Global epidemiological comparison of Streptococcus pyogenes emm-types associated with pharyngitis and pharyngeal carriage

OBJECTIVES

To test the prevailing dogma that S. pyogenes emm-types that cause pharyngitis are the same as those associated with carriage, using a global dataset.

METHODS

Drawing on our systematic review of the global distribution of S. pyogenes emm-types and emm-clusters from 1990 to 2023, we compared the distribution and diversity of strains associated with pharyngitis and pharyngeal carriage, in the context of local United Nations Development Programme Human Development Index (HDI) values.

RESULTS

We included 20 222 isolates from 71 studies done in 34 countries, with the vast majority of carriage strain data from studies in 'Low HDI' settings (550/1293; 43%). There was higher emm-type diversity for carriage than pharyngitis strains (Simpson Reciprocal Index of diversity 28.9 vs 11.4). Compared to pharyngitis strains, carriage emm-types were disproportionately from emm-clusters E and D, usually described as 'generalist' or 'skin' strains.

CONCLUSIONS

A limited number of studies have compared S. pyogenes strains from cases of pharyngitis compared to carriage. Our understanding of strains associated with carriage is poorest for high-income settings. In low and medium HDI countries, we found greater strain associated with pharyngeal carriage than pharyngitis. Improving our understanding of S. pyogenes carriage epidemiology in the pre-vaccine era will help to decipher direct and potential indirect effects of vaccines.

Training strategies of 10,074 athletes from 121 countries based on human development index in early COVID-19 lockdown

The aim of this study was to investigate relationships between changes in training practices and human development index (HDI) levels, and identify strategies employed by athletes who consistently maintained their training quantity during the first 100 days of the COVID-19 pandemic. A total of 10,074 athletes (5290 amateur and 4787 professional athletes from 121 countries) completed an online survey between 17 May to 5 July 2020. We explored their training practices, including specific questions on training frequency, duration and quantity before and during lockdown (March-June 2020), stratified according to the human development index (HDI): low-medium, high, or very high HDI. During the COVID-19 lockdown, athletes in low-medium HDI countries focused on innovative training. Nevertheless, women and amateur athletes experienced a substantial reduction in training activity. Performance-driven athletes and athletes from higher HDI indexed countries, were likely to have more opportunities to diversify training activities during lockdowns, facilitated by the flexibility to perform training away from home. Factors such as lockdown rules, socioeconomic environment, and training education limited training diversification and approaches, particularly in low-medium and high HDI countries. Athletes (amateurs and professionals) who maintained the quantity of training during lockdown appeared to prioritize basic cardiovascular and strength training, irrespective of HDI level. Modifying training and fitness programs may help mitigate the decrease in training activities during lockdowns. Customized training prescriptions based on gender, performance, and HDI level will assist individuals to effectively perform and maintain training activities during lockdowns, or other challenging (lockdown-like) situations.

The Global Road Traffic Death Rate and Human Development Index from 2000 to 2019: A Trend Analysis

BACKGROUND

Numerous studies on the association between the human development index (HDI) and road traffic death rate (RTDR) merely focus on developed countries, not reflecting the relationship between the HDI components and RTDR in a time-trend analysis. Accordingly, this study analyzes the trends of RTDR and their association with the HDI and its components from 2000 to 2019.

METHODS

The RTDR data of 154 countries were imported into the unconditional latent growth model (LGM) to assess the RTDR trends. The impact of the HDI and its components (viz., education, income, and life expectancy [LE viz]) on the trajectory of RTDR was also evaluated using the conditional LGM.

RESULTS

The results of the unconditional LGM indicated an overall decreasing trend in RTDR. The conditional LGM results revealed the negative effect of the HDI and its components on the model parameters. The findings of random forests indicated that education and LE were the most crucial variables.

CONCLUSION

Overall, this study emphasizes the significance of HDI and its components, particularly education and LE, in lowering the number of traffic fatalities. In this sense, improving formal education and LE could be one of the main policies that policymakers could consider to reduce RTDR.

Evaluating the resource curse hypothesis and the interplay of financial development, human development, and political stability in seven emerging economies

The present study empirically confabulates the authenticity of the "resource curse hypothesis" in selected emerging nations. Furthermore, we also assessed the interconnections of three essential economic indicators with financial development, i.e., human development, political stability, and gross domestic product. To effectuate these objectives, we used annual data for the time frame 1990 to 2020 and advanced panel estimation techniques for getting the empirical outcomes. The study's empirical outcomes illustrate the existence of the "resource curse hypothesis" in sample nations. In addition, human development index and gross domestic product play an essential part in the furtherance of financial development in the long-run. The human development index is upsurging the financial development. Furthermore, political stability is also exerting a favorable influence on financial development. A similar interconnection is observed in the short-time period; nonetheless, the amplitude of the short-run impacts is smaller if we have a look at the long-run impacts. The empirical analysis offers a few pertinent policy insights for policymakers to improve the situation in the selected sample. Note: Financial development positively interconnected with human development, GDP and political stability while negatively associated with natural resources, respectively.

Transformative role of educational funding in shaping national development across SAARC countries in the 21st century: A panel NARDL approach

Since the beginning of this century, there has been evidence of a rise in educational funding among the South Asian Association for Regional Cooperation (SAARC). However, there has been a decline in recent years despite South Asia being a highly populated and poverty-ridden region. Thus, the present study comes to assess how well the countries are doing in relation to the effect of educational funding on national development indicators, namely economic growth, human capital development, and the unemployment rate among the SAARC countries in the 21st century using Panel Nonlinear Autoregressive Distributed Lag (PNARDL) model formulated in Salisu and Isah (2017). The findings revealed that the impact of educational funding on economic growth and the unemployment rate is an asymmetry in the long run and symmetry in the short run but on the human development index, it is an asymmetry in both terms. However, educational funding is influencing economic growth in the long run, but in the short run is not. Furthermore, educational funding influences human capital development in both terms, but in the long run is negligible. Moreover, educational funding is negligibly discouraging the unemployment rate in both terms.

Impact of social and economic factors on global thyroid cancer incidence and mortality

PURPOSE

The incidence of thyroid cancer has increased substantially over the past few decades and is partially explained by overdiagnosis. Geographical variations in incidence rates were reported to be related to national development status. This study aimed to gain deeper insights into global thyroid cancer burden by incorporating additional social and economic factors to account for cross-national disparities.

METHODS

We performed a multivariate analysis of age-standardized incidence and mortality data from the GLOBOCAN 2020 database for 126 countries that had more than 100 incident cases of thyroid cancer. The human development index (HDI), current health expenditure, and additional Global Health Observatory indicators were extracted from multiple sources.

RESULTS

Age-standardized incidence was highly correlated with HDI (standardized coefficient beta = 0.523, 95% confidence interval [CI] = 0.275-0.771) among the countries studied. The prevalence of raised fasting blood glucose was associated with age-standardized mortality (beta = 0.277, 95% CI = 0.038-0.517). Generally, the mortality-to-incidence ratio was higher in males than in females. In multivariate analysis, HDI (beta = - 0.767, 95% CI = - 0.902 to - 0.633), current health expenditure (beta = 0.265, 95% CI = 0.137-0.394), and fine particulate matter (PM2.5) concentrations (beta = 0.192, 95% CI = 0.086-0.298) were associated with mortality-to-incidence ratios.

CONCLUSIONS

National developments gauged by HDI explain the majority of the variation in incidence rates of thyroid cancer but play a smaller role in disparities in mortality rates. The association between air pollution and thyroid cancer outcomes warrants further investigation.

Impact of energy depletion, human development, and income distribution on natural resource sustainability

Constant exploitation of natural resources has resulted from the industrialization and urbanization of society. One of the possible causes of the COVID-19 pandemic is an ecological disturbance caused by excessive resource exploitation. Countries worldwide have taken precautionary measures to limit the spread of this disease because of its highly infectious nature: lockdowns, quarantines, curfews, etc. This paper explores the impacts of energy depletion and the human development index on natural resources, considering the roles of CO₂ emissions and economic growth in China from 1971 to 2019. We apply advanced economic modeling using the Phillips-Ouliaris test for integration, Gaussian identity mixed-effects Generalized Linear Model, and Robust GEE population-averaged model for long-run estimates. Results explain that CO₂ emissions and economic growth devalue natural resources, while the human development index and energy depletion increase them. Depletion of natural resources occurs due to overexploitation and overuse of natural resources, as well as unsustainable planning and waste. In the case of natural resources that man uses to make other resources, such as dams, roads, sports complexes, etc., these are considered human-made resources. It is, therefore, essential to develop human resources as a part of the natural resource development process. Research limitations and future directions are discussed.

