Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regions

ObjectiveTo assess health inequities associated with retinoblastoma across various Socio-Demographic Index (SDI) regions and evaluate whether these inequities have decreased from 1990 to 2021, with the aim of enhancing awareness and guiding government policies.DesignPopulation-based demographic anal...

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Main Authors: Xi Li, Ying Chang, Xiaoyu Zhao, Xi Liu, Ying Zhang, Xuan Wang, Junhong Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1513526/full
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author Xi Li
Ying Chang
Xiaoyu Zhao
Xi Liu
Ying Zhang
Xuan Wang
Junhong Li
author_facet Xi Li
Ying Chang
Xiaoyu Zhao
Xi Liu
Ying Zhang
Xuan Wang
Junhong Li
author_sort Xi Li
collection DOAJ
description ObjectiveTo assess health inequities associated with retinoblastoma across various Socio-Demographic Index (SDI) regions and evaluate whether these inequities have decreased from 1990 to 2021, with the aim of enhancing awareness and guiding government policies.DesignPopulation-based demographic analysis.ParticipantsChildren diagnosed with retinoblastoma from 204 countries and territories.MethodsThe estimates and their 95% uncertainty interval (UI) for disability-adjusted life-years (DALYs) of retinoblastoma were extracted from Global Burden of Disease study (GBD) 2021. The age-standardized DALYs and the average annual percentage change (AAPC) were evaluated.Main measuresThe Slope Index of Inequality (SII) and concentration index were computed to quantify the absolute and relative cross-national health inequality.ResultsAll SDI regions and the majority of countries experienced a significant decline in age-standardized DALYs from 1990 to 2021. The decrease was more rapid in middle to high SDI regions than in low to low-middle SDI regions. Globally, the 2–4 years age group had the highest DALYs rate, consistent with trends in low to middle SDI regions. In contrast, the highest DALYs rate in high and high-middle SDI regions was found in the 12–23 months age group. The SII was −40.81 (95% CI −36.04 to −45.58) DALYs per 100,000 population in 1990 and − 30.32 (95% CI −27.18 to −33.47) DALYs per 100,000 population in 2021. The concentration index increased from −0.37 (95% CI −0.46 to −0.28) in 1990 to −0.45 (95% CI −0.53 to −0.36) in 2021, although this increase did not reach statistical significance (p = 0.256).ConclusionDespite advancements in retinoblastoma management, the overall burden of the disease-related DALY remains disproportionately concentrated in poorer populations. The health inequalities are persisting and widening. This underscores the limitations of current efforts. Until progress benefits everyone, the vision of equitable healthcare remains imperfect.
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spelling doaj-art-4c9ddfa331044be9920fb58eae282bd62025-08-20T02:15:30ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.15135261513526Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regionsXi Li0Ying Chang1Xiaoyu Zhao2Xi Liu3Ying Zhang4Xuan Wang5Junhong Li6Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaShanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaDepartment of Ophthalmology, First Hospital of Shanxi Medical University, Taiyuan, ChinaEye Institute, Affiliated Hospital of Nantong University, Nantong, ChinaDepartment of Ultrasound, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, ChinaShanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaShanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaObjectiveTo assess health inequities associated with retinoblastoma across various Socio-Demographic Index (SDI) regions and evaluate whether these inequities have decreased from 1990 to 2021, with the aim of enhancing awareness and guiding government policies.DesignPopulation-based demographic analysis.ParticipantsChildren diagnosed with retinoblastoma from 204 countries and territories.MethodsThe estimates and their 95% uncertainty interval (UI) for disability-adjusted life-years (DALYs) of retinoblastoma were extracted from Global Burden of Disease study (GBD) 2021. The age-standardized DALYs and the average annual percentage change (AAPC) were evaluated.Main measuresThe Slope Index of Inequality (SII) and concentration index were computed to quantify the absolute and relative cross-national health inequality.ResultsAll SDI regions and the majority of countries experienced a significant decline in age-standardized DALYs from 1990 to 2021. The decrease was more rapid in middle to high SDI regions than in low to low-middle SDI regions. Globally, the 2–4 years age group had the highest DALYs rate, consistent with trends in low to middle SDI regions. In contrast, the highest DALYs rate in high and high-middle SDI regions was found in the 12–23 months age group. The SII was −40.81 (95% CI −36.04 to −45.58) DALYs per 100,000 population in 1990 and − 30.32 (95% CI −27.18 to −33.47) DALYs per 100,000 population in 2021. The concentration index increased from −0.37 (95% CI −0.46 to −0.28) in 1990 to −0.45 (95% CI −0.53 to −0.36) in 2021, although this increase did not reach statistical significance (p = 0.256).ConclusionDespite advancements in retinoblastoma management, the overall burden of the disease-related DALY remains disproportionately concentrated in poorer populations. The health inequalities are persisting and widening. This underscores the limitations of current efforts. Until progress benefits everyone, the vision of equitable healthcare remains imperfect.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1513526/fullretinoblastomahealth inequalityglobal burden of disease studydemographic indexslope indexconcentration index
spellingShingle Xi Li
Ying Chang
Xiaoyu Zhao
Xi Liu
Ying Zhang
Xuan Wang
Junhong Li
Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regions
Frontiers in Public Health
retinoblastoma
health inequality
global burden of disease study
demographic index
slope index
concentration index
title Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regions
title_full Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regions
title_fullStr Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regions
title_full_unstemmed Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regions
title_short Global health inequities in retinoblastoma: a 1990–2021 analysis across socio-demographic index regions
title_sort global health inequities in retinoblastoma a 1990 2021 analysis across socio demographic index regions
topic retinoblastoma
health inequality
global burden of disease study
demographic index
slope index
concentration index
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1513526/full
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