middle SDI regions. These findings underscore the necessity for the development of effective interventions and public health policies, contributing to the attainment of the sustainable development goals established by the World Health Organization (WHO).

The role of socio-economic and institutional factors in explaining dental health inequalities

This paper aims to investigate the effect of socio-economic and institutional factors on dental health outcomes and inequalities among countries. By applying the oral health status indicator DMFT 12-year-olds index, 117 countries were classified into three dental health groups. The analysis of variance (ANOVA) was employed to examine the relations among a set of socio-economic and institutional variables and dental health inequalities. Variables included are GDP per capita, current health expenditures, number of dentists, Corruption Perceptions Index, quality of health services, unemployment rate, internal conflict, Gini index, UHC service index, and general government health expenditures. The results showed that higher corruption prevalence in a country is associated with poor outcomes in a nation's dental health. In countries with the highest satisfaction with the quality of health services, this may be attributed to substantial public health expenditures. The size of health expenditures and the number of dentists available to the country’s population do not necessarily grant advanced dental health, even in economically prosperous countries. Indicators of social inequality do not explain the dental health outcomes, suggesting there are other factors describing better the disparities among low- and higher- DMFT index country groups. Inequalities in dental health are explained by institutional factors, corruption prevalence, and public health funding being important ones. Policy implications towards more generous public funding of health services and implementation of anti-corruption measures could contribute to seizing dental health inequalities worldwide.