Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study
Abstract Background Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Are...
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-023-01958-8 |
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| author | Carlos Alexandre Soares Andrade Nour Mahrouseh Jonila Gabrani Periklis Charalampous Sarah Cuschieri Diana Alecsandra Grad Brigid Unim Enkeleint A. Mechili José Chen-Xu Brecht Devleesschauwer Gaetano Isola Elena von der Lippe Carl Michael Baravelli Florian Fischer Nanna Weye Mirza Balaj Romana Haneef Mary Economou Juanita A. Haagsma Orsolya Varga |
| author_facet | Carlos Alexandre Soares Andrade Nour Mahrouseh Jonila Gabrani Periklis Charalampous Sarah Cuschieri Diana Alecsandra Grad Brigid Unim Enkeleint A. Mechili José Chen-Xu Brecht Devleesschauwer Gaetano Isola Elena von der Lippe Carl Michael Baravelli Florian Fischer Nanna Weye Mirza Balaj Romana Haneef Mary Economou Juanita A. Haagsma Orsolya Varga |
| author_sort | Carlos Alexandre Soares Andrade |
| collection | DOAJ |
| description | Abstract Background Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Area (EEA) countries. Therefore, the aim of the present study was to quantify health inequalities in age-standardized disability adjusted life years (DALY) rates for NCDs overall and 12 specific NCDs across 30 EEA countries between 1990 and 2019. Also, this study aimed to determine trends in health inequalities and to identify those NCDs where the inequalities were the highest. Methods DALY rate ratios were calculated to determine and compare inequalities between the 30 EEA countries, by sex, and across time. Annual rate of change was used to determine the differences in DALY rate between 1990 and 2019 for males and females. The Gini Coefficient (GC) was used to measure the DALY rate inequalities across countries, and the Slope Index of Inequality (SII) to estimate the average absolute difference in DALY rate across countries. Results Between 1990 and 2019, there was an overall declining trend in DALY rate, with larger declines among females compared to males. Among EEA countries, in 2019 the highest NCD DALY rate for both sexes were observed for Bulgaria. For the whole period, the highest DALY rate ratios were identified for digestive diseases, diabetes and kidney diseases, substance use disorders, cardiovascular diseases (CVD), and chronic respiratory diseases – representing the highest inequality between countries. In 2019, the highest DALY rate ratio was found between Bulgaria and Iceland for males. GC and SII indicated that the highest inequalities were due to CVD for most of the study period – however, overall levels of inequality were low. Conclusions The inequality in level 1 NCDs DALYs rate is relatively low among all the countries. CVDs, digestive diseases, diabetes and kidney diseases, substance use disorders, and chronic respiratory diseases are the NCDs that exhibit higher levels of inequality across countries in the EEA. This might be mitigated by applying tailored preventive measures and enabling healthcare access. |
| first_indexed | 2024-03-12T21:10:42Z |
| format | Article |
| id | doaj.art-1ee515e789a145a08893882faad1c1c9 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-03-12T21:10:42Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-1ee515e789a145a08893882faad1c1c92023-07-30T11:10:16ZengBMCInternational Journal for Equity in Health1475-92762023-07-0122112010.1186/s12939-023-01958-8Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 studyCarlos Alexandre Soares Andrade0Nour Mahrouseh1Jonila Gabrani2Periklis Charalampous3Sarah Cuschieri4Diana Alecsandra Grad5Brigid Unim6Enkeleint A. Mechili7José Chen-Xu8Brecht Devleesschauwer9Gaetano Isola10Elena von der Lippe11Carl Michael Baravelli12Florian Fischer13Nanna Weye14Mirza Balaj15Romana Haneef16Mary Economou17Juanita A. Haagsma18Orsolya Varga19Department of Public Health and Epidemiology, Faculty of Medicine, University of DebrecenDepartment of Public Health and Epidemiology, Faculty of Medicine, University of DebrecenFaculty of Medicine, University of BaselDepartment of Public Health, Erasmus MC University Medical CenterFaculty of Medicine and Surgery, University of MaltaDepartment of Public Health, Babes-Bolyai UniversityDepartment of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di SanitàDepartment of Healthcare, Faculty of Health, University of VloraPublic Health Unit, Primary