Association between inequalities in human resources for health and all cause and cause specific mortality in 172 countries and territories, 1990-2019: observational study

• DOI: 10.1136/bmj-2022-073043
• Publication Date: 2023-05-11T00:00:37Z
• Authors: Wenxin Yan; Chenyuan Qin; Liyuan Tao; Xin Guo; Qiao Liu; Min Du; Lin Zhu; Zhongdan Chen; Wannian Liang; Min Liu; Jue Liu
• Keywords: Association (psychology)

To explore inequalities in human resources for health (HRH) relation to all cause and specific mortality globally 1990-2019.Observational study.172 countries territories.Databases of the Global Burden Disease Study 2019, United Nations Statistics, Our World Data.The main outcome was age standardized per 100 000 population HRH density 10 population, secondary mortality. The Lorenz curve concentration index (CCI) were used assess trends HRH.Globally, total increased, from 56.0 1990 142.5 whereas decreased, 995.5 743.8 2019. lay below equality line CCI 0.43 (P<0.05), indicating that workforce more concentrated among territories ranked high on development index. stable, at about 0.42-0.43 between 2001 continued decline (narrowed inequality), 0.38 2019 (P<0.001). In multivariable generalized estimating equation model, a negative association found level mortality, with highest levels as reference (low: incidence risk ratio 1.15, 95% confidence interval 1.00 1.32; middle: 1.14, 1.01 1.29; high: 1.18, 1.08 1.28). A rate pronounced some types including neglected tropical diseases malaria, enteric infections, maternal neonatal disorders, diabetes kidney diseases. death likely be higher people lower doctors, dentistry staff, pharmaceutical aides emergency medical workers, optometrists, psychologists, personal care physiotherapists, radiographers.Inequalities have been decreasing over past 30 years but persist. All most relatively limited workforce, especially several priority findings highlight importance strengthening political commitment develop equity oriented policies, expanding financing, implementing targeted measures reduce deaths related inadequate achieve universal coverage by 2030.