Health inequity and the risk of MAFLD/MASLD

Metabolic dysfunction-associated fatty/steatotic liver disease (MAFLD/MASLD) affects over 1 billion people globally, yet its relationship with health inequity remains poorly defined. This study aimed to clarify the impact of socioeconomic factors and food insecurity on MAFLD/MASLD prevalence and outcomes using the diverse Arab region as a model.

Data for 22 Arab countries were extracted from the Global Burden of Disease 2021 and FAOSTAT datasets. We analyzed correlations between MAFLD/MASLD metrics (prevalence, mortality, DALYs) and indices of socioeconomic development (SDI), healthcare quality (HAQ), and food security.

MAFLD/MASLD prevalence correlated positively with SDI (r = 0.83, p < 0.001) and HAQ (r = 0.90, p < 0.001). Conversely, prevalence was negatively correlated with undernourishment (r = -0.47) and food insecurity (r = -0.85). While higher SDI nations had higher prevalence, the correlation between SDI and mortality/DALYs disappeared, suggesting that superior healthcare infrastructure mitigates severe outcomes.

The relationship between socioeconomic status and MAFLD/MASLD is complex and divergent. While increasing urbanization and food security initially drive higher prevalence, improved healthcare infrastructure in high-income nations is critical for reducing mortality. Addressing the root causes of structural inequity and promoting equitable access to care are essential to curb the global liver disease crisis.