Healthcare Cluster Baixo MondegoDepartment of Epidemiology and Public HealthDepartment of General Surgery and Surgical Medical Specialties, University of CataniaDepartment of Epidemiology and Health Monitoring, Robert Koch InstituteDepartment of Disease Burden, Norwegian Institute of Public HealthInstitute of Public Health, Charité - Universitätsmedizin BerlinDepartment of Disease Burden, Norwegian Institute of Public HealthDepartment of Sociology and Political Science, Centre for Global Health Inequalities Research (CHAIN), Norwegian University of Science and Technology (NTNU)Department of Non-Communicable Diseases and Injuries, Santé Publique FranceDepartment of Nursing, School of Health Sciences, Cyprus University of TechnologyDepartment of Public Health, Erasmus MC University Medical CenterDepartment of Public Health and Epidemiology, Faculty of Medicine, University of DebrecenAbstract Background Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Area (EEA) countries. Therefore, the aim of the present study was to quantify health inequalities in age-standardized disability adjusted life years (DALY) rates for NCDs overall and 12 specific NCDs across 30 EEA countries between 1990 and 2019. Also, this study aimed to determine trends in health inequalities and to identify those NCDs where the inequalities were the highest. Methods DALY rate ratios were calculated to determine and compare inequalities between the 30 EEA countries, by sex, and across time. Annual rate of change was used to determine the differences in DALY rate between 1990 and 2019 for males and females. The Gini Coefficient (GC) was used to measure the DALY rate inequalities across countries, and the Slope Index of Inequality (SII) to estimate the average absolute difference in DALY rate across countries. Results Between 1990 and 2019, there was an overall declining trend in DALY rate, with larger declines among females compared to males. Among EEA countries, in 2019 the highest NCD DALY rate for both sexes were observed for Bulgaria. For the whole period, the highest DALY rate ratios were identified for digestive diseases, diabetes and kidney diseases, substance use disorders, cardiovascular diseases (CVD), and chronic respiratory diseases – representing the highest inequality between countries. In 2019, the highest DALY rate ratio was found between Bulgaria and Iceland for males. GC and SII indicated that the highest inequalities were due to CVD for most of the study period – however, overall levels of inequality were low. Conclusions The inequality in level 1 NCDs DALYs rate is relatively low among all the countries. CVDs, digestive diseases, diabetes and kidney diseases, substance use disorders, and chronic respiratory diseases are the NCDs that exhibit higher levels of inequality across countries in the EEA. This might be mitigated by applying tailored preventive measures and enabling healthcare access.https://doi.org/10.1186/s12939-023-01958-8Health inequalityEuropean UnionEuropean Economic AreaNon-communicable diseasesDALY rateGlobal Burden of Disease |
| spellingShingle | Carlos Alexandre Soares Andrade Nour Mahrouseh Jonila Gabrani Periklis Charalampous Sarah Cuschieri Diana Alecsandra Grad Brigid Unim Enkeleint A. Mechili José Chen-Xu Brecht Devleesschauwer Gaetano Isola Elena von der Lippe Carl Michael Baravelli Florian Fischer Nanna Weye Mirza Balaj Romana Haneef Mary Economou Juanita A. Haagsma Orsolya Varga Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study International Journal for Equity in Health Health inequality European Union European Economic Area Non-communicable diseases DALY rate Global Burden of Disease |
| title | Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study |
| title_full | Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study |
| title_fullStr | Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study |
| title_full_unstemmed | Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study |
| title_short | Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study |
| title_sort | inequalities in the burden of non communicable diseases across european countries a systematic analysis of the global burden of disease 2019 study |
| topic | Health inequality European Union European Economic Area Non-communicable diseases DALY rate Global Burden of Disease |
| url | https://doi.org/10.1186/s12939-023-01958-8 |
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