Global health inequalities are substantial, growing, and influenced by economic, social and health-sector variables as well as geography, a study concludes in the November issue of the Journal of Epidemiology and Community Health.
"Particularly disturbing findings from this study are that countries with high mortality in young children are making slow progress, gaps in adult mortality are becoming wider, and countries with the highest adult mortality have reversed their trend from mortality reduction," said lead author Jennifer Prah Ruger, assistant professor of public health in the Department of Epidemiology and Public Health at Yale School of Medicine.
This is the first systematic study of global inequalities in adult and child mortality to identify three distinct mortality groups--better off, worse-off and mid-level--using cluster analysis methods to reveal new associations and structure in data, and examine the underlying risk factors associated with inequality in mortality. "Unlike previous studies, this research focuses on gaps in health inequalities between countries," Ruger said.
The probability that a child will die before age five and an adult will die at an early age are disproportionately higher throughout sub-Saharan Africa and Afghanistan than in countries in any other geographic region, according to the study. The authors report that these countries have lower average incomes, more extreme poverty, higher inflation and less trade. They also have lower levels of investment in human and physical resources, more health risk factors and less effective disease prevention, and worse educational outcomes.
Ruger and co-author Hak Ju Kim, from the Department of Social Welfare, Gyeongsang National University, Jinju, South Korea, found that these countries have a four-fold higher percentage of people living on less than $1 per day; more than double the female illiteracy rate, less than one-sixth the gross national inco
Contact: Karen N. Peart