Wirayuda Anak Agung Bagus, Al-Mahrezi Abdulaziz, Al-Azri Mohammed, Chan Moon Fai
Department of Family Medicine and Public Health, Sultan Qaboos University, Muscat, Oman.
Faculty of Medicine and Health, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.
BMC Public Health. 2025 Jan 15;25(1):161. doi: 10.1186/s12889-025-21296-4.
Understanding the determinants of life expectancy (LE) is essential for effective policy planning and enhancing public health in the Gulf Cooperation Council (GCC) countries. This study aims to elucidate the complex interactions among sociodemographic (SD), macroeconomic (ME), and health resource (HR) factors that influence LE among the GCC countries.
We employed a Meta-Analytic Structural Equation Modeling to develop a comparative model across six GCC countries using annual data from 1990 to 2020. The pairwise comparison utilized Partial Least Squares Multi-Group Analysis, allowing us to examine the differences of SD, ME, and HR influences on LE among the GCC countries.
Our analysis highlighted that HR and ME factors directly impact LE across all GCC countries examined. We observed significant mediation effects where SD factors influenced ME or HR, affecting LE. Notably, the final pairwise comparisons revealed that the impact of SD on LE was particularly significant, with effect sizes ranging from 0.2679 (p = 0.0018) in the Oman-Kuwait comparison to 0.6686 (p < 0.0001) in the Emirate-Saudi comparison. Furthermore, while HR and ME factors consistently influenced LE in each model, the differences in their impacts across the six countries did not show significant variations between each pairing.
Generally, the findings highlight the critical need for GCC countries to strengthen the integrated framework of SD, ME, and HR factors rather than relying solely on HR improvements. Specifically, the findings highlight the importance of tailoring health policies to address specific sociodemographic contexts within the GCC to enhance LE effectively. The insights gained from our model could significantly inform targeted health policy initiatives and provide a valuable reference for future research in similar settings.
了解预期寿命（LE）的决定因素对于海湾合作委员会（GCC）国家进行有效的政策规划和改善公共卫生至关重要。本研究旨在阐明影响海湾合作委员会国家预期寿命的社会人口统计学（SD）、宏观经济（ME）和卫生资源（HR）因素之间的复杂相互作用。
我们采用元分析结构方程模型，利用1990年至2020年的年度数据，为六个海湾合作委员会国家建立了一个比较模型。成对比较采用偏最小二乘多组分析，使我们能够检验海湾合作委员会国家中社会人口统计学、宏观经济和卫生资源对预期寿命影响的差异。
我们的分析强调，在所研究的所有海湾合作委员会国家中，卫生资源和宏观经济因素直接影响预期寿命。我们观察到显著的中介效应，即社会人口统计学因素影响宏观经济或卫生资源，进而影响预期寿命。值得注意的是，最终的成对比较显示，社会人口统计学对预期寿命的影响尤为显著，效应大小从阿曼与科威特比较中的0.2679（p = 0.0018）到阿联酋与沙特比较中的0.6686（p < 0.0001）不等。此外，虽然卫生资源和宏观经济因素在每个模型中都持续影响预期寿命，但它们在六个国家中的影响差异在每对国家之间并未显示出显著变化。
总体而言，研究结果凸显了海湾合作委员会国家加强社会人口统计学、宏观经济和卫生资源因素综合框架的迫切需求，而不是仅仅依赖于卫生资源的改善。具体而言，研究结果强调了制定卫生政策以适应海湾合作委员会内部特定社会人口统计学背景以有效提高预期寿命的重要性。我们模型获得的见解可为有针对性的卫生政策举措提供重要参考，并为类似背景下的未来研究提供有价值的参考。
