Evidence map›Paper›PMID 32133191›Full record

ArticleBMJ global health2020

The household economic burden of non-communicable diseases in 18 countries.

Adrianna Murphy, Benjamin Palafox, Marjan Walli-Attaei, Timothy Powell-Jackson, Sumathy Rangarajan, Khalid F Alhabib, Alvaro Jr Avezum, Kevser Burcu Tumerdem Calik, Jephat Chifamba, Tarzia Choudhury and 30 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 117 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
117citing papers in PubMed, 11 pooled it
32.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

117 citing papers in PubMed, 11 syntheses or guidelines pooled it, 228 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Trial
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. The role of regulatory policies on unhealthy commodities to prevent and control noncommunicable diseases in the Americas.Revista panamericana de salud publica = Pan American journal of public health · 2026
    Article
  20. Article

57 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors at 20 institutions in 21 countries.

Adrianna MurphyLondon School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK.ORCID 0000-0003-4065-6744
Benjamin PalafoxLondon School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK.ORCID 0000-0003-3775-4415
Marjan Walli-AttaeiPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
Timothy Powell-JacksonLondon School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK.
Sumathy RangarajanPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
Khalid F AlhabibDepartment of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Alvaro Jr AvezumDante Pazzanese Institute of Cardiology, São Paulo, Brazil.
Kevser Burcu Tumerdem CalikDepartment of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
Jephat ChifambaDepartment of Physiology, University of Zimbabwe, Harare, Zimbabwe.
Tarzia ChoudhuryIndependent University, Dhaka, Bangladesh.
Gilles DagenaisInstitut universitaire de cardiologie et de pneumologie de Québec, Quebec City, Ontario, Canada.
Antonio L DansDepartment of Medicine, University of the Philippines Manila, Manila, Philippines.
Rajeev GuptaEternal Heart Care Centre and Research Institute, Jaipur, India.
Romaina IqbalDepartment of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Manmeet KaurSchool of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Roya KelishadiIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, the Islamic Republic of Iran.
Rasha KhatibDepartment of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Iolanthe Marike KrugerAfrica Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa.
Vellappillil Raman KuttyHealth Action by People, Trivandrum, Kerala, India.
Scott A LearFaculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
Wei LiState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, University Teknologi MARA, Beijing, China.
Patricio Lopez-JaramilloFOSCAL, Medical School, Universidad de Santander (UDES), Bucaramanga, Colombia.
Viswanathan MohanDr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, Chennai, India.
Prem K MonySt John's Medical College and Research Institute, Bangalore, India.
Andres OrlandiniECLA Foundation, Santa Fe, Argentina.
Annika RosengrenDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University, Gothenburg, Sweden.
Ismail RosnahCommunity Health Department, Faculty of Medicine, UKM Medical Centre, Kuala Lumpur, Malaysia.
Pamela SeronFacultad de Medicina, Universidad de La Frontera, Temucu, Chile.
Koon TeoPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
Lap Ah TseJC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Lungiswa TsolekileSchool of Public Health, University of the Western Cape, Bellville, Western Cape, South Africa.
Yang WangState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Andreas WielgoszDepartment of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Ruohua YanState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Karen E YeatesDepartment of Medicine, Queen's University, Kingston, New Hampshire, Canada.
Khalid YusoffUiTM, Selayang, Selangor and UCSI University, Cheras, Kuala Lumpur, Malaysia.
Katarzyna ZatonskaDepartment of Social Medicine, Wroclaw Medical University, Wroclaw, Poland.
Kara HansonLondon School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK.
Salim YusufPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
Martin McKeeLondon School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK.
London School of Hygiene & Tropical Medicine · GBPopulation Health Research Institute · CAChinese Academy of Medical Sciences & Peking Union Medical College · CNAga Khan University · PKChinese University of Hong Kong · HKEstudios Clínicos Latinoamérica · AREternal Hospital · INHealth Action by People · INIndependent University · BDInstituto Dante Pazzanese de Cardiologia · BRInstitut universitaire de cardiologie et de pneumologie de Québec · CAIsfahan University of Medical Sciences · IRKing Saud University · SAMadras Diabetes Research Foundation · INMarmara University · TRNorthwestern University · USNorth-West University · ZAPost Graduate Institute of Medical Education and Research · INQueen's University · CASahlgrenska University Hospital · SE

Funding

CIHRWellcome TrustWellcome Trust 104349/Z/14/Z
6 · The paper itself

Abstract

Background: Non-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries. Methods: Using data from the PURE Study, we estimated risk of catastrophic health spending and impoverishment among households with at least one person with NCDs (cardiovascular disease, diabetes, kidney disease, cancer and respiratory diseases; n=17 435), with hypertension only (a leading risk factor for NCDs; n=11 831) or with neither (n=22 654) by country income group: high-income countries (Canada and Sweden), upper middle income countries (UMICs: Brazil, Chile, Malaysia, Poland, South Africa and Turkey), lower middle income countries (LMICs: the Philippines, Colombia, India, Iran and the Occupied Palestinian Territory) and low-income countries (LICs: Bangladesh, Pakistan, Zimbabwe and Tanzania) and China. Results: The prevalence of catastrophic spending and impoverishment is highest among households with NCDs in LMICs and China. After adjusting for covariates that might drive health expenditure, the absolute risk of catastrophic spending is higher in households with NCDs compared with no NCDs in LMICs (risk difference=1.71%; 95% CI 0.75 to 2.67), UMICs (0.82%; 95% CI 0.37 to 1.27) and China (7.52%; 95% CI 5.88 to 9.16). A similar pattern is observed in UMICs and China for impoverishment. A high proportion of those with NCDs in LICs, especially women (38.7% compared with 12.6% in men), reported not taking medication due to costs. Conclusions: Our findings show that financial protection from healthcare costs for people with NCDs is inadequate, particularly in LMICs and China. While the burden of NCD care may appear greatest in LMICs and China, the burden in LICs may be masked by care foregone due to costs. The high proportion of women reporting foregone care due to cost may in part explain gender inequality in treatment of NCDs.

Indexed as

Noncommunicable DiseasesBangladeshChinaCost of IllnessFemaleHumansIndiaMalePakistanProspective StudiesSwedencardiovascular diseasediabeteshealth economicshealth insurancehealth systems

Identifiers

PMID32133191
PMCPMC7042605
OpenAlexW3005770889

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.