Department of Ophthalmology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Ophthalmology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Am J Ophthalmol. 2019 Feb;198:1-7. doi: 10.1016/j.ajo.2018.09.020. Epub 2018 Sep 27.
To explore gender inequality in global burden of uncorrected refractive error (URE) by year, age, and socioeconomic status using disability-adjusted life years (DALYs).
International, comparative burden-of-disease study.
Global, regional, and national gender-specific DALY numbers; crude DALY rates; and age-standardized DALY rates caused by URE, by year and age, were extracted from the Global Burden of Disease Study 2015. Human development index (HDI) in 2015 as an indicator of national socioeconomic status was extracted from the Human Development Report. Pearson correlation and linear regression analyses were conducted to investigate the association between socioeconomic status and gender inequality.
Gender inequality in global URE burden has persisted since 1990, through 2015, with little improvement over the decades. Age-standardized DALY rates were 189.8 among male subjects vs 223.0 among female subjects in 1990 and 188.4 vs 225.2 in 2015. Female subjects had higher burden than male subjects of the same age, and gender inequality increased with age. Female-minus-male difference in age-standardized DALY rates (r = -0.562, P < .001; standardized β = -0.562, P < .001) and female-to-male age-standardized DALY rate ratios (r = -0.258, P < .001; standardized β = -0.258, P < .001) were negatively related to HDI.
Gender inequality in global URE burden has persisted over the past few decades, with female individuals bearing more burden than male individuals. Older age and lower socioeconomic status are related to greater gender inequality. These findings highlight the importance of making gender-sensitive health policy to manage global vision loss caused by URE.
使用伤残调整生命年（DALY）探讨未经矫正的屈光不正（URE）全球负担中的性别不平等，按年份、年龄和社会经济地位进行划分。
国际比较疾病负担研究。
从 2015 年全球疾病负担研究中提取全球、区域和国家特定性别 DALY 数量、未经矫正的屈光不正造成的粗 DALY 率和年龄标准化 DALY 率；从《人类发展报告》中提取 2015 年人类发展指数（HDI）作为国家社会经济地位的指标。进行 Pearson 相关和线性回归分析，以探讨社会经济地位与性别不平等之间的关联。
自 1990 年以来，全球 URE 负担中的性别不平等一直存在，几十年来几乎没有改善。1990 年男性 DALY 率为 189.8，女性为 223.0，2015 年男性为 188.4，女性为 225.2。相同年龄的女性比男性负担更大，且性别不平等随年龄增长而增加。年龄标准化 DALY 率的女性减男性差异（r=-0.562，P<.001；标准化β=-0.562，P<.001）和女性对男性年龄标准化 DALY 率比（r=-0.258，P<.001；标准化β=-0.258，P<.001）与 HDI 呈负相关。
过去几十年中，全球 URE 负担中的性别不平等一直存在，女性的负担比男性更大。年龄较大和社会经济地位较低与更大的性别不平等相关。这些发现强调了制定性别敏感的卫生政策以管理 URE 导致的全球视力丧失的重要性。
