Persistence of severe global inequalities in the burden of blindness and vision loss from 1990 to 2019: findings from the Global Burden of Disease Study 2019.

Jul 10, 2023

Experts: Yuancun Li,Hongxi Wang,Zhiqiang Guan,Chengyao Guo,Pi Guo,Yali Du,Shengjie Yin,Binyao Chen,Jiao Jiang,Yueting Ma,Liu Jing,Yingzi Huang,Ke Zheng,Qian Ma,Ruiqing Zhou,Min Chen,Nathan Congdon,Kunliang Qiu,Mingzhi Zhang

To assess the global burden and economic inequalities in the distribution of blindness and vision loss between 1990 and 2019.
A secondary analysis of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019. Data for disability-adjusted life-years (DALYs) due to blindness and vision loss were extracted from the GBD 2019. Data for gross domestic product per capita were extracted from the World Bank database. Slope index of inequality (SII) and concentration index were computed to assess absolute and relative cross-national health inequality, respectively.
Countries with high, high-middle, middle, low-middle and low Socio-demographic Index (SDI) had decline of age-standardised DALY rate of 4.3%, 5.2%, 16.0%, 21.4% and 11.30% from 1990 to 2019, respectively. The poorest 50% of world citizens bore 59.0% and 66.2% of the burden of blindness and vision loss in 1990 and 2019, respectively. The absolute cross-national inequality (SII) fell from -303.5 (95% CI -370.8 to -236.2) in 1990 to -256.0 (95% CI -288.1 to -223.8) in 2019. The relative inequality (concentration index) for global blindness and vision loss remained essentially constant between 1991 (-0.197, 95% CI -0.234 to -0.160) and 2019 (-0.193, 95% CI -0.216 to -0.169).
Though countries with middle and low-middle SDI were the most successful in decreasing burden of blindness and vision loss, a high level of cross-national health inequality persisted over the past three decades. More attention must be paid to the elimination of avoidable blindness and vision loss in low-income and middle-income countries.

© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

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ABOUT THE EXPERTS

Yuancun Li,Hongxi Wang,Zhiqiang Guan,Chengyao Guo,Pi Guo,Yali Du,Shengjie Yin,Binyao Chen,Jiao Jiang,Yueting Ma,Liu Jing,Yingzi Huang,Ke Zheng,Qian Ma,Ruiqing Zhou,Min Chen,Nathan Congdon,Kunliang Qiu,Mingzhi Zhang

Yuancun Li

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Hongxi Wang

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Zhiqiang Guan

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Chengyao Guo

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Medical College, Shantou University, Shantou, China.

Pi Guo

Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China.

Yali Du

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Shengjie Yin

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Binyao Chen

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Jiao Jiang

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Yueting Ma

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Liu Jing

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Medical College, Shantou University, Shantou, China.

Yingzi Huang

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Ke Zheng

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Medical College, Shantou University, Shantou, China.

Qian Ma

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Medical College, Shantou University, Shantou, China.

Ruiqing Zhou

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Medical College, Shantou University, Shantou, China.

Min Chen

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China.

Medical College, Shantou University, Shantou, China.

Nathan Congdon

Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangdong, China.

Orbis International, New York City, New York, USA.

School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Science, Centre for Public Health, Royal Victoria Hospital, Queen’s University, Belfast, UK.

Kunliang Qiu

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China zmz@jsiec.org qkl@jsiec.org.

Mingzhi Zhang

Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University, Shantou, People’s Republic of China zmz@jsiec.org qkl@jsiec.org.