Temporal transition trends of cord blood lead levels in various human development index countries and in the Taipei metropolitan area

Since low-level lead exposure is still of concern for neonates, it is worth further characterizing the temporal transition trends of cord blood lead levels (CBLLs) globally and locally in Taipei, Taiwan, after the cessation of leaded gasoline use. A literature review on CBLLs around the world was performed by searching three databanks, i.e., PubMed, Google Scholar and Web of Science, with the search keywords "cord blood" combined with "lead" or "Pb" for studies published from 1975 to May 2021. In total, 66 articles were included. Linear regressions for the reciprocal of sample size weighed CBLLs against calendar year presented a high r² value (0.722) for the very high Human Development Index (HDI) countries and a moderate r² value (0.308) for the combined high and medium HDI countries. The predicted CBLLs in 2030 and 2040 were 6.92 (95% CI: 6.02-7.81) μg/L and 5.85 (95% CI: 5.04-6.66) μg/L, respectively, for the very high HDI countries and 13.10 (95% CI: 7.12-19.09) μg/L and 10.63 (95% CI: 5.37-15.89) μg/L, respectively, for the combined high and medium HDI countries. To characterize the CBLL transitions in the Great Taipei metropolitan area, data from five studies conducted from 1985 to 2018 were employed. Although the results of the early four studies indicated that the Great Taipei metropolitan area did not reach the pace in CBLL reduction among the very high HDI countries, the CBLLs of the latest study during 2016-2018 were pretty low (8.1 ± 4.5 μg/L), approximately 3 years in advance of the very high HDI countries as one group to reach this low CBLL. In conclusion, further effective reduction in environmental lead exposure is challenging and must be based on the efforts from the aspects reflected by the HDI index compositions, i.e., economics, education and health, mostly implying health disparity and inequality.

The Effects of Urban Living Conditions on Subjective Well-Being: The Case of German Foreign Service Employees

In an increasingly urbanized world, understanding the determinants of urban well-being will continue to grow in importance. Although the effects of different indicators of living conditions on well-being have been widely studied individually, little is known about their relative impact when examined jointly. In this study, we use a unique multi-source dataset that allows us to investigate the effect and relative importance of a variety of subjectively and objectively assessed aspects of urban living conditions on the subjective well-being (SWB) of German Foreign Service expatriates. The study captures living conditions in metropolises around the world at different stages of development, and assesses living conditions in a culturally comparably homogeneous set of participants, thus being potentially less confounded with cultural differences. Using linear regression and dominance analysis, we find that 'quality of and access to nature' (i.e., green space), 'quality of housing', and 'quality of public goods' (i.e., water, air, and sewage systems) have the strongest associations with SWB. Subjectively rated characteristics show stronger associations with SWB than externally assessed characteristics. Additionally, we examine whether the size of a city or the level of development of a country has an effect on SWB. Both living in a megacity (≥ 10 million inhabitants) and a lower development status have negative effects on SWB. However, these effects disappear when the various indicators of living conditions are controlled for. Our findings can inform organisations sending employees abroad as well as urban planners seeking to improve their policies and decision-making.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11482-023-10169-w.

Measurement of China's Human Development Index and Analysis of Its Influencing Factors from the Perspective of New Development Concept

This paper redefines the connotation of China's human development in the context of the new development concept and high-quality development, and constructs the China Human Development Index (CHDI) indicator system accordingly. Then, based on the inequality adjustment model and DFA model, the human development level of each region in China from 1990 to 2018 is measured, and the spatial and temporal evolution characteristics of China's CHDI and the current situation of regional imbalance are analyzed accordingly. Finally, LMDI decomposition technique and spatial econometric model were used to study the influencing factors of China's human development index. The results show that: (1) The weights of the CHDI sub-index estimated by the DFA model have good stability, and it is a relatively good objective weighting method. (2) Compared with the HDI, the CHDI in this paper can better reflect the level of human development in China. (3) China's human development has made great achievements and has basically achieved the leap from the low human development level group to the high human development level group. However, there are still significant gaps between regions. (4) From the results of LMDI decomposition, the livelihood index is the most important driving index of CHDI growth in each region. From the results of spatial econometric regressions, there is a strong spatial autocorrelation of China's CHDI among the 31 provinces. GDP per capita, financial education expenditure per capita, urbanization rate, and financial health expenditure per capita are the main influencing factors of CHDI. Based on the above research findings, this paper proposes a scientific and effective macroeconomic policy with important reference value for promoting the high-quality development of China's economy and society.

The Effect of Human Development Index on Obesity Prevalence at the Global Level: A Spatial Analysis

Background

Obesity is one of the major public health concerns, and its prevalence is increasing worldwide. This study aimed to investigate the effect of human development index on the prevalence of obesity across 152 countries.

Methods

Country-level data on obesity prevalence and its influencing variables related to 152 countries were obtained during 2000-2019 from several sources. A Spatial Bayesian Hierarchical model was employed in this research, and the analyses were performed using R statistical software (version 3.6.1).

Results

We found a positive relation between HDI and obesity prevalence, in such a way if low HDI countries advance to high HDI countries, the obesity rate is expected to increase significantly by 7.45%. Moreover, the association between obesity prevalence and the percentage of people aged 40-59 (β=0.07), urbanization rate (β=0.11), percentage of internet users (β=0.01), percentage of alcohol users (β=0.16), milk consumption per capita (β=0.15) and Percentage of depression (β=0.58) was significantly positive. Conversely, per capita consumption of fruits and vegetables (β=-0.15), and smoking rate (β=-0.02) was negatively associated with obesity prevalence.

Conclusion

The prevalence of obesity is growing across all countries, especially in the countries with high and very high HDI. Therefore, policymakers must also pay attention to the negative effects of development when trying to improve the welfare of society.

Factors of foreign direct investment flows to Indonesia in the era of COVID-19 pandemic

This paper presents a new spectrum and recommendations the Indonesian Government might find highly useful in attracting foreign direct investment (FDI) through electricity and water availability, Human Development Index (HDI), and COVID-19 pandemic evidence. Our study depends on cross-sectional data from 34 provinces and the time-series data from 2009 to 2020. We carry out the causality test (Dumitrescu-Hurlin) to check whether our research model is good enough to provide strategic options nationally. Furthermore, we employ the pooled ordinary least squared (POLS), fixed effect model (FEM), and random effect model (REM). The three models have so-called static panel data. Based on the Chow's and Hausman's test, we also find that the random effect is the best model to explain our empirical research. Our findings indicate that the electricity, water, HDI, and COVID-19 pandemic significantly contribute to the FDI. Our research also contributes to the literature on the predictors of FDI. This research is expected to help the Indonesian Government to make decisions on electricity, water, and human capital policy. Moreover, it highlights the direction a government or policymaker can take to attract the FDI.

[Global liver cancer incidence and mortality and future trends from 2000 to 2020: GLOBOCAN data analysis]

Objective: To compare the geographical differences and time trends of liver cancer incidence and mortality in different regions around the world so as to predict the future burden of liver cancer. Methods: The incidence and mortality data of liver cancer in different Human Development Index (HDI) countries from 2000 to 2020 were collected from the GLOBOCAN 2020 database. The joinpoint model and annual percent change (APC) were used to analyze the liver cancer global incidence and mortality as well as future epidemic trends from 2000 to 2020. Results: ASMR for male liver cancer was increased from 8.0/100, 000 in 2000 to 7.1/100,000 in 2015 (APC = -0.7, 95%CI: -1.2 ~ -0.3, P = 0.002), while ASMR for female liver cancer was increased from 3.0/100, 000 in 2000 to 2.8/100, 000 in 2015 (APC = -0.5, 95%CI: -0.8 ~ -0.2, P < 0.001). The ratio of male to female ASMR was 2.67:1 in 2000 and 2.51:1 in 2015, indicating a slight narrowing of the difference in mortality between men and women. In 2020, the global ASIR and ASMR for liver cancer were 9.5/100 000 and 8.7/100 000, respectively. Male ASIR and ASMR (14.1/100, 000 and 12.9/100, 000, respectively) were 2 ~ 3 times higher than females (5.2/100, 000 and 4.8/100, 000, respectively). There were significant differences between ASIR and ASMR in different HDI countries and regions (P(ASIR) = 0.008, P(ASMR) < 0.001), and the distributions of ASMR and ASIR were very similar. New cases and deaths were expected to increase by 58.6% (143,6744) and 60.9% (133, 5 375) in 2040, with the number of cases and deaths increasing by 39,7003 and 37,4208 in Asia, respectively. Conclusion: ASMR due to liver cancer worldwide has had a downward trend between 2000 and 2015. However, the latest epidemiological status and predictions of liver cancer in 2020 indicate that prevention and control will still be a major challenge globally in the next 20 years.

