收入不平等和流行病:来自HIV/AIDS和COVID-19的见解 - - 一项多国观察性研究
John Ele-Ojo Ataguba1,2, Charles Birungi3, Santiago Cunial4
1African Health Economics and Policy Association, Accra, Ghana john.ataguba@umanitoba.ca.
BMJ global health
|September 17, 2023
概括
收入不平等与全球更高的艾滋病发病率,艾滋病死亡率和COVID-19死亡率有关. 在不平等的社会中,解决收入不平等对于有效的流行病准备和应对至关重要.
科学领域:
- 全球健康 全球健康
- 流行病学 流行病学
- 健康的社会经济决定因素
背景情况:
- 收入不平等是健康的重要社会决定因素,可能对传染病和流行病的结果产生影响.
- 以前的研究已经探索了社会经济因素与健康之间的联系,但与艾滋病毒和COVID-19死亡率的具体关系需要进一步调查.
研究的目的:
- 评估基尼指数衡量的收入不平等与许多国家的艾滋病毒发病率,艾滋病死亡率和COVID-19过度死亡率之间的关系.
- 确定收入不平等与这些健康结果之间的关联是否在全球,非洲和非非洲国家样本中存在差异.
主要方法:
- 一项多国观察性研究,利用来自多达217个国家的HIV/AIDS和151个国家的COVID-19的国家级数据.
- 收入不平等的吉尼指数是主要解释变量,艾滋病毒发病率,艾滋病死亡率和COVID-19过度死亡率是主要结果指标.
- 对全球样本,非洲亚样本和不包括非洲国家的亚样本进行了分析.
主要成果:
- 在所有样本中发现收入不平等与艾滋病毒发病率之间存在显著的积极关系 (p<0.01),非洲样本的影响更强.
- 在所有样本中,收入不平等与艾滋病死亡率有关 (p<0.01).
- 在全球和非非洲样本 (p<0.05) 中观察到收入不平等和COVID-19过度死亡率之间存在积极和显著的关联,尽管仅在非洲样本中并不显著 (p<0.1).
结论:
- 更高的收入不平等与全球艾滋病毒发病率,艾滋病死亡率和COVID-19过度死亡率的增加显著相关.
- 收入不平等似乎削弱了有效的流行病应对措施,凸显了不平等社会需要量身定制的战略.
- 优先考虑收入不平等作为健康的社会决定因素,对于改善全球的流行病准备和应对工作至关重要.
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