Correlation between structural determinants and universal health coverage in 2010 and 2019: An analysis of the global burden of disease study.

<h4>Objective</h4>To assess the correlation between structural determinants - governance, macroeconomic policies, culture/societal values, and public and social policies - and the Universal Health Coverage (UHC) Effective Coverage Index in 2010 and 2019, in 204 countries and territories....

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Main Authors: Orlando Luiz do Amaral Junior, Maria Laura Braccini Fagundes, Fernando Neves Hugo, Nicholas J Kassebaum, Jessye Melgarejo do Amaral Giordani
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0004770
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author Orlando Luiz do Amaral Junior
Maria Laura Braccini Fagundes
Fernando Neves Hugo
Nicholas J Kassebaum
Jessye Melgarejo do Amaral Giordani
author_facet Orlando Luiz do Amaral Junior
Maria Laura Braccini Fagundes
Fernando Neves Hugo
Nicholas J Kassebaum
Jessye Melgarejo do Amaral Giordani
author_sort Orlando Luiz do Amaral Junior
collection DOAJ
description <h4>Objective</h4>To assess the correlation between structural determinants - governance, macroeconomic policies, culture/societal values, and public and social policies - and the Universal Health Coverage (UHC) Effective Coverage Index in 2010 and 2019, in 204 countries and territories.<h4>Methods</h4>This ecological study analyzed UHC effective coverage in 204 countries and territories using estimates from the Global Burden of Disease (GBD) 2019 study. Structural determinants were examined across five dimensions. Spearman's correlation was used to examine the correlations.<h4>Results</h4>UHC showed a positive correlation with structural determinants in both years. In 2010, moderate correlations were observed for governance (ρ = 0.61), GDP (ρ = 0.69), SDI (ρ = 0.62), and government expenditure (ρ = 0.58). In 2019, governance (ρ = 0.56), GDP (ρ = 0.71), SDI (ρ = 0.66), and government expenditure (ρ = 0.48) remained significantly correlated with UHC. GDP and SDI consistently showed the strongest correlations in both periods.<h4>Conclusion</h4>Countries with more favorable structural conditions had greater UHC, emphasizing the influence of governance and socioeconomic context on health systems performance. Persistent disparities highlight the need for policies targeting social and economic inequalities to achieve universal health coverage globally.
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spelling doaj-art-2ad901fb409843748cc8a02c8019a8bb2025-08-20T03:50:49ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752025-01-0157e000477010.1371/journal.pgph.0004770Correlation between structural determinants and universal health coverage in 2010 and 2019: An analysis of the global burden of disease study.Orlando Luiz do Amaral JuniorMaria Laura Braccini FagundesFernando Neves HugoNicholas J KassebaumJessye Melgarejo do Amaral Giordani<h4>Objective</h4>To assess the correlation between structural determinants - governance, macroeconomic policies, culture/societal values, and public and social policies - and the Universal Health Coverage (UHC) Effective Coverage Index in 2010 and 2019, in 204 countries and territories.<h4>Methods</h4>This ecological study analyzed UHC effective coverage in 204 countries and territories using estimates from the Global Burden of Disease (GBD) 2019 study. Structural determinants were examined across five dimensions. Spearman's correlation was used to examine the correlations.<h4>Results</h4>UHC showed a positive correlation with structural determinants in both years. In 2010, moderate correlations were observed for governance (ρ = 0.61), GDP (ρ = 0.69), SDI (ρ = 0.62), and government expenditure (ρ = 0.58). In 2019, governance (ρ = 0.56), GDP (ρ = 0.71), SDI (ρ = 0.66), and government expenditure (ρ = 0.48) remained significantly correlated with UHC. GDP and SDI consistently showed the strongest correlations in both periods.<h4>Conclusion</h4>Countries with more favorable structural conditions had greater UHC, emphasizing the influence of governance and socioeconomic context on health systems performance. Persistent disparities highlight the need for policies targeting social and economic inequalities to achieve universal health coverage globally.https://doi.org/10.1371/journal.pgph.0004770
spellingShingle Orlando Luiz do Amaral Junior
Maria Laura Braccini Fagundes
Fernando Neves Hugo
Nicholas J Kassebaum
Jessye Melgarejo do Amaral Giordani
Correlation between structural determinants and universal health coverage in 2010 and 2019: An analysis of the global burden of disease study.
PLOS Global Public Health
title Correlation between structural determinants and universal health coverage in 2010 and 2019: An analysis of the global burden of disease study.
title_full Correlation between structural determinants and universal health coverage in 2010 and 2019: An analysis of the global burden of disease study.
title_fullStr Correlation between structural determinants and universal health coverage in 2010 and 2019: An analysis of the global burden of disease study.
title_full_unstemmed Correlation between structural determinants and universal health coverage in 2010 and 2019: An analysis of the global burden of disease study.
title_short Correlation between structural determinants and universal health coverage in 2010 and 2019: An analysis of the global burden of disease study.
title_sort correlation between structural determinants and universal health coverage in 2010 and 2019 an analysis of the global burden of disease study
url https://doi.org/10.1371/journal.pgph.0004770
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