Human development at the cost of the environment?-an application of planetary pressures-adjusted human development index in the lens of planetary boundaries

The human development index (HDI) was an important step toward a more human-oriented assessment of socioeconomic prosperity. Nevertheless, at the onset of the anthropocene, the environmental pillar of sustainable development is indispensable. This work aims to understand this conundrum of human development and its environmental cost or pressure through the use of the planetary pressures-adjusted human development index (PHDI) as well as introduce another modified version, planetary pressures, and inequality-adjusted human development index (PIHDI). PHDI incorporates two biophysical consumption-based indicators (CO₂ emissions and material footprint, MF) as a proxy of environmental pressures into traditionally socioeconomic development-focused HDI. This work spans 164 nations and 27 years (1990-2016). Various statistical techniques such as Pearson's correlation, hierarchical clustering (HCA), generalised additive modelling (GAM), data envelopment analysis (DEA), linear regression, and ARIMA forecasting have been used to explore interrelationships, non-linearity, efficiency analysis, and future projections (up to 2030) and delve into two scenarios: high human development and for human development permitted only within the two planetary boundaries (PBs) (viz. climate change and material footprint) and their consequences when exceeded. Though most of the countries with high PHDI and PIHDI scores are from the global north and have a high income, it is also possible to attain human development (i.e. increase PHDI and PIHDI scores) without overexploiting biophysical resources. From 2016, human development scores could increase by 55-63% (climate change) or 30-46% (material consumption) within a safe operating space in 2030. Without the required focus on the environment, aiming for a superior score in PHDI and PIHDI could result in 43-58% (CO₂ emissions) or 57-58% (material footprint) of countries that would exceed PB. Based on the outcome of this work, it can be recommended that governments and policymakers that it is well within the limits of feasibility as well as necessary to make human socioeconomic development aspire to sustainability to address the needs of humanity, while respecting the well-being of the surrounding biosphere.

Building a case for incorporating sport as an indicator in human development index

Purpose

United Nations General Assembly adopted a resolution 73/24 on 3rd December 2018, to recognize sport as an enabler of sustainable development. To examine whether sport really plays an enabling role, the medals ranking of countries on the basis of medals obtained (per million population) in Summer Olympics during the five Olympics games over the first two decades of 21st century has been chosen as an indicator of sports achievement of a country and has been compared with their Human Development Index (HDI) ranking during that particular year of Olympics. The aim of this research was to examine the correlation between sports achievement and HDI.

Methods

This research uses the Summer Olympic Rank as per medals obtained per million population (for the years 2000, 2004, 2008, 2012, 2016) of various countries as the Indicator of their sports achievement and compares them with their HDI Rank during these specific years.

Results

The researchers tested the hypothesis that the higher the sports achievement, the higher the HDI of a country and vice-versa. The analysis shows a very high positive correlation between the Olympic medal ranking and the HDI ranking, revealing that the countries with higher sports achievement have higher HDI.

Conclusions

Hence, the conclusion is, if a sport is include in HDI as an indicator of the Human Development Index, sport could become an important vehicle for the improvement of HDI, especially in low and middle-income countries where the sports achievement is low and the HDI is also low.

The impact of FDI on host countries' social welfare: a panel data analysis of 146 countries over the period 2002-2019

Foreign direct investment (FDI) is an important driver of the increasing globalization of the word economy, and despite being a widely studied phenomenon, studies on the effects of FDI on host countries' social welfare are scarce. So, this work aims to analyze the impact of FDI on welfare measured through the human development index and its three dimensions (education, life expectancy, and income). Based on a sample of 146 countries for the period 2002-2019, the results obtained by two-staged least squares-instrumental variable estimation suggest that FDI impact on social welfare depends on the countries' human capital which reflects countries' absorptive capacity. Results also highlight the role of government expenses in consumption, political stability, and quality of technological infrastructures. Therefore, the results suggest that, in order to improve social welfare, countries should focus and gear their policies towards fostering the improvement of their human resources, political stability, and technological infrastructures.

Well-being and relative deprivation in a digital era

Social unrest is a feature of the early 21st century, yet relatively little research binds theoretical aspects with empirical validation of the drivers of protests and revolutions. This study aims to empirically validate the Davies J-Curve considering the digital era, with economic, social, and political factors. Using big data techniques, network analysis, and theoretical analysis, we analyzed countries' similarities by analyzing Human Development Index (HDI) and Worldwide Governance Indicator (WGI) as proxies of social well-being. Results established the existence of a J-Curve during social crises in countries prior to an occurrence of large-scale social unrest. In addition, our results suggest that HDI was not a sufficient indicator regarding countries' experienced well-being, likely because it is missing the highly granular aspects of daily life. We further recommended that other indicators from political and psychological areas should be considered and treated in the data preparation phase for future society-wide well-being research for a more realistic baseline.

Correlation between human development index and its components with COVID-19 indices: a global level ecologic study

Background

Given that COVID-19 continues to spread worldwide, attempts to restrain the virus and to prevent the effects that critically ill patients with COVID-19 have on healthcare systems, has become a public health priority. This ecological study aimed to investigate the correlation between the Human Development Index (HDI) and the epidemiological indicators of COVID-19, including the cumulative incidence rate of cases, the cumulative incidence rate of death, performed COVID-19 tests per million, recovery rate, and case fatality rate.

Methods

In this ecological study, a data set was provided, which included the epidemiologic indices of COVID-19, HDI, and its components for each country. Correlation coefficients were used to determine linear correlation. Also, the scatter plots of the HDI for the studied countries based on the epidemiologic indices of COVID-19 were drawn.

Results

This study showed that HDI and its components had positive correlation with a cumulative incidence rate of cases, the cumulative incidence rate of death, and performed COVID-19 tests (p < 0.001). HDI and two of its components, including literacy and Gross National Income (GNI) components had negative correlation with case fatality rate (CFR). Also, HDI and two of its components, including literacy and life expectancy components had negative correlation with recovery rate.

Conclusion

Our study showed that the HDI and its components can affect the epidemiological status of COVID-19. As HDI increased, the cumulative incidence rate of cases, cumulative incidence rate of death, and COVID-19 tests increased as well. As HDI increased, CFR and recovery rate decreased as well. Although the HDI is higher in high-income countries, these countries may have also better reporting and surveillance systems.

Conceptualizing Saudi women's participation in the knowledge economy: the role of education

This paper is part of a project that aims to conceptualize the knowledge economy (KE) in the Saudi context, focusing on gender in relation to education, employment, human development index, innovation, and ICT. It uses a quantitative methodology. However, the used data is secondary data collected from different government and non-government sources. Different statistical analysis methods were conducted including descriptive statistics, graphs, correlation, and trend analysis. The paper found that despite the importance placed on KE and women empowerment (Saudi Vision, 2030), gender discrepancies were observed in relation to employment, innovation and ICT. Those components, according to our data, are positively correlated with the current Saudi ranking under KEI. The paper shows that although the rate of female graduates from higher education is slightly higher than male, this difference was not translated into participation in the labor market, particularly in jobs related to KE. It was also found that though Saudi Arabia's ranking under innovation and ICT was internationally low, there was a lack of public information regarding the gender dimension. This suggests that gender was not understood as a crucial factor in improving the country's ranking under those components. The paper concludes by highlighting the national innovation system's shortfalls as reflected by education, patents, and innovation. It suggests further investigations into utilizing women under jobs related to KE and calls for including the gender dimension as a variable in any future planning or studies related to the knowledge economy.

Global trends in total fertility rate and its relation to national wealth, life expectancy and female education

Objectives

Along with the development of the times and progress of the society, the total fertility rate (TFR) markedly changed in each country. Therefore, it is critical to describe the trend of TFR and explore its influencing factors. However, previous studies did not consider the time lag and cumulative effect in the associations between the influencing factors and TFR. Thus, our study aimed to analyze the associations from a new dimension.

Methods

The study was employed using national-level data from the World Bank and United Nations Development Programme. Distributed lag non-linear models with 5-year lag were used to examine the independent associations between the relevant factors and TFR.

Results

The cumulative exposure-TFR curves were inverted U-shaped for log gross domestic product (GDP) per capita and life expectancy at birth, while the cumulative exposure-response curves were approximately linear for female expected years of schooling and human development index (HDI). However, it is worth noting that in the developed regions, TFR increased slightly with the high level of GDP per capita, female expected years of schooling and HDI.

Conclusions

Nowadays, with the growth of GDP per capita, life expectancy at birth, female expected years of schooling and HDI, TFR are on a drastic downward trend in most regions. Besides, with the development of society, when levels of the factors continued to increase, TFR also showed a slight rebound. Therefore, governments, especially those in developing countries, should take measures to stimulate fertility and deal with a series of problems caused by declining TFR.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13656-1.

Trends in the disease burden of congenital heart disease in China over the past three decades

OBJECTIVE

To investigate the disease burden of congenital heart disease (CHD) in China from 1990 to 2019.

METHODS

Using the data from Global Burden of Disease (GBD) study 2019, the incidence, age-standardized incidence rates, the mortality, age-standardized mortality rates, disability-adjusted life year (DALY) and age-standardized DALY rates of CHD were calculated. Time trend analysis of disease burden-related indicators was analyzed by Joinpoint regression model. Age-period-cohort model was used to describe age, period, and birth cohort effects in CHD mortality population. The relationship between age-standardized incidence, mortality, DALY rates of congenital heart disease and human development index (HDI) were analyzed by Pearson correlation.

