Debalkie Atnafu Desta, Bannink Mbazzi Femke, Yitayal Mezgebu, Kuper Hannah
International Centre for Evidence in Disability, Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Department of Health System Management and Health Economics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia.
Afr J Disabil. 2025 Mar 12;14:1514. doi: 10.4102/ajod.v14i0.1514. eCollection 2025.
People with disabilities on average experience health care barriers, poorer health and higher mortality.
This study aims to review and synthesise life expectancy (LE) and years of life lost (YLL) comparing people with disabilities to those without in low and middle-income countries (LMICs).
A systematic review was conducted across six databases. Longitudinal studies with a comparator group that measured LE in or YLL between people with and without disabilities in LMICs were eligible for inclusion. Two reviewers independently assessed study eligibility, extracted data and assessed the risk of bias. Meta-analyses were undertaken using R 4.3.3. The study assessed heterogeneity with I and publication bias with a funnel plot. Sub-group and meta-regression analyses were performed, and the risk of bias was evaluated.
Twelve full-text articles were included in this meta-analysis. The pooled mean LE was lower in people with disabilities (57.98 years; 95% confidence intervals [CI]: 53.40-62.95) compared with people without disabilities (70.86 years; 95% CI: 64.06-78.38). The overall weighted years of YLL in people with disabilities was 15.84 years (95% CI: 11.1-22.61). There was no significant difference in YLL between men (16.33 years; 95% CI: 11.49-23.21) and women (13.7 years; 95% CI: 8.45-22.22).
The average LE in people with disabilities was substantially lower compared to those without disabilities in LMICs. This inequity highlights that health systems and public health efforts are failing to meet the needs of people with disabilities and must be improved to become more inclusive.
The study emphasises the need for inclusive policies and robust research in the health system to address health disparities.
残疾人平均面临医疗保健障碍、健康状况较差且死亡率较高。
本研究旨在回顾和综合比较低收入和中等收入国家（LMICs）中残疾人和非残疾人的预期寿命（LE）及寿命损失年数（YLL）。
对六个数据库进行了系统综述。纳入在LMICs中设有比较组且测量了残疾人和非残疾人之间的LE或YLL的纵向研究。两名评审员独立评估研究的纳入资格、提取数据并评估偏倚风险。使用R 4.3.3进行荟萃分析。该研究使用I评估异质性，并用漏斗图评估发表偏倚。进行了亚组和元回归分析，并评估了偏倚风险。
本荟萃分析纳入了12篇全文文章。与非残疾人（70.86岁；95%置信区间[CI]：64.06 - 78.38）相比，残疾人的合并平均LE较低（57.98岁；95% CI：53.40 - 62.95）。残疾人的总体加权YLL为15.84年（95% CI：11.1 - 22.61）。男性（16.33年；95% CI：11.49 - 23.21）和女性（13.7年；95% CI：8.45 - 22.22）的YLL无显著差异。
在LMICs中，残疾人的平均LE显著低于非残疾人。这种不平等凸显了卫生系统和公共卫生工作未能满足残疾人的需求，必须加以改进以使其更具包容性。
该研究强调了在卫生系统中制定包容性政策和进行有力研究以解决健康差距的必要性。
