“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 income in international dollars; and one-fifth the outpatient visits, hospital beds, and physicians as their low-mortality counterparts. The study also showed an even greater gap in total per capita expenditure on health care: a 20-fold difference in spending between countries with low and high adult mortality and a 50-fold difference in spending between countries with low and high under five-year old mortality.
“The AIDS epidemic is likely driving some of the gap in adult mortality,” said Ruger. “We found that countries with high adult mortality rates had roughly 35 times the prevalence of HIV infection than the lowest mortality countries.”
Ruger and Kim analyzed data from the World Development Indicators 2003 database over the past five decades, compiled by the World Bank. They emphasize that results from this study are particularly relevant for directing global health policy and multinational organizations like the World Bank, which work in multiple policy domains affecting health inequalities.
In an accompanying article, Ruger, who is also an assistant adjunct professor at Yale Law School, examines the ethical challenges posed by such inequalities for the global health community—why such inequalities are morally troubling and efforts to reduce them are morally justified, and how much priority disadvantaged groups should receive. Ruger asserts that ethical commitments are required for social organization and action for redistribution of resources, legislation and policy, public regulation and oversight, and the creation of public goods.
Ruger argues for shared health governance in correcting global health inequalities and places responsibility on state and international governments and institutions, along with non-governmental organizations, businesses, communities, families and individuals.
“Individual nation-states must assume a prior and direct role of responsibility,” Ruger said. “Ethical principles have the power to motivate and hold global and national actors accountable for achieving common goals.”
Karen N. Peart | EurekAlert!
Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel
Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.
Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
18.07.2018 | Life Sciences
18.07.2018 | Materials Sciences
18.07.2018 | Health and Medicine