RESULTS

From 1990 to 2019, the mean annual percentage change (AAPC) in age-standardized incidence rate, mortality rate and DALY rate of CHD in China were -0.1%(95% CI: -0.7%-0.4%)、-3.5%(95% CI: -3.7%--3.2%) and -3.5%(95% CI: -3.7%--3.2%), respectively. CHD usually occurred in the first year of life. The mean incidence rate at birth was 2497.9/100 000, and the mean incidence rate under 1 year of age was 2626.6/100 000. During the period of 1995-2000, the incidence rate in newborn and <1 year children showed an exponential upward trend, then it remained a steady downward trend. However, there was an exponential increase in <1 year children during 2010-2013 and 2014-2015, followed by an exponential decrease to the lowest value in the last three decades. The mortality of CHD tended to decrease with age, with mortality of 101.67/100 000 for children under 5 years of age and a decrease after 5 years of age. However, there was a transient increase in mortality in age group 55-<60. From 1995 to 2019, the relative risk of death of patients with CHD showed a downward trend. Compared with 1995-1999, the rate ratio of death decreased by 24% in 2015-2019. Such downward trend was also observed in the birth cohort after 1945. Compared with the 1945-1949 birth cohort, the rate ratio of death for patients with CHD decreased by 75% in the 2015-2019 birth cohort. When HDI<0.58 (before 1999), the age-standardized incidence of CHD was positively correlated with HDI ( r=0.74, P<0.05). When HDI≥0.58 (after 1999), the age-standardized incidence of CHD was negatively correlated with HDI ( r=-0.76, P<0.01). The age-standardized mortality and DALY rates were negatively correlated with HDI ( r=-0.95 and -0.93, both P<0.01).

CONCLUSIONS

During 1990 to 1999, the incidence of CHD increases and is positively correlated with the social development. During 1999 to 2019, the incidence of CHD decreases and is negatively correlated with the social development. The disease burden of CHD decreases and is negatively correlated with the social development. Some progress has been made in the field of prevention and control of CHD, but the disease burden remains high among younger population in China.

Socioeconomic development role in hospitalization related to air pollution and meteorology: A study case in southern Brazil

Air pollution is one of the foremost environmental threats to human health. However, the meteorological and social factors that lead to respiratory and cardiovascular diseases have not been fully elucidated. In this study, we use Principal Component Analysis and Generalized Linear Model (PCA-GLM) to investigate the combined effect of socioeconomic development and air pollution on cardiorespiratory hospitalization in southern Brazil. This region has the highest rates of hospitalization by cardiorespiratory diseases in the country. We analyze three main sources of data: (i) air pollutants density from TROPOMI/Sentinel-5p satellite; (ii) temperature, humidity, and planetary boundary layer height (PBLH) modeled with the Weather Research Forecast model; and (iii) hospitalization by cardiorespiratory diseases obtained from the Brazilian National Health System. We estimate the Relative Risk (RR) using the PCA-GLM coefficients and interquartile variations of air pollutants density and meteorological parameters. Our results show that the population living in colder and drier municipalities is more prone to cardiorespiratory hospitalization. Regarding respiratory hospitalization, municipalities with lower socioeconomic development are more sensitive to meteorology and pollution variability than highly developed ones. In less developed municipalities, we observe the highest rates of cardiorespiratory hospitalization even if air pollution is low, which we interpret in terms of higher vulnerability. The RR analysis suggests that air pollution is an important environmental risk to cardiovascular diseases and respiratory diseases is more sensitive to air pollution and meteorology than cardiovascular ones. Our findings corroborate the mounting evidence that social vulnerability is a significant factor affecting the increase of cardiorespiratory hospitalization in the world.

COVID-19 needs no passport: the interrelationship of the COVID-19 pandemic along the U.S.-Mexico border

OBJECTIVES

To investigate the impact of the COVID-19 pandemic along the U.S.-Mexico border region and evaluate the relationship of COVID-19 related mortality, socioeconomic status, and vaccination.

METHODS

We used indirect standardization to age-adjust mortality rates and calculate standardized mortality ratios [SMR] in both countries. To examine the impact of socioeconomic factors, we calculated the Human Development Index (HDI) by county/municipality. We performed linear regression to understand the relationship between mortality, vaccination, and HDI. We used choropleth maps to visualize the trends seen in the region.

RESULTS

Between January 22nd, 2020 and December 1st, 2021, surges of cases and deaths were similar in dyad cities along the U.S.-Mexico border visualizing the interconnectedness of the region. Mortality was higher in U.S. counties along the border compared to the national average (SMR 1.17, 95% CI 1.15-1.19). In Mexico, border counties had a slightly lower mortality to the national average (SMR 0.94, 95% CI 0.93-0.95). In U.S. border states, SMR was shown to negatively correlate with human development index (HDI), a socioeconomic proxy, resulting in a higher SMR in the border region compared to the rest of the counties. Conversely in Mexican border states, there was no association between SMR and HDI. Related to vaccination, U.S. counties along the border were vaccinated at a greater percentage than non-border counties and vaccination was negatively correlated with HDI. In Mexico, states along the border had a higher ratio of vaccinations per person than non-border states.

CONCLUSIONS

The U.S.-Mexico border is a divide of incredible importance not only to immigration but as a region with unique social, economic, environmental, and epidemiological factors that impact disease transmission. We investigated how the COVID-19 pandemic followed trends of previously studied diseases in the corridor such as tuberculosis, HIV, and influenza H1N1. These data state how targeted intervention along the U.S.-Mexico border region is a necessity when confronting COVID-19 and have implications for future control of infectious diseases in the region.

The research output of rod-cone dystrophy genetics

Non-syndromic rod-cone dystrophy (RCD) is the most common condition in inherited retinal diseases. The aim of this study was to evaluate the research output and productivity related to RCD genetics per countries as classified by the human development index (HDI), by analyzing publication frequency and citations, the choice of journals and publishers, since 2000 to date. We have also analyzed the use of next-generation sequencing (NGS) in publications originating from countries with different HDIs. One thousand four hundred articles focusing on non-syndromic RCD were downloaded and analyzed. Citations and published articles were adjusted per one million individuals. The research output is significantly higher in very high HDI countries (86% of the total publications and 95% of the citations) than countries with lower HDIs in all aspects. High and medium HDI countries published together 13.6% of the total articles worldwide and received 4.6% of the citations. On the publication level, the USA (26%), United Kingdom (10%), and Japan (7%) were the top 3 among very high HDI countries, while China (6%) and India (2%) ranked first in high and medium HDI countries respectively. On the citation level, similar profiles were found. Following adjustment for population size, Switzerland (~14%), Jordan (~ 1%) and Morocco (<0.2%) showed the highest rates of publications in very high, high and medium HDI countries respectively. Very high HDI countries published 71% of their papers in first quartile journals (first quartile in Scimago journal rank; Q1), and 23% in Q2 journals. High and medium HDI countries showed a similar profile in quartiles with ~ 40% of their papers published in Q1 journals and ~ 30% in Q2 journals. The first publication using NGS was issued in 2009 in very high HDI countries, while it appeared in 2012 in high HDI countries, and in 2017 in medium HDI countries, with a respective lag of 3 to 8 years compared to very high HDI countries. A profound gap exists between very high HDI countries and the rest of the world. To fill it in, we propose implementing NGS, supporting international collaborations, building capacities and infrastructures, improving accessibility of patients to services, and increasing national and international funding.

Acculturation and 4-year caries increment among children of foreign-born mothers in Sweden: a register-based cohort study

Background

To study the association of maternal age upon arrival and length of residence in Sweden with the 4-year caries increment in their children between ages 3 and 7 years in relation to the human development index (HDI) of the maternal country of origin.

Method

This registry-based cohort study included all children born in 2000–2003 who resided in Stockholm County, Sweden, at age 3 years and who were followed up at age 7 (n = 63,931). Negative binomial regressions were used to analyze different models adjusted for sociodemographic factors.

Results

Children of foreign-born mothers, regardless of the HDI of the maternal country of origin, had a higher risk of caries increment between ages 3 and 7 years than children of Swedish-born mothers. Furthermore, children of mothers who had arrived from a low or medium HDI country had a lower caries increment if their mothers arrived before age 7 compared with after age 7. Nearly half (44%) of the children whose mothers arrived in Sweden at age ≥ 20 years from a low HDI country had a caries increment compared to 22% of the children whose mothers had arrived in Sweden before 7 years of age. Furthermore, children whose mothers were born in a low HDI country and had resided in Sweden ≤ 19 years had approximately 1.5 times higher risk of caries increment compared to children of mothers who had resided in Sweden for more than 20 years.

Conclusions

Caries increment in the children of foreign-born mothers was associated with the age of their mother when she arrived in Sweden and was lower when the mother had arrived before age 7 years. This indicates an intergenerational effect that carries over to the children and is greater the longer the mother has participated in Swedish dental healthcare.

