Global burden and inequality of iron deficiency: findings from the Global Burden of Disease datasets 1990-2017

Mengying Wang; He Gao; Jianing Wang; Chenliang Cao; Xiaoling Ying; Yingming Wei; Zhiying Yu; Jie Shao; Hengjin Dong; Min Yang

doi:10.1186/s12937-022-00771-3

Global burden and inequality of iron deficiency: findings from the Global Burden of Disease datasets 1990-2017

Nutr J. 2022 Mar 18;21(1):16. doi: 10.1186/s12937-022-00771-3.

Authors

Mengying Wang^{1

2}, He Gao³, Jianing Wang⁴, Chenliang Cao⁵, Xiaoling Ying¹, Yingming Wei⁶, Zhiying Yu¹, Jie Shao⁷, Hengjin Dong⁸, Min Yang⁹

Affiliations

¹ Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
² Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
³ Department of Nutrition, The Second Affiliated Hospital of Zhejiang University School of Medicine, Linping Campus, Hangzhou, China.
⁴ Nutritional Department, Chongqing Health Center for Women and Children, Chongqing, China.
⁵ Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China.
⁶ Department of Periodontology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
⁷ Department of Pediatric Health Care Children's Hospital, Zhejiang University School of Medicine National Clinical Research Center for Child Health, Hangzhou, China. haojie@zju.edu.cn.
⁸ Center for Health Policy Studies, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. donghj@zju.edu.cn.
⁹ Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China. ymin36@zju.edu.cn.

Abstract

Background: Iron deficiency (ID) impairs patient physical activity, recognition and life quality, which is difficult to perceive but should not be underestimated. Worldwide efforts have been made to lower ID burden, however, whether it decreased equally in different regions and sexes is unclear. This study is to examine regional and sex inequalities in global ID from 1990 to 2017.

Methods: We conducted a longitudinal, comparative burden-of-disease study. Disability-adjusted life-years (DALYs) of ID were obtained from Global Burden of Disease Report 2017. Human Development Index (HDI) data were obtained from Human Development Report 2017. Gini coefficient and the concentration index were calculated to assess the equities in global burden of ID.

Results: A downward trend of global ID burden (from 569.3 (95% Uncertainty Interval [UI]: 387.8-815.6) to 403.0 (95% UI: 272.4-586.6), p < 0.001), age-adjusted DALYs per 100,000 population) but an uptrend of its inequalities (from 0.366 to 0.431, p < 0.001, Gini coefficients) was observed between 1990 and 2017. ID burden was heavier in women than that in men ([age-adjusted DALYs per 100,000 population from 742.2 to 514.3] vs [from 398.5 to 291.9]), but its inequalities were higher in men since 1990. The between-sex gap of ID burden was narrowed with higher HDI (β = - 364.11, p < 0.001). East Asia & Pacific and South Asia regions made a big stride for ID control in both sexes over decades [age-adjusted DALYs per 100,000 population from 378.7 (95% UI: 255.8-551.7) in 1990 to 138.9 (95%UI: 91.8-206.5) in 2017], while a heavy burden among Sub-Saharan African men was persistent[age-adjusted DALYs per 100,000 population, 572.5 (95% UI: 385.3-815) in 1990 and 562.6 (95% UI: 367.9-833.3) in 2017].

Conclusions: Redistributing attention and resources to help countries with low HDI, especially take care of women with low socioeconomic status (SES) and men under high ID burden may help hold back the expanding ID inequality.

Keywords: Equality; Global burden of disease; Iron deficiency; Micronutrient deficiency; Sex difference; Socioeconomic status.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Disabled Persons*
Female
Global Burden of Disease
Global Health
Humans
Iron Deficiencies*
Male
Quality-Adjusted Life Years