Socioeconomic Disparity in the Global Burden of Cataract
American Journal of Ophthalmology, September 2017
Although cataract is easy to treat, it remains a leading cause of blindness worldwide. Lou et al. analyzed 2013 data pertaining to the burden of cataract and examined trends since 1990. They found that the general global progress in cataract management has been uneven, in large part because of substantial socioeconomic disparities between countries.
Using disability-adjusted life year (DALY) data, the authors determined socioeconomic differences in the global burden of cataract. Their international comparative study entailed collecting published national age-standardized DALY rates attributed to cataract, as well as human development index (HDI) composite statistics. All data were examined longitudinally for 1990-2013, and the relationship between age-standardized DALY rates and HDI in 2013 was analyzed. Health-related Gini coefficients and concentration indexes were calculated to determine between-country trends in cataract burden from 1990 to 2013.
HDI data for 2013 were available for 183 countries: 47 with very high HDI, 51 with high HDI, 42 with medium HDI, and 43 with low HDI. Multiple comparisons demonstrated that countries with lower HDIs had higher age-standardized DALY rates for cataract. According to linear regression analysis, age-standardized DALY rates correlated inversely with HDI. Global age-standardized DALY rates decreased from 1990 to 2013, and Gini coefficients increased during the same period (from 0.409 to 0.439). Concentration indexes showed that socioeconomic inequality declined in the 1990s but grew thereafter.
The investigators concluded that, unfortunately, the global health progress achieved in cataract management coincides with broadening socioeconomic inequality. Cataract burden is greatest in countries with the lowest socioeconomic status. These findings emphasize the need for more cataract services in developing countries and the importance of addressing barriers to cataract surgery among disadvantaged populations.
The original article can be found here.