Relationship between socio-demographic correlates and human development index with physical activity and sedentary time in a cross-sectional multicenter study

BACKGROUND

Socio-demographic correlates and human development index (HDI) are associated with self-reported physical activity, but only a few studies have focused on device-measured physical activity and sedentary time in Latin America. We examined the relationship between socio-demographic correlates and HDI with physical activity and sedentary time in a cross-sectional study.

METHODS

We based our analyses on 2522 (53.1% women; 18-65 years [mean age 38.3 years]) adults drawn from the eight Latin America countries. Physical activity (light, moderate, vigorous, and moderate-to-vigorous intensity and steps) and sedentary time were assessed using Actigraph GT3X + accelerometers. Sex, age, and race/ethnicity were self-reported. The HDI country information was obtained from the United Nations Development Program.

RESULTS

For the age, ethnicity, vigorous physical activity and steps/day, there were significant differences between high and very high HDI countries. Women and younger age presented lower sedentary time than men and older. In moderate-to-vigorous physical activity, we found lower duration in women (-13.4 min/week), younger age (-0.1 min/week), and white/caucasian (-2.7 min/week) than men, older ages and mixed ethnicity. Women (-1266.5 steps/week) and very high HDI (-847.3 steps/week) presented lower steps than men and high HDI. Black (2853.9 steps/week), other (1785.4 steps/week), and white/caucasian ethnicity (660.6 steps/week) showed higher steps than mixed ethnicity.

CONCLUSIONS

Different socio-demographic correlates are associated with physical activity intensity; however, HDI is associated with vigorous physical activity and steps in the Latin American region, which can in turn guide policies to promote physical activity in the region.

TRIAL REGISTRATION

ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.

Spatial characteristics and influential mechanism of the coupling coordination degree of urban accessibility and human development index in China

To optimize the accessibility algorithm and quantify the potential relationship between human development index and traffic comprehensive accessibility system, this paper analyzed the spatial distribution pattern of urban accessibility and human development index of highway, railway, and aviation transportation systems using data on highway, railway, and aviation schedules based on GIS spatial analysis method. Furthermore, the coupling degree between human development index and accessibility and its influence mechanism on the city level in China were explored based on the super-efficiency data envelopment analysis model. Results showed as follows: (1) Spatial distribution of human development index from high to low was gradually changing from east to west. The spatial distribution of urban accessibility of the three traffic systems had an evident "Hu Huanyong Line" effect. (2) The coordination degree of urban accessibility and human development index spread in a ladder mode. High coordination of cities in North and East China and the central Yangtze River region forms the spatial distribution of urban development circles connecting an urban development belt. (3) Railway connectivity and control value were highly sensitive to human development index in cities where serious imbalance between accessibility and human development index. Highway connectivity and control value were highly sensitive to human development index in cities where high coordination between accessibility and human development index. The results would provide scientific references for spatial planning of transportation, economic, and social development of cities and coordinated development of urban agglomeration in China.

Global pattern of trends in incidence, mortality, and mortality-to-incidence ratio rates related to liver cancer, 1990-2019: a longitudinal analysis based on the global burden of disease study

Background

Liver cancer (LC) is considered as one of the most dominant malignant tumors which ranked 4^th and 6^th in terms of global mortality and incidence, respectively. This work aimed to investigate the global temporal trends in LC mortality-to-incidence ratio (MIR) and its components, with a particular focus on examining long-term effect of human development index (HDI) on these metrics in a 30-year follow-up.

Methods

The age-standardized LC incidence and mortality data were derived from the global burden of disease (GBD) study 2019. We first leveraged joinpoint piecewise linear regression analysis to ascertain time trends in LC incidence, mortality, and MIR complement [1-MIR] and the average annual percentage change (AAPC) of the rates over the period 1990–2019. Then, the association between the metrics and HDI was explored through longitudinal multilevel models (LMMs).

Results

The incidence rates paralleled the mortality rates worldwide and they had similar significant monotonic decrementing trends with AAPC values of − 1.10% (95% confidence interval (CI): − 1.40, − 0.90%) and − 1.40% (− 1.50, − 1.30%), respectively from 1990 to 2019. The [1-MIR] rates were around 0 and showed an increasing pattern from 1.70 to 8.10 per 100,000 people (AAPC, 4.90%) at the same period of time. Results from the LMMs displayed that the majority of the variation lies at the country level accounted for about 88% of the total variance. Moreover, our analysis supported that the HDI was negatively associated with either incidence or mortality over time (p < 0.05).

Conclusions

Our findings highlighted that the global long-term temporal trends of LC incidence and mortality decreased slightly during 1990–2019 which may reflect improved therapeutic strategies and public health interventions. Besides, the low rates of [1-MIR] revealed the five-year relative survival rate was poor implying LC is diagnosed late in its development. Thereby, the policymakers’ focus must be on early screening and detection of liver cancer.

Does gender role explain a high risk of depression? A meta-analytic review of 40 years of evidence

BACKGROUND

This meta-analytic review aimed to systematically evaluate associations of depression with multiple gender role dimensions (masculinity, femininity, androgyny, and undifferentiated traits) and to determine potential moderators (participant characteristics, study instruments and sociocultural factors) of the relationship.

METHODS

Of 4481 initially identified records in three electronic databases, 58 studies published 1978 to 2021 were included for meta-analysis.

RESULTS

(1) Association of depression and gender role is moderated by study year and human development indices. (2) Masculinity is a protective factor for depression, while this dominance has declined as life expectancy increases. (3) A negative, weak but significant association between depression and femininity is observed in women, and college students, which starts to emerge with the gradual increase in the national education and income index from 1990 to 2019. (4) Androgynous individuals reported the lowest level of depression as compared with other gender role orientations (masculine, feminine, and undifferentiated trait group). This disparity is becoming more extreme with life expectancy and per capita income index increases.

LIMITATIONS

English-language studies were only included in this review.

CONCLUSIONS

Androgyny might be the most ideal gender role protecting both women and men from depression.

Can the human development level in middle-income regions meet the challenges of natural capital change from the perspective of decoupling? Evidence from Shaanxi Province

Human activities in middle-income regions (MIRs) accelerate the appropriation of natural capital (NC) through production and living activities. The environmental changes caused by these activities in turn have an impact on human development and challenge the human adaptability of MIRs. Therefore, it is very important to realize the decoupling of NC and human development. This study takes China's Shaanxi Province as a case and establishes a research framework that decouples the human development index (HDI) from the perspective of NC stock and flow. Shaanxi is evaluated based on an analysis of the changing HDI and measuring changes in NC indicators from 2005 to 2018. The state of decoupling between the HDI and NC utilization levels is also discussed. The results show that the average annual growth of the HDI and per capita ecological footprint is 1.54% and 3.22%, respectively. The rate of consumption of the NC stock is greater than the rate of NC flow consumption. The HDI and the three-dimensional ecological footprint have not achieved real decoupling, and the changes in the two are the same as those in the left half of the inverted U-shaped environmental Kuznets curve. However, the inflection point has not been reached. This shows that the NC and HDI in Shaanxi have not achieved decoupling, and rapid NC changes hinder the ability to improve human well-being. This discovery helps MIRs focus on the role of restoration ecosystems in supporting regional human development and respond to the challenge of insufficient human adaptability due to excessive consumption of NC.

Global burden of periodontal disease and its relation with socioeconomic development during 1990-2019

To analyze the global burden of periodontal disease and its relation with socioeconomic development. Data of global disability-adjusted life year (DALY) due to periodontal disease and human development index (HDI) from 1990 to 2019 were obtained from Global Health Data Exchange (GHDx) and human development reports. The trend of the global burden of periodontal disease from 1990 to 2019 was described. The correlation between age-standardized DALY rates and HDI were examined in 2019, and between-country periodontal disease burden inequality from 1990 to 2019 was measured using health-related Gini coefficients and concentration indexes. From 1990 to 2019, the global DALY rate due to periodontal disease increased from 78.63 to 85.48, and the epidemiological burden did not increase significantly. Statistical differences were found across different HDI categories for age-standardized DALY rates of periodontal disease ( 44.315, <0.01) in 2019. Linear regression analysis also revealed a negative correlation between age-standardized DALY rate of periodontal disease and HDI ( = -0.417, <0.01) . Gini coefficients decreased from 0.361 to 0.281 and concentration indexes fell from 0.0339 to -0.0538 between 1990 and 2019. The global burden of periodontal disease did not increase between 1990 and 2019, though the socioeconomic-associated inequality still existed. The burden of periodontal disease was more concentrated in less developed countries, and the socioeconomic-associated inequality has increased since 2000.

Global socioeconomic inequality in the burden of communicable and non-communicable diseases and injuries: an analysis on global burden of disease study 2019

BACKGROUND

Examining the distribution of the burden of different communicable and non-communicable diseases and injuries worldwide can present proper evidence to global policymakers to deal with health inequality. The present study aimed to determine socioeconomic inequality in the burden of 25 groups of diseases between countries around the world in 2019.

