Fu Lei, Liu Siyao, Yang Yuqiang, Xu Zhihong, Liu Xiong, Pan Mandong, Yang Chengbin, Lin Jiyan, Huang Xiaodong
Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Emergency, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Glob Health Med. 2025 Jun 30;7(3):211-225. doi: 10.35772/ghm.2025.01042.
Pancreatitis is a rapidly expanding global non-communicable disease, marked by substantial disparities across populations. However, comprehensive long-term assessments of global health inequalities remain scarce. This study examined inequality in the pancreatitis burden from 1990 to 2021, identified principal determinants, and forecasted future trends across countries with varying Socio-demographic Index (SDI) levels. Using data from the Global Burden of Disease 2021, we assessed inequalities in the prevalence, incidence, and disability-adjusted life years of pancreatitis the Slope Index of Inequality (SII) and Concentration Index (CI). Decomposition analysis was used to identify drivers of change, and a Bayesian age-period-cohort model projected trends to 2030. Between 1990 and 2019, the SII decreased from 13.83 to 8.61, signaling a reduction in absolute health inequality. Nevertheless, beginning in 2020, the SII turned negative, reaching -10.79 in 2021, indicating a structural reversal in disease burden distribution from high- to low-SDI countries. Concurrently, the CI declined from -0.04 to -0.10, suggesting worsening relative inequality. Decomposition revealed population growth and aging as primary drivers of the rising burden, while epidemiological improvements contributed minimally, particularly in low-SDI regions. Projections suggest that while global age-standardized rates may continue to decrease through 2030, the proportional burden in low-SDI countries is expected to rise steadily. The global socioeconomic distribution of pancreatitis burden is experiencing a profound shift, with inequalities increasingly concentrated in low-SDI areas. Driven by demographic trends, this shift underscores the necessity for targeted global strategies to mitigate disparities and bolster health system resilience.
胰腺炎是一种在全球范围内迅速蔓延的非传染性疾病，不同人群之间存在显著差异。然而，对全球健康不平等的全面长期评估仍然匮乏。本研究考察了1990年至2021年期间胰腺炎负担的不平等情况，确定了主要决定因素，并预测了不同社会人口指数（SDI）水平国家的未来趋势。利用2021年全球疾病负担的数据，我们评估了胰腺炎患病率、发病率和伤残调整生命年的不平等情况——不平等斜率指数（SII）和集中指数（CI）。分解分析用于确定变化的驱动因素，贝叶斯年龄-时期-队列模型预测了到2030年的趋势。1990年至2019年期间，SII从13.83降至8.61，表明绝对健康不平等有所减少。然而，从2020年开始，SII变为负数，2021年达到-10.79，这表明疾病负担分布从高SDI国家向低SDI国家发生了结构性逆转。与此同时，CI从-0.04降至-0.10，表明相对不平等加剧。分解结果显示，人口增长和老龄化是负担上升的主要驱动因素，而流行病学方面的改善贡献极小，尤其是在低SDI地区。预测表明，虽然到2030年全球年龄标准化率可能会继续下降，但低SDI国家的比例负担预计将稳步上升。胰腺炎负担的全球社会经济分布正在经历深刻转变，不平等现象越来越集中在低SDI地区。在人口趋势的推动下，这一转变凸显了制定有针对性的全球战略以减少差距和增强卫生系统复原力的必要性。
