Global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040

BackgroundIodine deficiency remains a leading preventable cause of childhood developmental intellectual disability (DID), imposing a substantial and enduring global public health burden; despite decades of global efforts to combat iodine deficiency, persistent health inequalities and uneven progress...

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Main Authors: Zihao Liu, Youhui Lin, Li Liang, Xuanyi Li, Zhiyin Wang, Wei Cheng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1598949/full
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author Zihao Liu
Youhui Lin
Li Liang
Xuanyi Li
Zhiyin Wang
Wei Cheng
author_facet Zihao Liu
Youhui Lin
Li Liang
Xuanyi Li
Zhiyin Wang
Wei Cheng
author_sort Zihao Liu
collection DOAJ
description BackgroundIodine deficiency remains a leading preventable cause of childhood developmental intellectual disability (DID), imposing a substantial and enduring global public health burden; despite decades of global efforts to combat iodine deficiency, persistent health inequalities and uneven progress highlight critical gaps. This study aimed to comprehensively analyze the global burden, temporal trends, and inequalities in childhood DID attributable to iodine deficiency from 1990 to 2021 and projected to 2040. Our results will inform evidence-based public health policies, especially in the most affected areas.MethodsThis observational study utilized secondary data from the Global Burden of Disease 2021 study, which covered 204 countries and territories. The burden of DID was stratified by age, sex, and region. Age-standardized prevalence rates (ASPR) and age-standardized years lived with disability (ASYR) were calculated. Trends were analyzed using joinpoint regression by estimated the annual percent change and average annual percent change (AAPC). Health inequalities were assessed using the slope index of inequality. Forecasts to 2040 were generated using the Bayesian age-period-cohort model.ResultsGlobal ASPR declined from 43.06 to 8.96/100,000 (AAPC = −4.95) and ASYR from 7.71 to 1.67/100,000 (AAPC = −4.81) between 1990 and 2021. Despite this progress, low socio-demographic index (SDI) regions, particularly Central Sub-Saharan Africa and South Asia, continue to bear the highest burden. Somalia had the highest 2021 rates (ASPR: 47.86; ASYR: 9.40/100,000). SDI correlated negatively with ASPR (R = −0.62, p < 0.001) and ASYR (R = −0.62, p < 0.001). The slope index showed reductions in decline rates for prevalence (−19.256 [95%CI: −26.992, −11.520] to −12.531 [−16.107, − 8.955]) and YLDs (−3.662 [−5.047, − 2.276] to −2.451 [−3.144, − 1.757]), though overlapping confidence intervals indicated non-significance. Projections suggest stable ASPR/ASYR by 2040 but rising absolute cases (489,983 prevalent cases; 85,491 YLDs).ConclusionWhile public health interventions have reduced the global burden of DID caused by iodine deficiency, persistent inequalities in vulnerable regions demand urgent policy action: scaling up universal salt iodization programs in high-burden areas, integrating maternal nutrition education into primary healthcare systems, and prioritizing resource allocation to regions with stagnating SDI indices.
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spelling doaj-art-762bedf042a34eec97ede8e2a736e47e2025-08-20T02:40:17ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15989491598949Global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040Zihao Liu0Youhui Lin1Li Liang2Xuanyi Li3Zhiyin Wang4Wei Cheng5School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaSchool of Management, Beijing University of Chinese Medicine, Beijing, ChinaSchool of Management, Beijing University of Chinese Medicine, Beijing, ChinaSchool of Management, Beijing University of Chinese Medicine, Beijing, ChinaSchool of Management, Beijing University of Chinese Medicine, Beijing, ChinaSchool of Management, Beijing University of Chinese Medicine, Beijing, ChinaBackgroundIodine deficiency remains a leading preventable cause of childhood developmental intellectual disability (DID), imposing a substantial and enduring global public health burden; despite decades of global efforts to combat iodine deficiency, persistent health inequalities and uneven progress highlight critical gaps. This study aimed to comprehensively analyze the global burden, temporal trends, and inequalities in childhood DID attributable to iodine deficiency from 1990 to 2021 and projected to 2040. Our results will inform evidence-based public health policies, especially in the most affected areas.MethodsThis observational study utilized secondary data from the Global Burden of Disease 2021 study, which covered 204 countries and territories. The burden of DID was stratified by age, sex, and region. Age-standardized prevalence rates (ASPR) and age-standardized years lived with disability (ASYR) were calculated. Trends were analyzed using joinpoint regression by estimated the annual percent change and average annual percent change (AAPC). Health inequalities were assessed using the slope index of inequality. Forecasts to 2040 were generated using the Bayesian age-period-cohort model.ResultsGlobal ASPR declined from 43.06 to 8.96/100,000 (AAPC = −4.95) and ASYR from 7.71 to 1.67/100,000 (AAPC = −4.81) between 1990 and 2021. Despite this progress, low socio-demographic index (SDI) regions, particularly Central Sub-Saharan Africa and South Asia, continue to bear the highest burden. Somalia had the highest 2021 rates (ASPR: 47.86; ASYR: 9.40/100,000). SDI correlated negatively with ASPR (R = −0.62, p < 0.001) and ASYR (R = −0.62, p < 0.001). The slope index showed reductions in decline rates for prevalence (−19.256 [95%CI: −26.992, −11.520] to −12.531 [−16.107, − 8.955]) and YLDs (−3.662 [−5.047, − 2.276] to −2.451 [−3.144, − 1.757]), though overlapping confidence intervals indicated non-significance. Projections suggest stable ASPR/ASYR by 2040 but rising absolute cases (489,983 prevalent cases; 85,491 YLDs).ConclusionWhile public health interventions have reduced the global burden of DID caused by iodine deficiency, persistent inequalities in vulnerable regions demand urgent policy action: scaling up universal salt iodization programs in high-burden areas, integrating maternal nutrition education into primary healthcare systems, and prioritizing resource allocation to regions with stagnating SDI indices.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1598949/fulliodine deficiencydevelopmental intellectual disorderGlobal Burden of DiseaseschildhoodBayesian age-period-cohort model
spellingShingle Zihao Liu
Youhui Lin
Li Liang
Xuanyi Li
Zhiyin Wang
Wei Cheng
Global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040
Frontiers in Public Health
iodine deficiency
developmental intellectual disorder
Global Burden of Diseases
childhood
Bayesian age-period-cohort model
title Global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040
title_full Global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040
title_fullStr Global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040
title_full_unstemmed Global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040
title_short Global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040
title_sort global burden of childhood developmental intellectual disability caused by iodine deficiency from 1990 to 2021 and projection to 2040
topic iodine deficiency
developmental intellectual disorder
Global Burden of Diseases
childhood
Bayesian age-period-cohort model
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1598949/full
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