METHODS

In the current study data according to 204 countries in the world was gathered from the Human Development Report and the Global Burden of Diseases study. Variables referring to incidence, prevalence, years of life lost (YLL), years lived with disability (YLD) and disability adjusted life years (DALY) resulting by 25 groups of diseases and injuries also human development index was applied for the analysis. For measurement of socioeconomic inequality, concentration index (CI) and curve was applied. CI is considered as one of the popular measures for inequality measurement. It ranges from - 1 to + 1. A positive value implies that a variable is concentrated among the higher socioeconomic status population and vice versa.

RESULTS

The findings showed that CI of the incidence, prevalence, YLL, YLD and DALY for all causes were - 0.0255, - 0.0035, - 0.1773, 0.0718 and - 0.0973, respectively. CI for total Communicable, Maternal, Neonatal, and Nutritional Diseases (CMNNDs) incidence, prevalence, YLL, YLD and DALY were estimated as - 0.0495, - 0.1355, - 0.5585, - 0.2801 and - 0.5203, respectively. Moreover, estimates indicated that CIs of incidence, prevalence, YLL, YLD and DALY for Non-Communicable Diseases (NCDs) were 0.1488, 0.1218, 0.1552, 0.1847 and 0.1669, respectively. Regarding injuries, the CIs of incidence, prevalence, YLL, YLD and DALY were determined as 0.0212, 0.1364, - 0.1605, 0.1146 and 0.3316, respectively. In the CMNNDs group, highest and lowest CI of DALY were related to the respiratory infections and tuberculosis (- 0.4291) and neglected tropical diseases and malaria (- 0.6872). Regarding NCDs, the highest and lowest CI for DALY is determined for neoplasms (0.3192) and other NCDs (- 0.0784). Moreover, the maximum and minimum of CI of DALY for injuries group were related to the transport injuries (0.0421) and unintentional injuries (- 0.0297).

CONCLUSIONS

The distribution of all-causes and CMNNDs burden were more concentrated in low-HDI countries and there are pro-poor inequality. However, there is a pro-rich inequality for NCDs' burden i.e. it was concentrated in high-HDI countries. On the other hand, the concentration of DALY, YLD, prevalence, and incidence in injuries was observed in the countries with higher HDI, while YLL was concentrated in low-HDI countries.

A multi-national test on self-reported compliance with COVID-19 public health measures: The role of individual age and gender demographics and countries' developmental status

Rationale/objective

The COVID-19 pandemic has brought far-reaching consequences on individual and societal levels. Social distancing and physical hygiene constitute effective public health measures to limit the spread of the virus. This study investigated age and gender demographics, in tandem with national levels of human development, as crucial factors influencing self-reported compliance with COVID-19-related public health measures.

Methods

The present study leveraged a large multi-national sample that ranged across the adult lifespan (18–100 years) and comprised 45,772 women and men from 66 countries/territories. Data were collected in Spring (2020) during the earlier phase of the COVID-19 pandemic. Self-reports of compliance with two public health measures (spatial distancing and physical hygiene) were assessed via online survey. Human Development Index (HDI), developed by the United Nations Development Program, was used as a proxy of a country's achievement in key dimensions of human development.

Results

Older age, female gender, and lower HDI were independently associated with greater self-reported compliance. A significant three-way interaction further revealed that self-reported compliance was lowest in young males from well-developed countries, while highest among females across all ages from less-developed countries.

Conclusion

The study offers an integration of individual-level and country-level demographic predictors of self-reported compliance and allows for robust testing in a large multi-national adult lifespan sample for enhanced generalizability. The results highlight the potential of data-driven, tailored (i.e., towards specific demographics, countries) health campaigns and public policies in the fight against a global pandemic.

Trend analysis of disability adjusted life years due to cardiovascular diseases: results from the global burden of disease study 2019

BACKGROUND

Cardiovascular diseases (CVDs) are the number one cause of global mortality representing about one third of all deaths across the world. The objective of the present study was to model the global trend in disability-adjusted life years (DALY) and its components due to CVD over the past three decades. We also aimed to evaluate the longitudinal relationship between CVD DALY and Human Development Index (HDI) in this period of time.

METHODS

The age-standardized rates of years lost due to disability (YLD), years of life lost (YLL) and DALY were extracted for cardiovascular diseases from the Global Burden of Disease (GBD) Study 2019 in years 1990 to 2019. Additionally, the United Nations Development Programme (UNDP) database was used to retrieve HDI values for all world countries at the same period time. The trend analysis was performed using the joinpoint regression model.

RESULTS

The obtained revealed a significant downward trend for DALY and its components with the average annual percent change of - 1.0, - 0.3 and - 1.1 per 100,000 population, respectively for DALY, YLD and YLL. We also found that countries with high/very high levels of HDI have remarkably experienced steeper declining slope of trend than those in lower levels of HDI over the study period.

CONCLUSIONS

Although the observed decreasing trend of CVD burden is a hopeful message for all world countries, the considerable gap in slope of trend between richer and poorer parts of the world is a serious alarm for health policy makers. Regarding this, there is an urgent need to put more efforts on implementing preventive programs, improving the level of patients' care and providing efficient treatment, especially in regions with lower levels of HDI.

Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population-based study

BACKGROUND

Relevant studies focusing on epidemiological of profiles hypertensive disorders of pregnancy from global data that report the cause-specific prevalence and trends of hypertensive disorders of pregnancy at global, regional and national levels from 1990 to 2019 by age and sociodemographic index are still limited.

METHODS

For hypertensive disorders of pregnancy, point prevalence, annual incidence, and years lived with disability numbers and age standardized rates per 100,000 population were compared at regional and national levels by age and sociodemographic index using data from the global Burden of Disease 2019 Study, covering populations from 204 countries and territories. Estimates are reported with uncertainty intervals to exhibit the changing trends during a specific period.

RESULTS

The incidence of hypertensive disorders of pregnancy increased from 16.30 million to 18.08 million globally, with a total increase of 10.92 % from 1990 to 2019. The age-standardized incidence rate decreased, with an estimated annual percent change of -0.68 (95 % confidence interval [CI] -0.49 to -0.86). The number of deaths due to hypertensive disorders of pregnancy was approximately 27.83 thousand in 2019, representing a 30.05 % decrease from 1990. Based on the incidence and prevalence, the number of deaths and years lived with disability were highest in the group aged 25-29 years, followed by the groups aged 30-34 and 20-24 years, while the lowest estimated incidence rate was observed in the group aged 25-29 years and higher incidence rates were observed in the youngest and oldest groups. Positive associations between incidence rates and the sociodemographic index and human development index were found for all countries and regions in 2019. Age-standardized incidence rates were higher in countries/regions with lower sociodemographic indices and human development indices.

CONCLUSIONS

Our study provides a comprehensive overview of the global burden of hypertensive disorders of pregnancy. The death and incidence rates are decreasing in most countries and all regions except for those with low sociodemographic and human development indexes. This difference is mainly due to the increasing attention to prenatal examinations and health education. Further investigations should focus on forecasting the global disease burden of specific hypertensive disorders of pregnancy and modifiable risk factors.

Worldwide incidence and mortality of ovarian cancer and Human Development Index (HDI): GLOBOCAN sources and methods 2018

Objective

Ovarian cancer is known as the seventh most common cancer among women, accounting for about 4% of all cancers associated with the females.

Method

This is a descriptive cross-sectional study based on cancer incidence data and cancer mortality rates from the Global Cancer Data in 2018. The incidence and mortality rates were estimated and ovarian cancer distribution maps for world countries were drawn. To analyze data, correlation and regression tests were used to evaluate association between its incidence and mortality with human development index (HDI)

Results

Results revealed a direct and significant correlation between ovarian cancer incidence (R = 0.409, P < 0.0001) and mortality (R = 0.193, P < 0.05) with HDI. It also projected a direct and significant correlation between incidence with Gross National Income per 1,000 capita (GNI), mean years of schooling (MYS), life expectancy at birth (LEB) and expected years of schooling (EYS) (P < 0.0001). The findings also demonstrated a direct and significant correlation between mortality and GNI, MYS, LEB as well as EYS (P < 0.05). The linear regression model showed that a higher MYS [B = 0.2, CI 95%: (-0.03, 0.5)] can significantly augment the incidence of ovarian cancer while an increased MYS [B = 0.2, CI 95% (0.03, 0.4)] can induce mortality.

Conclusions

Given the direct and significant correlation between ovarian cancer incidence and mortality with HDI, attention to risk factors in these countries can be effective in curbing its incidence and mortality.

