Health Inequality in the Global Burden of Chronic Obstructive Pulmonary Disease: Findings from the Global Burden of Disease Study 2019

Abstract

Haifeng Li,1,* Hongsen Liang,2,* Li Wei,2 Donglei Shi,2 Xin Su,3 Fajun Li,4 Junhang Zhang,2 Zhaojun Wang2 1Department of Anesthesiology, Guangdong Provincial People’s Hospitall, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China; 2Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China; 3Department of Respiratory, Hainan Hospital of PLA General Hospital, Sanya, People’s Republic of China; 4Department of Critical Care Medicine, The First People’s Hospital of Kunshan, Suzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Junhang Zhang; Zhaojun Wang, Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, 628 Zhenyuan Road, Shenzhen, People’s Republic of China, Tel/Fax [phone], Email [email protected]; [email protected]: This study assessed health inequality in the global burden of chronic obstructive pulmonary disease (COPD) between 1990 and 2019 using data extracted from the Global Burden of Diseases (GBD 2019) study.Methods: Data were extracted from the GBD 2019 study. A series of comparative and descriptive analyses of the disease burden between women and men in countries with different socioeconomic development (SDI) status were performed. The slope index of inequality (SII), relative index of inequality (RII), and concentration index (CI) were calculated to measure the socioeconomic-related cross-national health inequity between 1990 and 2019.Results: The global health burden caused by COPD increased by 25.7% in terms of disability-adjusted life years (DALY) from 59.2 million years in 1990 to 74.4 million years in 2019. Global age-standardized DALY rate (ASDR) associated with COPD decreased by 40.0%, from 1537.7 per 100,000 population in 1990 to 926.1 per 100,000 population in 2019. The highest sex-specific DALY number was at age 70– 74 in male and female, and female is lower than male. However, after controlling for population size, the burden of COPD is more concentrated in the population living in low SDI countries, relative health inequality indicators (RII and CI) supported this conclusion.Conclusion: The health inequalities caused by the disparity of socioeconomic status are increasing, and the increasing concentration of wealth worldwide is likely to aggravate health inequalities associated with COPD.Keywords: chronic obstructive pulmonary disease, disease burden, health inequality

Keywords

• chronic obstructive pulmonary disease
• disease burden
• health inequality