Towards equitable scheduling of global health teleconferences: a spatial exploration of the world’s population and health by time zone

Abstract

Objectives To examine the world’s population, development, and health by condensed Coordinated Universal Time (UTC) offset to support a normative position on how to most defensibly schedule global health teleconferences with the primary goal of advancing equitable regard for participants by health condition.Design Spatial exploration examined through the lens of equitable regard for participants.Setting The Earth.Participants The global population.Main outcome measures Global population, countries, Human Development Index (HDI), and health measured in total and disease-specific disability-adjusted life years (DALYs) per 100 000 per year by UTC offset. Strengths and weaknesses of scheduling teleconferences accordingly to alternative approaches.Results The UTC offset with the largest population of approximately 1 724 million persons occurred in UTC+5, largest country count of approximately 40 countries in UTC+1, and the lowest median HDI of 0.527 occurred in UTC0. The highest median total DALYs per 100 000 per year of 41 873 occurred in UTC+11, highest median HIV/AIDS DALYs per 100 000 per year of 941 in UTC0, and highest median typhoid and paratyphoid fevers DALYs per 100 000 per year of 279 occurred in UTC+5. Hypothetical teleconference scheduling scenarios generated temporal distances of up to 11 hours to UTC offsets representing the most countries and greatest number of DALYs per 100 000 per year. Teleconference scheduling based on egoism was considered to be problematic, and contractualism as unrealistically demanding. Utilitarianism resulted in the risk of systematically disadvantaging small, temporally remote groups. Egalitarianism offered equality, but prioritarianism offered the possibility of addressing health inequities.Conclusions Global health teleconferences may generate great temporal distances between participants compromising representative participation, as well as the well-being of attendees. Our spatial exploration of the world’s population and health by UTC offset may be used to support a normative position on scheduling global health teleconferences that enhance progress towards health equity.