Socioeconomic determinants of global distribution of multiple sclerosis: an ecological investigation based on Global Burden of Disease data

BACKGROUND

Socioeconomic factors may be involved in risk of multiple sclerosis (MS), either indirectly or as confounding factors. In this study two comprehensive indicators reflecting socioeconomic differences, including the Human Development Index (HDI) and Prosperity Index (PI), were used to assess the impact of these factors on the worldwide distribution of MS.

METHODS

The data for this global ecological study were obtained from three comprehensive databases including the Global Burden of Disease (as the source of MS indices), United Nations Development Programme (source for HDI) and the Legatum Institute Database for PI. MS indices (including prevalence, incidence, mortality, and disability-adjusted life years) were all analyzed in the form of age- and sex-standardized. Correlation and regression analyses were used to investigate the relationship between HDI and PI and their subsets with MS indices.

RESULTS

All MS indices were correlated with HDI and PI. It was also found that developed countries had significantly higher prevalence and incidence rates of MS than developing countries. Education and governance from the PI, and gross national income and expected years of schooling from the HDI were more associated with MS. Education was significantly related to MS indices (p < 0.01) in both developed and developing countries.

CONCLUSION

In general, the difference in income and the socioeconomic development globally have created a landscape for MS that should be studied in more detail in future studies.

Temporal and Spatial Evolution of China's Human Development Index and Its Determinants: An Extended Study Based on Five New Development Concepts

This paper innovatively expands China's human development index under the background of development concept in the new era, constructs the index system of China's human development index (CHDI) with four core dimensions of "life span, education, income and sustainable development" and measures the human development level of 31 provinces and the whole country from 1990 to 2017. Using the method of exploratory spatial data analysis (ESDA), this paper studies the spatiotemporal evolution characteristics of CHDI in 31 provinces from 1990 to 2017 and discusses the mechanism of CHDI in China. The results show that: ① CHDI in eastern China is obviously ahead of other regions and there is a big gap in human development among different regions. CHDI of 31 provinces had positive spatial correlation, showing significant spatial aggregation effect. ② In addition to its own influencing factors, the CHDI of a province is also affected by the CHDI of its "neighboring" provinces. ③ Urbanization rate, per capita financial expenditure on education and the number of health professionals are the three main positive driving factors of China's CHDI and the per capita carbon emission is the main reverse driving factor. This study provides policy suggestions for improving the level of human development in China and realizing regional balanced development.

Assessing the Relationship between Chronic Lymphoid Leukemia Mortality Rates and Human Development Index: A 26-Year Trend Analysis Using Location-Scale Mixed Effects Model

BACKGROUND

Chronic lymphoid leukemia (CLL) is one of the most prevalent types of leukemia, which is responsible for a remarkable mortality rate in the world. This study aimed to investigate the global trend of this cancer from 1990 to 2015 and to determine the relationship between trend of CLL mortality rate and Human Development Index (HDI) throughout the world.

METHODS

The age-standardized mortality rate data of all countries of the world (per 100,000) were extracted from the GBD database. In addition, the HDI values for the studied countries in different years were obtained from the UNDP database. The statistical analysis was performed using the mixed-effects location-scale model in the SAS software, version 9.4.

RESULTS

The findings of the statistical modeling showed a downward slope for CLL Age Standardized Mortality Rate (ASMR) for total world countries (β̂ = -0.002). We also find a significant association between CLL ASMR and HDI. Countries with higher HDI had higher level of CLL ASMR in years 1990 to 2015 with a negative slope. Furthermore, countries with lower HDI had Lower level of CLL ASMR with rather fixed rates in this period.

CONCLUSION

These findings showed a decreasing trend of global CLL ASMR in the previous decades, although, the fixed trend of CLL ASMR in countries with low HDI is worrisome. The health policymakers should make more efforts to decrease the mortality due to this cancer in these countries.

Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from global burden of disease study 2017

Background

Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-incidence ratio (MIR) across the world over 28 years.

Methods

The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.

Results

The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.

Conclusions

Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.

Inequalities in health and health-related indicators: a spatial geographic analysis of Pakistan

Background

In developing countries, Pakistan is one of the countries where access to health and health-related indicators is a major concern. Their improvement would reduce inequalities among various Communities/Districts or groups of Communities. A Community health index (CHI) in this regard is estimated to explore inequality ratio, inequality slope, and spatial analysis of inequalities among all Communities at regional and geographical levels.

Methods

Data from Pakistan Social and Living Standard Measurement (PSLM) survey, Round-VI, 2014–15 were used to construct CHI. The index was constructed in two steps. In the first step, the study indicators were standardized while in the second step, the standardized indicators were aggregated into a single metric by applying non-linear Geometric Mean formula.

Results

The inequality ratio of 16.59 estimated for Pakistan was found to be higher than the ratio of Atlanta city, GA (5.92), whereas, a lower slope coefficient was estimated for Pakistan than Atlanta city, GA (0.38 < 0.54). This ratio of disparity was also found to be lower for urban regions as compared to rural (7.78 < 17.54). While the slope coefficient was slightly higher for urban regions (0.45 > 0.43). The results of the spatial analysis revealed different patterns of inequalities. A cluster of healthy districts was found in Punjab province, whereas districts from Baluchistan had made a bunch of deprived/unhealthy districts in terms of CHI scores. Besides, separate maps for all provinces showed that capital districts of all provinces were relatively well-off/developed.

Conclusion

The instant results concluded that inequalities in access to health and health-related indicators exist across countries as well as across geographical regions. To reduce or eradicate these inequalities, government and public health workers are recommended to set priorities based on access to composite index.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09870-4.

The association between incidence and mortality of brain cancer and human development index (HDI): an ecological study

Background

Brain cancer is a rare and deadly malignancy with a low survival rate. The present study aims to evaluate the epidemiology of brain cancer and its relationship with the human development index (HDI) worldwide.

Methods

This is an ecological study. The data on cancer incidence and cancer mortality was extracted from the World Bank for Cancer in 2018 (GLOBOCAN 2018). The incidence, mortality rate, and brain cancer distribution maps were drawn for different countries. We used correlation and regression tests to examine the association of incidence and mortality rates of brain cancer with HDI. The statistical analysis was carried out by Stata-14 and a significance level of 0.05 was considered.

Results

According to the results of Global Cancer Registry in 2018, there were 18,078,957 registered cases of cancer in both sexes, of which 29,681 were related to brain cancer. The highest incidence (102,260 cases, 34.4%) and mortality (77,815 cases, 32.3%) belonged to very high HDI regions. Results showed that incidence (r = 0.690, P < 0.0001) and mortality rates (r = 0.629, P < 0.001) of brain cancer are significantly correlated with HDI. We also observed a positive correlation between brain cancer incidence and Gross National Income (GNI) (r = 0.346, P < 0.001), Mean Years of Schooling (MYS) (r = 0.64, P < 0.001), TABLE (LEB) (r = 0.66, P < 0.001) and Expected Years of Schooling (EYS) (r = 0.667, P < 0.001). Results also revealed that mortality rate was significantly correlated with GNI (r = 0.28, P < 0.01), MYS (r = 0.591, P < 0.01), LEB (r = 0.624, P < 0.01), and EYS (r = 0.605, P < 0.01).

Conclusion

The results of the study showed that the incidence and mortality of brain cancer in countries with higher HDI levels is higher than countries with lower HDI levels, so attention to risk factors and action to reduce it in countries with higher HDI levels in controlling this cancer in this Countries are effective.

Achieving Sustainable Development Goal for Clean Water in India: Influence of Natural and Anthropogenic Factors on Groundwater Microbial Pollution

Worldwide, >2 billion people (~1/3 world population), mostly living in economically stressed areas of Africa and South Asia, still do not have access to basic sanitation, and ~1 billion still practice open defecation. Water pollution due to open defecation may primarily be linked to economy, and other factors such as social and hygiene practices, land use and hydrogeological parameters could also have sufficient influence. The present study describes the effect of human development index (HDI, 2001-2015) and economic development (NL, 1992-2013) on groundwater microbial pollution (FC, 2002-2017) across India. Economic development pattern suggested discernable inverse relationship with FC in most areas, although areas with inferior water quality, improper human practices were found to outweigh economic development. Vulnerability modelling, using these data, along with measured FC in groundwater-sourced drinking water locations (n = 235) demonstrated the heterogeneity of FC distribution potential in areas of homogenous economy, social practices, and land use. High-resolution numerical modelling of the advective transport of the hypothetical FC particles in the aquifers, suggest up to ~24 times faster movement of pollutants under irrigation-induced pumping regimes. Hence, the results of our study highlight and quantify the potential pitfalls that are possible hindrance for achieving the United Nations sustainable development goal, despite social and economic development, across the spatial scales.

