ArticleBMJ global health2019
Quantifying changes in global health inequality: the Gini and Slope Inequality Indices applied to the Global Burden of Disease data, 1990-2017.
Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Socio-economic inequalities and heart failure morbidity and mortality: A systematic review and data synthesis.ESC heart failure · 2025Pooled it
- Causal Assessment of Income Inequality on Self-Rated Health and All-Cause Mortality: A Systematic Review and Meta-Analysis.The Milbank quarterly · 2024Pooled it
- Trial
- Can we predict who will benefit most from biologics in severe asthma? A post-hoc analysis of two phase 3 trials.Respiratory research · 2023Trial
- Examining the association between spatial accessibility to emergency cardiac care centers and cardiovascular mortality in Georgia, United States.BMC cardiovascular disorders · 2026Article
- Decomposition of cross-country socioeconomic inequality in mortality by 288 causes of death and 84 risk factors from 1990 to 2021.Nature communications · 2026Article
- Global burden and cross-country inequalities of alcoholic cardiomyopathy: A 1990-2021 analysis.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- An analysis and optimization model for healthcare equity of medical resources allocation in an aging community.BMC health services research · 2026Article
- Global Inequality and Injustice in Mortality Burden from Floods and Landscape Fire-Sourced Air Pollution.Health data science · 2026Article
- Spatial and temporal disparities in general practitioner provision: a 21-year longitudinal analysis from Lower Saxony, Germany.International journal of health geographics · 2025Article
- Changes in life expectancy across selected countries in the Western Pacific Region and their underlying risk factors, 1990-2021.BMC public health · 2025Article
- Global, regional, and national trends and inequality analysis of the total cancers and 29 cancer types from 1990 to 2021.BMC public health · 2025Article
- The global burden, trends, and inequalities of HIV/AIDS: a multicountry observational analysis.BMC infectious diseases · 2025Observational
- The Impact of Polycrisis on Healthcare Systems-Analyzing Challenges and the Role of Social Epidemiology.Healthcare (Basel, Switzerland) · 2025Review
- Income-related inequalities in the prevalence of dental pain intensity in adults: gender differences.Frontiers in oral health · 2025Article
- Mapping inequalities in the health of older adults around the world: Heterogeneities in cognitive and physical functioning.Vienna yearbook of population research · 2025Article
- Applying Multiple Analyses to Quantify Changes in the Global, Regional, and National Burden of Tuberculosis From 1990 to 2021 and the Forecast Until 2035.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2025Article
- Global trends and inequalities in the burden of drug use disorders: a comprehensive analysis from 1990 to 2021 with future projections.Frontiers in public health · 2025Article
- Persistent burden and health inequalities of lung cancer among adolescents and young adults, 1990-2021.Frontiers in oncology · 2025Article
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Abstract
backgroundThe major shifts in the global burden of disease over the past decades are well documented, but how these shifts have affected global inequalities in health remains an underexplored topic. We applied comprehensive inequality measures to data from the Global Burden of Disease (GBD) study.
methodsBetween-country relative inequality was measured by the population-weighted Gini Index, between-country absolute inequality was calculated using the population-weighted Slope Inequality Index (SII). Both were applied to country-level GBD data on age-standardised disability-adjusted life years.
findingsAbsolute global health inequality measured by the SII fell notably between 1990 (0.68) and 2017 (0.42), mainly driven by a decrease of disease burden due to communicable, maternal, neonatal and nutritional diseases (CMNN). By contrast, relative inequality remained essentially unchanged from 0.21 to 0.19 (1990-2017), with a peak of 0.23 (2000-2008). The main driver for the increase of relative inequality 1990-2008 was the HIV epidemic in Sub-Saharan Africa. Relative inequality increased 1990-2017 within each of the three main cause groups: CMNNs; non-communicable diseases (NCDs); and injuries.
conclusionsDespite considerable reductions in disease burden in 1990-2017 and absolute health inequality between countries, absolute and relative international health inequality remain high. The limited reduction of relative inequality has been largely due to shifts in disease burden from CMNNs and injuries to NCDs. If progress in the reduction of health inequalities is to be sustained beyond the global epidemiological transition, the fight against CMNNs and injuries must be joined by increased efforts for NCDs.
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