Decoupling or delusion? Mapping carbon emission per capita based on the human development index in Southwest China

Reducing energy-related carbon emissions has become the essential measure to mitigate global climate change. Based on decoupling analyses and index decomposition, this study is the first to explore whether carbon emission per capita decouples from the human development index from 2000 to 2015 at the provincial level in Southwest China [Chongqing (CQ), Sichuan (SC), Guizhou (GZ), and Yunnan (YN)]. We demonstrate the following. (1) The economic output and energy intensity effects among the five drivers are the strongest to promote and suppress the growth of carbon emission per capita from 2001 to 2015. (2) At the provincial level, we observed four decoupling statures, and the decoupling impact was organized in decreasing order: CQ > GZ > SC > YN (2001-2005), GZ > YN > CQ > SC (2006-2010), YN > SC > GZ > CQ (2011-2015). (3) The overall decoupling effect of Southwest China has been generally reinforced from 2000 to 2015, and finally entered a strong decoupling status in 2013-2015; an environmental Kuznets curve explained that this finding is related to historical peaks in total carbon emissions. Overall, this study provides guidance for the government on carbon emissions mitigation strategies and a valuable decision-making reference for other regions attempting to accelerate low-carbon development.

The hispanic landscape of triple negative breast cancer

Triple-negative breast cancer (TNBC) is a heterogeneous and complex disease characterized by the absence of immunohistochemical expression of estrogen receptor, progesterone receptor and HER2. These breast tumors present an aggressive biology and offer few opportunities to be treated with targeted therapy resulting in bad disease outcomes. The epidemiology of TNBC is intriguing where the understanding of its biology has progressed quickly. One of the peculiarities of this type of cancer is a high prevalence in Afrodescendants and Hispanic patients compared to Caucasian women. In this review we describe some features of TNBC, focusing in the Hispanic population, such as epidemiological, clinicopathological features and molecular features and the correlation between TNBC prevalence and the human development index.

Social, economic, and legislative factors and global road traffic fatalities

BACKGROUND

Road traffic fatalities (RTF) is the 8th cause of mortality around the world. At the end of the Decade of Action, it would be of utmost importance to revisit our knowledge on the determinants of RTF. The aim of this study is to assess factors related to RTF at global level.

METHODS

We used road safety development index which accounts for the interactions between system, human and products to assess the RTF in 115 and 113 countries in 2013 and 2016, respectively. To analyze data, three statistical procedures (linear regression, classification and regression trees, and multivariate adaptive regression splines) were employed.

RESULTS

Classification and regression trees has the best performance amongst all others followed by multivariate adaptive regression splines for 2013 and 2016 data set with an R2 around 0.83. Results show that any increase in human development index was associated with RTF reduction. Comparing RTF data of 2013 and 2016, 8 countries experienced a change of more than 30%, which demonstrated a significant relationship with GINI index (named after Corrado Gini). Considering the three components of human development index, it is revealed that education explained most of RTF variation in classification and regression trees model followed by income and life expectancy.

CONCLUSION

Policymakers should consider road collisions as a socio-economic issue. In this regard, they can make provisions to reduce RTF in the long run by focusing on enhancing the three components of human development index, mainly education. However, there is a need to investigate the causation pathway among these three components with RTF with different time-trend procedures.

Sustainable total-factor ecology efficiency of regions in China

This paper presents a new index called sustainable total-factor ecology efficiency (STFEcE), which integrates the ecological footprint and human development index into the framework of total-factor energy efficiency. Compared with the total-factor ecology efficiency index, the new index can better reflect the sustainable development efficiency of a region. This study uses data from 30 provinces of China over the period 2005-2016 to measure the STFEcE. Considering the heterogeneity of regional development in China, the meta-frontier slack-based data envelopment analysis (DEA) model is implemented. The results are as follows. First, the STFEcE for China is low, indicating the great potential for improvement in the sustainable development efficiency of China. Second, the heterogeneity of the STFEcE across the three regions of China (eastern, central, and western) is evident, given the "concave" trend from the eastern region to the western region. Third, decomposing the STFEcE into the technology inefficiency and management inefficiency indexes shows that the management efficiency of the eastern region needs to be improved, whereas the technology efficiency of the central region needs enhancement. For the western region, both the technology efficiency and management efficiency need improvement.

Prostate cancer management: long-term beliefs, epidemic developments in the early twenty-first century and 3PM dimensional solutions

In the early twenty-first century, societies around the world are facing the paradoxal epidemic development of PCa as a non-communicable disease. PCa is the most frequently diagnosed cancer for men in several countries such as the USA. Permanently improving diagnostics and treatments in the PCa management causes an impressive divergence between, on one hand, permanently increasing numbers of diagnosed PCa cases and, on the other hand, stable or even slightly decreasing mortality rates. Still, aspects listed below are waiting for innovate solutions in the context of predictive approaches, targeted prevention and personalisation of medical care (PPPM / 3PM).A.PCa belongs to the cancer types with the highest incidence worldwide. Corresponding economic burden is enormous. Moreover, the costs of treating PCa are currently increasing more quickly than those of any other cancer. Implementing individualised patient profiles and adapted treatment algorithms would make currently too heterogeneous landscape of PCa treatment costs more transparent providing clear "road map" for the cost saving.B.PCa is a systemic multi-factorial disease. Consequently, predictive diagnostics by liquid biopsy analysis is instrumental for the disease prediction, targeted prevention and curative treatments at early stages.C.The incidence of metastasising PCa is rapidly increasing particularly in younger populations. Exemplified by trends observed in the USA, prognosis is that the annual burden will increase by over 40% in 2025. To this end, one of the evident deficits is the reactive character of medical services currently provided to populations. Innovative screening programmes might be useful to identify persons in suboptimal health conditions before the clinical onset of metastasising PCa. Strong predisposition to systemic hypoxic conditions and ischemic lesions (e.g. characteristic for individuals with Flammer syndrome phenotype) and low-grade inflammation might be indicative for specific phenotyping and genotyping in metastasising PCa screening and disease management. Predictive liquid biopsy tests for CTC enumeration and their molecular characterisation are considered to be useful for secondary prevention of metastatic disease in PCa patients.D.Particular rapidly increasing PCa incidence rates are characteristic for adolescents and young adults aged 15-40 years. Patients with early onset prostate cancer pose unique challenges; multi-factorial risks for these trends are proposed. Consequently, multi-level diagnostics including phenotyping and multi-omics are considered to be the most appropriate tool for the risk assessment, prediction and prognosis. Accumulating evidence suggests that early onset prostate cancer is a distinct phenotype from both aetiological and clinical perspectives deserving particular attention from view point of 3P medical approaches.

Role of molecular biomarker human papilloma virus (HPV) E6 oncoprotein in cervical cancer screening

OBJECTIVE

The Onco E6™ Cervical Test, based on detection of the E6 oncoprotein of HPV 16 and 18 genotypes is evaluated as a screen for the early detection cervical neoplasia in resource-limited countries.

METHODS

This prospective study from June 2018 to June 2019 evaluated 235 women aged 21-65 years, who came to Gynaecological Oncology Outpatient Department by VIA, cytology, E6 oncoprotein test and by colposcopy. Screen-positive women by any of the tests or women with suspicious findings were further evaluated by biopsy at colposcopy. The McNemar test was used to compare the performance of E6 oncoprotein test with other screening tests.

RESULTS

The E6 oncoprotein positivity rate was 6.8% (n = 16) with 81.25% HPV 16 positive and 18.75% HPV 18 positive. Among VIA positive cases (n = 100), E6 oncoprotein was positive in 9% (p < .001). In histopathology confirmed chronic cervicitis, CIN I, CIN II, CIN III and invasive cervical cancer, E6 test was positive for 2.8%, 4.7%, 25%, 50% and 100% respectively. E6 oncoprotein test had the highest specificity and Positive Predictive Value (PPV; 97% and 75%) compared to VIA (42% and 18%), cytology (95% and 46%) and colposcopy (94% and 59%). Sensitivity of the E6 oncoprotein test for detection of CIN3+ was significantly higher than that of cytology (52% VS 25%) but lower than that of VIA (52% VS 74%).

CONCLUSIONS

The HPV E6 oncoprotein test is highly specific and is an effective triage test to reduce colposcopy referrals for the large number of false positive test outcomes seen with VIA.

Human well-being versus ecological footprint in MENA countries: A trade-off?

How to improve environmental quality and achieve human development remains major sustainability issues, particularly in the MENA region (the Middle East and North Africa). Most of the empirical literature fails to consider human well-being and environmental quality together although these concepts are fundamentally similar in their concern for distributive justice. This inquiry uses panel data for 13 MENA countries over the period 1990-2016 to examine the association between human development and ecological footprint and test whether trade-off nexus holds between these two sustainability-based indicators. To increase the policy relevance of this inquiry, the MENA region is divided into two sub-groups of countries: seven oil exporting countries and six non-oil exporting countries. The highlights pointed out the presence of a strong trade-off between the ecological footprint and human well-being captured by human development index for the whole sample and across the two subsamples. The crucial role played by economic institutions may help the MENA countries to mitigate the trade-offs to achieve simultaneously both targets of human well-being and environmental protection. Our empirical insights have important implications for achieving human development sustainability through the pursuit of the individual SDG targets.